Venous Thromboembolism (VTE) - Reducing the risk of a blood clot during and after your stay in hospital

Blood Clots

Blood clots often develop in the legs and are known as deep vein thrombosis (DVT). These clots can cause swelling and/or pain, sometimes they may not cause any symptoms.

Blood clots in your legs are not life threatening, however, they can become loose and travel within your body to your lungs. A clot which travels to your lungs is called a pulmonary embolism (PE).

While you are in hospital, there is an increased risk of developing a blood clot. This increased risk continues for up to 90 days after leaving the hospital.

A blood clot in your lungs (PE) can be life threatening and requires urgent treatment. Common symptoms of a PE are:

• Shortness of breath
• Chest pain
• Sudden collapse
• Coughing up blood
• Feeling sweaty and unwell

You may only have one of these symptoms.

Who is at risk?

Most people admitted to hospital are at risk, however, the risk further increases when any of the factors listed below are present:

• Age over 60 years
• Being overweight or obese
• Dehydration
• Taking oral contraceptive pill or hormone replacement therapy (HRT)
• Having cancer or having cancer treatment
• Having a condition which increases the risk of developing a blood clot
• Previous blood clots or have a direct family member who has had a blood clot
• Pregnancy or recent birth
• Having a long-term medical condition, such as heart or lung disease or diabetes
• Inflamed varicose vein
• Surgery
• Significant injury or physical trauma
• Being unable to walk about

Staff will assess your risk when you are admitted to hospital and prescribe medication if appropriate. This medication may be injections or tablets and is referred to as an anticoagulant. It is common to experience bruising with anticoagulants. In addition, or in place of an anticoagulant you may be required to wear special stockings.

How to reduce your risk of Blood Clots

• Keep moving or walking about as much as you can
• Drink plenty of fluids to keep hydrated
• Anticoagulants may be administered either as an injection or a tablet. Enoxaparin, Tinzaparin and Dalteparin injections are of animal origin, therefore if you have any concerns about using animal products, please inform your doctor and they will discuss other options with you.

If your hospital admission is planned in advance there are some additional precautions which can be considered:

• If you currently take oral contraception or hormone replacement therapy speak to your doctor about your prescription before you are admitted to hospital
• Keep a healthy weight

If you have been provided with stockings or compression sleeves please refer to the leaflet, “Anti Embolic Stockings and Intermittent Pneumatic compression Device Information for Patients” for further information on these.

What happens when I am discharged from hospital?

Your risk of developing a blood clot continues after you have been discharged from hospital. To reduce the risk:

• Try to be as mobile as possible (unless you have been advised otherwise)
• Continue any exercises you have been shown whilst in hospital
• Drink plenty of water-based fluids to avoid dehydration
• Take painkillers regularly as needed within prescribed limits 
• You may be prescribed anticoagulants to continue after your discharge. These may be tablets or injections. Patients who are prescribed injections may be taught to self-inject whilst others may have their injections administered by a district nurse.

If you experience any problems with your medication; seek help from your GP or other local medical practitioner.

Signs of a possible blood clot

There are certain signs to look out for after an illness or an operation that could mean you have a blood clot. Seek medical advice immediately either from your GP, your nearest Urgent Care Centre, or emergency department if you experience any of the following in the days or weeks after leaving hospital:

• Pain in your leg
• Swelling in your leg
• The skin on your leg is hot or discoloured (red, purple, blue)
• The veins near the surface of your leg appear larger than normal or you notice them more
• You become short of breath
• You feel pain in your chest, back or ribs, which gets worse when you breathe in deeply
• You cough up blood
• Any unexplained fainting or severe dizziness
• Collapse

Travelling/flying after surgery or with a health condition

There is an ongoing risk of developing a blood clot after you leave hospital. This risk can be increased by prolonged flight, car, or train travel. The reduction in mobility, prolonged sitting, seat- edge pressure, and individual risk factors can all contribute to the development of a DVT.

The risk of developing a blood clot when flying after surgery is dependent on your own individual situation. The risk factors mentioned on page 3 of this booklet are some of the factors which increase your risk of developing a blood clot. Other factors include the type of surgery or medical treatment you received whilst you were in hospital. Your recovery after your hospital admission will also influence your blood clot risk.

Fit to fly

If you are considering flying after surgery or other hospital admission you must check with your airline if confirmation of fitness to fly is required. If a fitness to fly is required you should request this from your G.P. Ensure your travel insurance company is informed.

Travelling with prescribed medication

• If taking medication abroad, check the rules on the country you are travelling through and to.
• Ensure you have sufficient supply for the duration of your trip and all medication will be in date
• When possible, take medication in handheld luggage
• Carry medication in its original packaging and carry a copy of your prescription as well
• Check on storage of medication whilst away from home
•  Also check with your insurance company and the airline on any additional requirements for medication you are carrying

DVT prevention on long journeys

• Avoid immobility
• Wear loose-fitting clothes
• While seated bend and straighten legs every 30 minutes
• Keep feet area free
• Press balls of feet down hard against floor to increase blood flow
• Do upper body breathing exercises
• Take occasional short walks
• Avoid sleeping tablets
• Drink more water and avoid alcohol

Seek urgent medical advice if you develop swollen painful leg/ breathlessness/chest pain.

Further information is available from the following internet sites:

https://www.thrombosisuk.org
DVT prevention for travellers | Health topics A to Z | CKS | NICE
Health guidelines for air travel | Civil Aviation Authority (caa.co.uk)