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.

If you are sitting with your feet up, but getting up to go to the loo, prepare food etc at regular intervals, and you are otherwise healthy, you should be fine.

I am really not trying to frighten people here, just to raise awareness.

no I don't think you are frightening anyone, just I hadn't considered it before, and self-centredly thought of my own risk

good luck with this campaign

Bumping once more before departing temporarily to attend to domestic responsibilites.

I am very overweight and after c-section had injections twice a day in my thigh which were for this, but didn't have stockings like I've read some have. Should I have or were injections enough?

My brother died from pulmonary embolism, which raised my awareness of it! My dental hygenist had a blood clot in her leg last year when pregnant, it took her an awful lot of persuasion to get a doctor to believe there was something wrong - I suppose as a young, slim, active, healthy woman she was 'low risk'. Raising awareness is important, thanks. Also, if you are sitting still or on a plane for long periods, drawing the alphabet with your feet and ankles is a good way to 'wiggle' in all directions.

Summatandnowt,

Probably it was decided the injections would be enough.

Sorry - I don't mean to be rude about your weight, but it is possible that that there were no appropriately sized stockings available, and stockings that are too tight are worse than no stockings.

It is supposed to be an individual risk assessment, so that each person can have the preventative treatment that is best for them.

I really must go, as it is way past bedtime for some people in this house, and they are getting a bit silly.

Night night, that usually ends in tears here!

I will come back though, and will keep it bumped.

stleger -

Thanks for posting this HPNC! I got a blood clot in my lung three years ago as a result of a snowboarding accident. Two weeks after returning from holiday, I developed awful chest pains, my GP sent me home, but luckily a private GP sent me to have a chest x-ray. 6 months on meds, and heparin injections every day throughout pregnancies. I'm glad to be alive, and shocked that so many NHS Trusts are not taking this issue seriously.

When I had my son be em c section n Edinburgh in 2002, I was given heparin injections afterwards for 5 days.

When I had my DD in Leeds last year, I was given surgical stockings, no injections and these were taken off me the next day as I was up and about. I was surprised at the lack of injections.

is hyperemesis a risk factor?

how is that?

Probably because of dehydration Lurker.

yeah, but how does dehydration etc put you at risk of DVT?

sorry if it's an obvious answer, just can't work it out

Aw, it's not rude, it was necessary for the explanation. Pregnancy was accident anyway, I wouldn't have planned doing it at my weight.

because blood is more viscous when you are dehydrated....like vimto with no water in....
more ast risk of clotting

I think (no medical qualifications) dehydration causes the blood to be a little thicker and the blood vessels to narrow and so slows the circulation.

aahh i see (thicko emoticon)

gosh! i'm off for a glass of water!

hmmm vimto

bump

i work in a surgical unit, i thought we were pretty good before, but in the last 3 months big measures have been put into place.

protocols have been set in place, flow chart diagrams all over the place.

every single member of staff had to atttend a study session on it.

every single drug chart has a risk assessment sticker stuck into it, prompting the dr's to prescribe.

lots of stuff done.

i am shocked that only a 3rd of hospitals have done anything about this.

as i tell my patients when i'm sticking them with clexane and their complaining that it hurts... prevention is better than cure!!

Really pleased to hear that saralou.

where do you work saralou? name and praise!

.

my dad has heart failure and diabetes. i will ask him about the clot thing.

my mum faints on planes, do you think she is high risk too hpnc?

i am clearly doomed.