Urgent Care For Blood Clot

Urgent Care Diagnosis And Management Of Deep Vein Thrombosis

John DesMarais, MD and Samidha Dutta, DO

Urgent message: Screening patients with suspected DVT using the Wells criteria is an efficient tool that would be even more impactful with access to point-of-care, high-sensitivity D-dimer testing in the urgent care setting.

Citation: DesMarais J, Dutta S. Urgent care diagnosis and management of deep vein thrombosis. J Urgent Care Med. 2021 15:13-17.

Visiting The Emergency Department For A Blood Clot: What To Expect

Taking a trip to the emergency department is stressful and potentially costly but it can be lifesaving. For patients with deep vein thrombosis or pulmonary embolism , its especially important to receive treatment in a timely manner.

When should you go to the ED?

If you suspect that you have a blood clot or experience any of the signs and symptoms, you should consider going to the ED.

Signs of DVT include:

• Swelling of the legs, ankles, or feet
• Discomfort, heaviness, pain, aching, throbbing, itching, or warmth in the legs
• Skin changes in the leg such as discoloration, thickening, or ulceration

Signs of PE include:

• Rapid or irregular heart rate

What can you expect in the ED?

While youre in the ED, you may be seen by multiple healthcare providers along the way, including doctors, nurses, and physician assistants. If you visit a large teaching hospital, you may also be seen by clinicians in training. All of these medical professionals are a resource for you. Dont be afraid to ask questions in the emergency room, says Dr. Jeremiah Schuur, Chair of the Department of Emergency Medicine at the Warren Alpert Medical School of Brown University. Since you may see multiple providers, its a good idea to ask questions or clarify things to make sure you understand what the doctor is considering and what the plan is.

Will you be admitted to the hospital or sent home?

If Im sent home, what do I do after my ED visit?

The bottom line

Immediate Action Required: Call 999 Or Go To A& e If:

You have symptoms of DVT, such as pain and swelling, and:

DVT can be very serious because blood clots in your veins can break loose, travel through your bloodstream and get stuck in your lungs. This is called a pulmonary embolism.

A pulmonary embolism can be life threatening and needs treatment straight away.

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What Is A Blood Clot

A blood clot is a thickened mass in the bloodstream. It is made from platelets, which are crucial to healing wounds and cuts. However, when platelets accumulate and cause a blood clot, this mass can travel throughout the body and into a persons lung, heart, brain, and other vital organs. Blood clots can cause a heart attack, stroke and death. If you are experiencing the symptoms of blood clots, you should go to the nearest ER immediately.

SignatureCare Emergency Center has multiple locations in Houston, Austin, College Station and other cities in Texas. Find an emergency center near you and seek immediate medical attention if you believe you have a blood clot.

What Are The Symptoms Of Venous Thrombosis

Superficial venous thrombosis can cause painful, red, warm swollen bumps on your leg over and around the site of the clot.

A DVT in the leg or pelvis can cause pain, swelling, redness and warmth in the whole leg, particularly in the calf.

Symptoms of a pulmonary embolism may include chest pain, coughing up blood and difficulty breathing. If a DVT caused the pulmonary embolism, you may also have symptoms of a DVT, such as leg pain.

If you or someone else is having trouble breathing, or if you have symptoms of a pulmonary embolism, call triple zero and ask for an ambulance. These can be life-threatening.

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Side Effects Of Blood Thinners

Blood thinners can cause side effects. Bleeding is the most common problem. Your doctor will watch you closely. If you notice something wrong that you think may be caused by your medication, call your doctor.

Signs Of A Pulmonary Embolism

Symptoms of a pulmonary embolism often depend on:

• The size of the clot.

Some common signs of a blood clot in your lungs include:

Shortness of breath

Shortness of breath thats new and different from what youve experienced before could be a sign of a blood clot in your lung especially if the feeling lingers.

Breathlessness or becoming easily winded with mild exertion will last for hours, even days, if there is a blood clot, notes Dr. Tran. If you feel breathless for a second and then youre OK, its probably not.

Chest pain

While chest pain may signal a heart issue, it can also be a sign of a clot. The chest pain will be constant or happen when you take deep breaths.

It may feel like a shooting pain that starts in your front and travels to the back in the chest area, says Dr. Tran. You may also feel chest heaviness or pressure that lasts. If its just fleeting, goes away and doesnt happen again, youre probably not dealing with a blood clot.

Coughing up blood

Another sign of a blood clot in your lung is coughing up blood. The sputum would have more than a tinge of blood in it, too: It would be much more teaspoons or tablespoons of blood, notes Dr. Tran.

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When To Seek Emergency Treatment For Blood Clots

Determining whether or not you have blood clots can be difficult without proper medical care. However, you should call a doctor if you experience numbing of your arms, hands, feet or legs. You should also get medical help if you experience a rapid heartbeat that does not subside with rest or a medication like low-dose aspirin. You should go to your nearest ER if you experience any of these symptoms or have chest, leg or back pain that does not subside with over-the-counter remedies or home treatment. Or, if any of the following symptoms are present:

• Shortness of breath or difficulty breathing
• Loss of consciousness or feeling light-headed
• Confusion or difficulty answering questions
• Sudden and intense pain that is located on only one side of the body
• Facial numbness or slurred speech
• Inability to lower and raise arms or grasp things with hands
• Inability to walk or bear weight on legs or feet

If you are experiencing symptoms of blood clots, please the closest ER. Our ERs are open 24/7 and we have several emergency center locations.

Acknowledgments Disclaimer And Licensing

This guide is based on a product developed by Ann Wittkowsky, Pharm.D., Brenda K. Zierler, Ph.D., R.N., R.V.T., and the V.T.E. Safety Toolkit Team at the University of Washington, Seattle, under Agency for Healthcare Research and Quality Grant No. U18 HS015898-01.

