Skip to main content

Deep Vein Thrombosis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • A constant balance exists between intravascular clot formation and clot dissolution, clot forming when the former overpowers the latter.

  • Clot can be superficial (to the fascia) or dee...

Diagnosis

Signs and Symptoms

  • Leg swelling:

    • >1 cm difference is usually significant.

  • Leg warmth and redness

  • Leg pain and tenderness

  • Palpable cord

  • In superficial thrombophlebitis, a red pipe cleaner–like c...

Treatment

Initial Stabilization/Therapy

In cases of phlegmasia cerulean, or alba dolens: 
  • IV access

  • Supplemental oxygen

  • Surgical or vascular consultation

Ed Treatment/Procedures

  • Systemic anticoagulation:

    • In ...

Follow-Up

Disposition

Admission Criteria

  • Patients with DVT unable to receive LMWH as an outpatient or poor follow-up

  • Patients with concomitant PE or other serious diseases (i.e., renal failure)

  • Patients t...

Pearls and Pitfalls

  • Do not use a negative Homans sign to exclude the diagnosis of DVT.

  • Use some measure (whether clinical gestalt or a formal scoring system such as the Wells score) to determine pretes...

Additional Reading

  • Cushman  M, Tsai  AW, White  RH, et al. Deep vein thrombosis and pulmonary embolism in two cohorts: The longitudinal investigation of thromboembolism etiology. Am J Med.  2004;...

Codes

ICD9

  • 453.40 Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity

  • 453.41 Acute venous embolism and thrombosis of deep vessels of proximal lower extremity

  • 453.82 Acute ...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×