The Perioperative Patient for Registered Nurses

Venous Thromboembolism

What are venous thromboembolism events?

  • Deep Vein Thrombosis (DVT): A blood clot forms in the deep veins.
  • Pulmonary Embolism (PE): This occurs when the clot from the DVT escapes the vein wall and finds its way into the bloodstream and then to the lungs. A large clot can be fatal.

(Spruce, 2020)

Normal Blood Flow
Deep Vein Thrombosis
Embolus
Risk Factors

Age

Pregnancy

Estrogen oral contraceptive medications

Obesity

Immobility

Trauma

Varicose veins with phlebitis

Dehydration

Myocardial infarction

Lowered limbs intraoperatively (knee arthroscopy)

Trendelenburg position (intraoperative)

Patient in stirups intra-op

Central Venous Catheter

Post op patients

(ORNAC 15th ed, 2021)

Common Signs and Symptoms of DVT

  • Leg pain and aches
  • Swelling of entire leg with a difference in circumference of >3cm
  • Pitting edema

Common Signs and Symptoms of PE

  • Rapid breathing
  • Tachycardia
  • Hypotension
  • Wheezing
  • Chest pain during inspiration
  • Cyanosis

Prevention/Interventions

  • Surgical patients are assessed for the risk of VTE and bleeding.
  • The preoperative risk assessment by the surgical team determines the most appropriate VTE prophylaxis for the patient.

(Cine-Med AORN, 1993)