Please, please read –it’s long, but very important.I t might save some lives.

[HPNC]

I am a regular poster, but have changed my name. If you recognise me please don?t out me. My employers would not be happy that I have posted this.

A couple of weeks ago it was National Thrombosis Week.

Every year, in England, 25,000 ? twenty five thousand ? people die as a result of thrombosis.

That is more than the total deaths from HIV AIDS, breast cancer and road traffic accidents.

It is 25 times the number of deaths from MRSA.

Those 25,000 are the tip of a massive iceberg. They represent a fraction of the total number of people who suffer a thrombosis (blood clot, often called DVT or PE ?Pulmonary Embolism), often as a consequence of being admitted to hospital for medical or surgical treatment.

The single most effective patient safety intervention would be to assess a person?s risk of developing thrombosis when they are admitted to hospital, and to provide that person with the correct, appropriate treatment to prevent thrombosis occurring. (For example, correctly fitted stockings, plus or minus injections to reduce the risk of clotting).

The risk factors are well recognised and risk assessment is a straightforward process.

NICE have already established and implemented guidelines for prevention of thrombosis (thromboprophylaxis) in surgical patients.

NICE are currently drafting the guidelines for risk assessment and preventative treatment for all patients who are admitted to hospital. They will be implemented in 2009.

In April 2007 the Chief Medical Officer, Sir Liam Donaldson, wrote to the Chief Executive of every NHS Trust in England and Ireland stating that every Trust should establish a Thrombosis committee, and set up a system to risk assess every patient who is admitted to hospital, and that this should be mandatory.

By April 2008 only one third of NHS Trusts had taken any action. People are still suffering this horrible condition and still dying.

Please, if you possibly can, write to your local NHS Trust Chief Executive and ask what their Trust is doing to prevent patients dying unnecessarily from blood clots. Copy the letter to your MP.

If you, or a relative, are admitted to hospital for any reason, don?t just ask your doctor or nurse to wash their hands, ask them ?What is my risk of developing a blood clot, and what are you going to do to reduce my risk??

If you are pregnant, please ask your doctor and midwife the same question.

Thrombosis is still a leading cause of pregnancy-related death. If you are pregnant and are admitted to hospital for any reason (apart from straightforward labour and delivery) you should be risk assessed on admission.

We know what the power of mumsnet did for Waitrose baby bottom butter. I really hope we can achieve something here.

Thank you for reading, if you have managed to get this far.

.

Thanks...Can you approach the papers etc with your findings?

No - because I work in a Trust that has not taken any action, and I would face disciplinary proceedings if I was identified.

I will keep bumping this because I believe that mumsnet can make a difference if enough people read it.

I was aware of this. I was admitted to hospital when I was pg with dd1 with respitory problems (which were identified as being 99% certainly pleuresy) As I refused point blank to have a chest x-ray I was given regular (and bloody painful) injections to reduce the risk of a blood clot. It was highlighted and explained to me many times why I was at a higher risk and why they really really would like me to have the x-ray. I think I am in a rare position re our Health care provider. We even have excellent Health Visitors round here . I will however contact our local MP if it will filter through to other local councils. Strength in numbers and all that.

I had a friend who died from a blood clot. Literally dropped dead on his way to work one morning. he was 33. . but it was believed his clot was caused by the amount of travelling he did.

But while I agree that it's important that steps be taken, I'm not sure that a load of women on a website are going to be able to succeed where the government have clearly failed.

I agree that it would be better to go to the media with this information. You could do it anonomously - you can't be the only person in the country with access to this information.

I would highlight this to the national press, bbc panorama, and any other investigative journalists out there such as Donald McEntyre (sp?).

My landlord nearly died from a clot.

He was medically retired early afterwards.

I must admit I thought that 25,000 preventable deaths would have raised at least as much interest as M&T parking, fruit shoots and sausage rolls.

I hope that anyone who is admitted to hospital will ask about the risks anyway.

I was admitted to my local hospital after having each of my two children by c-section. Both times, about a week after the births, I developed chest pains and shortness of breath. My care was fantastic both times and it was definately taken seriously.

I know this is slightly different from what the OP is about as it was immediately thought that a clot might be the cause and I was not admitted for something else and then assessed.

I hope more people read this tonight.

Thank you for highlighting this, HPNC. My father has suffered brain damage as a result of an embolism after surgery. If I'd realised that he could have been assessed beforehand I'd have pushed like mad for it.

