thromboembolism is the formation of a blood clot in a deep vein of the body. It
is often leads to major complications such as Pulmonary embolism(PE), deep vein
thrombosis(DVT) and post thrombotic syndrome. It is very common to find out
this type of disorder with increased age with multiple co morbidities. Patients
who suffers cardiac complication majorly gets affected by the DVT and other
problems. This is very complicated and risky condition in which there may be
chance of death if not identified or controlled correctly.
Working in a
In- patient rehab facility, it is always a challenging for me being a therapist
about how to start doing an evaluation and treatment protocol. Most of the
patients are going through with major trauma which includes accidents, trauma,
cardiac complications, strokes and many other severe problems. As far as I am
aware, all the patients have been treated by the nursing staff by blood thinner
to prevent the clot. However, the issue comes up when as a therapist we have to
start an evaluation by reading an order. It is not always accessible and
readily available about patient’s information that what was his past record in
detail. At that point, I used to get clearance from the nurse that if the patient
is clear for evaluation regardless any problems. After completing an
evaluation, screening process, sometime patient has been found out to report
that he is having some discomfort in leg and feels like red and warm at times.
Therapist can get an idea about possible issues but have to wait for doctor’s
order for ultrasound and possibly hold therapy. Sometimes, I used to treat
patient in bed side avoiding a limb which is at risk for DVT. However, I would
like to prefer to communicate with doctor and hold therapy for few hours till
results come out.
an article, I found out some important information about how to treat patient
with possible disorder of coagulation. It is always a very important to find out
a past history of patient if he has any related problems with coagulation or
taking any blood related medication. It may predict some possibility for
recurrence if patient is at risk. So,
detailed history is very important. Another main important use is Mechanical
compression. I would like to put this as a protocol for my future patients to
use at night time from first day of rehab stay if they are not having any risk
related to ABI (ankle-brachial index). Also, constant communication with
medical staff is very important if therapy should continue or should put on
hold. Sometime miscommunication can cause a big concern for life of a person as
therapist may not aware about the hold and therapist scheduled a patient for
therapy. I would also implement a practice to check a medicine report as soon
as I get my patients list about what medication they are taking and what time
they are scheduled for. By doing it so, even if not able to reach medical
staff, one can be confident about safety issue of patient.
Ellen, H., Michael, P., Ethel, M.F., Mary, T., Dennis,
C, S., & Beth, A. (2016) Role of the physical therapist in the management
of individual at risk for or diagnosed with venous thromboembolism: evidence
based clinical practice guideline.
Streiff, M.B., Brady, J.P., & Grant, A.M. (2014).
Grand rounds: preventing hospital associated venous thromboembolism. Morb Mortal Wkly Rep, 63,190-193.