Deep vein thrombosis, also known as DVT, is a condition that occurs when a blood clot forms in one of the deep veins of the body. This happens when a vein becomes damaged or if the blood flow within a vein slows down or stops. The most common site where DVT may occur is the deep venous system of the lower extremities (veins of the pelvis, calf, or thigh). However, catheters inserted in the arm can be a risk factor for DVT as well. DVT can occur when a coating of a clotted blood and blood proteins, also known as fibrins, form around a catheter. It may present itself as mild or moderate pain, however, it can lead to symptoms of pain, swelling, redness of the arm and hand, or enlarged veins in the neck and chest that form to try to bypass the clotted area. In the most serious consequences, if a blood clot were to break free it could travel through the bloodstream and block blood flow to the lungs, also known as a pulmonary embolism.
Who is at risk of DVT?
Anyone with an IV catheter can develop DVT, but some groups are at higher risk. This emphasizes the importance of conducting a proper evaluation of a patient’s signs, symptoms, and risk factors. There are several factors that can affect blood flow in the deep veins and increase the risks for developing blood clots. These include:
- Aging
- Personal or family history of DVT or pulmonary embolism
- Cancer
- Smoking
- Using birth control pills or hormone therapy
- Pregnancy
- Obesity
- Inheriting a blood-clot disorder
Detection & Treatment of DVT
Detecting blockages or blood clots in deep veins requires use of a duplex ultrasonography, an imaging test that uses sound waves to look at the flow of blood in the veins. It is the standard imaging test to diagnose DVT. Contrast venography is a special type of x-ray where contrast material (dye) is injected into a large vein in the foot or ankle to detect the deep veins in the leg and hip. It is the most accurate test for diagnosing blood clots that is an invasive procedure.
Treatment for DVT centers on anticoagulants to stabilize the clot and to prevent it from growing while the body’s own clot-dissolving system can start to break it up. There are different options of anticoagulants, which can depend on a patients age, other medical conditions, and the circumstances of hospitalization. Initial treatment may be with medication intravenously or injected under the skin, with eventual transition to a medication taken by mouth. Most patients with catheter related DVT are treated for a period of 3 months unless the catheter is to remain in place long-term.
Preventing DVT
When it comes to catheter-related thrombosis, prevention is better than treatment. Improper site selection, tip location, traumatic insertions, and type of central venous device should be carefully considered as these are risk factors for DVT. The International Society of Thrombosis and Haemostasias guidelines recommend that where possible, CVCs should be inserted on the right side, in the jugular vein with the tip located at the junction of the superior vena cava and the right atrium to minimize the risk of thrombosis.
A well-trained staff can make all the difference when identifying, treating, and preventing deep vein thrombosis. Skilled healthcare professionals all know the importance of continued education and the impact it can make on overall results. A great resource is CVC Health Care at https://www.zeroinfectionrates.com/. They provide tailored education services which include, CVC Classes, PICC/Midline Insertion Classes, and Ultrasound Guided PIV Insertion Classes.
Patient safety and positive outcomes are at the core of everything we do at Health Line International Corp. We strive to provide our distributers with the highest-quality vascular access medical devices so healthcare professionals around the world can continue to provide top-of-the-line care to their patients.
Health Line International Corp. is not responsible for any errors, omissions, injury, loss, or damage arising from or relating to the use (or misuse) of any information, statements, or conclusions contained in or implied by the contents of this document or any of the source materials. This content is not intended to replace professional medical advice.
References
Diagnosis and treatment of venous thromboembolism. (2020, February 07). https://www.cdc.gov/ncbddd/dvt/diagnosis-treatment.html
Deep vein thrombosis – orthoinfo – aaos. (n.d.). https://orthoinfo.aaos.org/en/diseases–conditions/deep-vein-thrombosis/
Hirsh J, Lee AY. How we diagnose and treat deep vein thrombosis. Blood. 2002 May 1;99(9):3102-10. doi: 10.1182/blood.v99.9.3102. PMID: 11964271.