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Dvt
- 5. Javed Iqbal FCPS, FRCS Professor Of Surgery Quaid-e-Azam Medical College, Bahawalpur
- 7. It is a serious disease Sudden death Long term morbidity • Chronic venous insufficiency • Ulceration
- 8. Its incidence is underestimated 10% of all hospitalized deaths are due to DVT/PE
- 9. Virchow’s triad Change in vessel wall • Injury • Inflammation Stagnation • Hospitalized patients Increased coagubility • Surgery • Malignancy • Thrombophilia
- 10. Thrombophillia Anti-thrombin III deficiency Protein C and S deficiency Anti-phospholipid antibodies Dysfibrogenaemia
- 11. Predisposing factors/situations Old age prolonged surgical procedures Procedures on Hip and pelvis Spleenectomy Gyaenacological procedures Stroke / and other neurological ailments
- 12. Myocardial Infarction / CCF Oral contraceptives / steroids Obesity Varicose veins Pregnancy malignancy
- 13. Air Travel Immobility Hypoxia Decreased cabin pressure 10 % of all passengers of long flights
- 14. E-thrombosis
- 15. What to do?
- 16. Don’t let it happen Prophylaxis
- 17. Every unit must have its own DVT prophylaxis policy According to local circumstances
- 18. The most important point is to keep in mind that DVT does exist
- 19. The standard guideline is to define and identify the risk groups
- 20. Low Risk Young patients with minor ailment having no risk factor and undergoing a procedure of less than an hour
- 21. Moderate risk Patient over 40 with debilitating illness Patient above 40 undergoing major surgical procedure But there is no risk factor
- 22. High Risk Patient over 40 Serious medical illness Major surgery Additional risk factor
- 24. 1 Minimizing the correctable risk factors
- 25. 2 Mechanical measures
- 26. Graduated compression dressing (TEDS) Sequential pneumatic compression Early ambulation
- 28. 3 Pharmacological intervention
- 29. Low dose (sub-cut) heparin : 5000 units bid Low molecular weight heparin
- 30. All moderate and high risk patients must have some DVT prophylaxis
- 31. If DVT does occur!
- 32. Symptoms/signs/labs Leg pain Swelling Redness Fever Increased TLC
- 33. D-Dimer
- 34. Doppler studies
- 35. 55% of DVT is in pelvic veins
- 36. Treatment Anticoagulation: Hepranization Elevation of limb Monitering
- 38. Massive embolism Massive embolism
- 39. Medium vessel embolism
- 41. Dyspnoea Cough Haemoptysis Hypoxia Acute right shift on ECG X-ray chest
- 42. Management Hepranization Standard resuscitation Antibiotics Long term anticoagulation
- 43. Thank you