I live abroad, but I'll certainly write to my parents' MP and NHS Trust Executive.

Thanks again.

Rosealbie,
Were you given post operative stockings and injections in your tummy after you had your C. Section?

You should have been. To prevent the clot.

I am very glad you were fortunate to have been diagnosed quickly and treated. Many people are not so lucky.

Trulymadlydeeply,

I am so sorry to hear about your father.

As I said in my OP, the 25,000 deaths are just the tip of the iceberg. Many thousands more are left disabled, or suffer long term health problems as a result of having a thrombosis.

It is a national scandal, and a tragedy.

Yes I was, both times. Stockings and then 5 days of injections.

After I was admitted with the pains etc, I was quickly given blood gas tests and also a CT scan on the second occasion.

Luckily , I didn't have a clot and all they could find was a small pocket of fluid under one lung after my second c-section. I initially went to A&E and then admitted onto a ward where a team of medics assessed me each time.

I have a friend who nearly died after developing a clot in her lungs whilst expecting her third child. The baby was delivered early but fortunately was and is ok and she recovered, there was one terrifying night though when her husband was called to the hospital because the staff feared they were losing her. It is a really importnat issue for everyone to be aware of.

Sorry rosealbie - I thought you did have a clot. I am glad you had such good treatment.

Thanks for the warning.
how would one get thrombosis in the normal course of events? Is it something i should be worrying about whether or not i go into hospital? what are the symptoms?

bump

thank you for this

my mum has had a spontanoues DVT, my sister has had 3 and i had two suspected ones.

scarily, my mum;s only symptom was an ache in her calf muscle

and oddly i had all the symptoms, hot calf, swollen, tender, unable to weight bear or bend and could not walk properly...but not a clot apparently

there are some diagnostic tests:

the pleth test , like a blood pressure cuff around your leg and a d-dimers blood test and a veinogram .

scans are offered, but usually only round the thigh. my mum and sister both had clots in their calves. my sister had to beg for her calf to be scanned.

Risk factors:

Family history of DVT or any sort of thrombosis
smoking
immobility (long haul travel,surgery, or just being in hospital, on bedrest, for any reason)
obesity
heart failure
diabetes
pregnancy
IV drug use
hormones such as the pill
cancer
other chronic diseases

One risk factor on its own is not usually a high risk, but each additional factor increases the risk.

For example, if you were obese, pregnant and smoked, and were admitted to hospital because you developed an infection, or had an injury, or couldn't move much for some reason, you would need to have stockings and injections, because that combination of factors would put you at high risk.

Pregnant ladies should be asked about family history of thrombosis as early as possible in pregnancy, so that their risk can be assessed.

Symptoms:

unexplained calf or leg pain, tenderness, swelling.

Chest pain with breathlessness, especially together with the above leg pain, or if there has been a history of leg pain

This is why the NICE guidelines say that each person should be assessed and a proper decision about preventative measures taken.
HTH

HPNC, Don't worry that the thread got off to a slow start. I tried to raise awareness about an issue 2 weeks ago and with alot of bumping word started to spread. What you've done is great, and you may well have made a difference already....Just keep posting...

Forgot

Hyperemesis
Dehydration
advancing age (risk goes up as you get older)
Having any kind of surgery.

Very worthwhile thread HPNC. I'm appalled that your Trust would discipline you for raising the issue.

My dd had an embolism post surgery. It was in her leg and actually put the viability of the leg at risk. The clot was surgically removed but we were concerned for some time that any break off would travel to her heart/lungs/brain. Thankfully she came through unscathed apart from an ongoing lack of circulation to the leg. I don't think her clot could have been prevented but our experience certainly raised my awareness of the issue.

this is something i am concerned with

have had 3 unexplained DVT and possibly a fourth with a hideous episode of phlebitis

i am happy to write to my MP/PCT

thank you

when you say immobility, for what period are we talking please? I am sitting with feet up for as much of the day as I can manage
is this something I should be worrying about?

Some Trusts quibble about the costs.

But the Chief Medical Officer has told them that they must put measures in place.

If you are admitted for surgery, and you develop a clot, you are entitled to ask for proof that you were risk assessed and that you were given appropriate preventative treatment. If that is proved not to be the case, then you could conceivably sue the Trust. That would cost them more than the prevention would have done.