Prevention of Deep Venous Thrombosis
There may be no way to prevent DVT, except by recognizing its risk factors and acting on them with limb elevation, compression stockings, and mobility. In patients with a strong family history of DVT, pulmonary embolism, or sudden unexplained death, tests for inherited defects in the clotting cascade should be done and if there were to be findings indicating the prudence of anticoagulation, such a preventative measure should be implemented.
Prevention via DVT Ultrasound
Any previous DVT, family history of DVT or pulmonary embolism, malignancy, or other risk factors, make occurrence and recurrence more likely. Duplex ultrasound, the dual ultrasonographic techniques of B mode and Doppler ultrasonography, are very accurate and cost-effective in surveillance of the deep veins of the lower extremities and pelvis in those who carry these risks.
Prevention of Complications After an Established Diagnosis of DVT
In considering prevention in regards to an established diagnosis of deep vein thrombosis (DVT), preventing its complication, pulmonary embolism, is the true goal, since this is what causes the unacceptable morbidity and mortality associated with DVT. Once DVT is diagnosed, the efforts of prevention center on avoiding the migration of thrombi to the pulmonary circulation.
The best way to prevent pulmonary embolism is to reduce the thrombosis with anticoagulation. The ultimate goal is to prevent death, so if pulmonary embolism is suspected, hemodynamic stability should be determined by the presence or absence of hypotension (shock). Supplemental oxygen and hemodynamic support with intravenous fluids are used, along with initiating anticoagulation in those not already being anticoagulated. If a patient is not already in a hospital, rapid transport is necessary to offer the best chances of preventing serious morbidity or mortality.