This document is in the public domain and may be used and reprinted without special permission. Citation of the source is appreciated.

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Acquired And Persistent Factors

The risk of DVT events is several times higher in patients with congestive heart failure under the age of 40 compared with those over age 80. Patients with CHF have increased venous stasis resulting from decreased cardiac output and patient immobility. Increasing severity of heart failure is directly correlated with an increased incidence of DVT.2

The overall risk of DVT in patients with advanced cancer increases by seven-fold when compared with the general population.2 Certain cancers such as non-Hodgkin lymphoma, lung, ovarian, brain, pancreatic, and gastrointestinal have higher rates of associated DVT.2 Chemotherapeutic agents such as 5-fluorouracil, tamoxifen, and cisplatin are all medications that influence factors such as hypercoagulability, endothelial injury, and/or blood flow which in turn also contributes to the increase risk of DVT in patients with cancer.2

Several other acquired risk factors include acute infection, chronic inflammatory diseases , chronic obstructive lung disease, chronic kidney disease, recent history of stroke , recent major surgery , and trauma .2,3

Jessica Stadlers Dvt/pe Story

May 1, 2013

Jessica Stadler went from being a healthy, active young woman to someone with 3 pulmonary emboli , and she wants to alert everyone to the signs and symptoms of DVT and PE, so that they seek care right away.

I have always been considered the healthy one among my friends and family. As an athletic young woman, I have grown up athletic, am active, and exercise almost every day. I also eat healthily. I never thought that I would find myself in a hospital on bed rest at age 20 due to a pulmonary embolism . I did a frantic phone search on PE to learn about what was happening and each description contained the word fatal. This was not reassuring. Even though I had no idea what the next few days would hold, I was confident that God was right there with me. I found myself wondering whether I would wake up the next morning.

When I woke up on Saturday, I did not feel any better, and went to an eight hour shift at work. I felt more horrible with each passing minute at work, and the shift dragged. My chest pain was constant and intense, my pulse was racing at a frighteningly high rate, and I could barely talk, much less breathe. I got even more concerned when I found it difficult to walk up a flight of 7 stairs that were easy for me to sprint before. I felt as if I was having a heart attack, and I got a burning sensation down my left arm as I drove to meet my mother for dinner. As soon as she saw me, she took me straight to the ER.

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How Is Deep Vein Thrombosis Treated

For DVT, medical treatment will stop the clot from growing, prevent a PE, and reduce the risk of future clots. This usually involves anticoagulant medicines, commonly known as blood thinners. The ER will likely give you an injectable anticoagulant. There are forms you can use at home once you leave the ER. This will continue for a few days while you start on blood thinners you take by mouth. There are also newer pill options that dont require injectable medicines to get started.

You will continue an anticoagulant for several months. Your body will eventually break down the clot and absorb it. Your doctor may recommend wearing during this time to support blood flow.

Sometimes, more aggressive treatment is necessary for DVT. This includes clot-busting drugsthrombolyticsto dissolve the clot or surgery to implant a vena cava filter. The filter will catch a clot before it can reach the lungs. Some DVT blood clots only require frequent monitoring with ultrasound.

In most cases, treatment of PE is similar to DVT treatment. Anticoagulants are the main treatment if your condition is not immediately life threatening. If the PE is more serious, doctors may use thrombolytics or a catheter-based procedure to remove the clot. Surgery to remove the clot may be necessary as a last resort

Blood Clot Signs And Treatment

Your body creates blood clots out of cells, platelets, and proteins to reduce bleeding when youre injured. After the injury heals, your body breaks down the clots and eliminates them, so they dont have an adverse effect on your health. Unfortunately, though, your body might form clots without a medical reason and fail to expel them. If that happens, they can travel to your lungs or another part of your body, cutting off the blood supply. This can cause a stroke or another potentially fatal medical emergency. Thus, go over the symptoms of a blood clot so youll know when to call 911 or visit the emergency room.

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Blood Clots: When To Worry

Thats what a blood clot can be, because many people are stricken by this devastating health issue without enduring obvious symptoms or warning signs.

While blood clotting is a normal and necessary bodily function, the type of clots that are most worrisome are known as Deep Vein Thrombosis . These clots typically form in deeply buried veins, like the ones that run along the back of your legs, but can also form in your groin area and even in your arms.

These clots are scary because if the clot breaks free within the vein, it can travel to the lungs, causing a pulmonary embolism. Pulmonary embolisms are dangerous, can block the flow of oxygen throughout the body and can lead to death.

Treating Complex Causes Of Dvt

If youve had DVT more than once despite treatment, you may need advanced testing to pinpoint whats causing your blood clots.

Our vascular surgeons work closely with UI Health Care hematologists who specialize in blood disorders. Together we can test for certain conditions that can cause your blood to clot too easily. These conditions include inherited disorders such as factor V Leiden and prothrombin gene mutations.

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How Is Thrombosis Treated

If you have superficial venous thrombosis, medicines, rest and a cold or warm compress can help.

Treatment of an arterial or deep vein thrombosis will depend on where it is and if it caused any damage. You may need treatment in hospital.

Your doctor may prescribe medicines to dissolve your clot. They may also recommend surgery to remove or bypass a blood clot, or to widen an artery. Compression stockings can relieve swelling and pain in your legs.

You might be prescribed an anticoagulation medicine, such as warfarin, to thin your blood and make it less likely to clot in the future. You may need to take anticoagulation medicines for months or years to prevent clots recurring.

• eating a healthy, balanced diet

Your doctor might recommend medicines to reduce your cholesterol and blood pressure.

To reduce your risk of venous thrombosis, you should quit smoking and maintain a healthy weight. If youre at a high risk of deep venous thrombosis, your doctor may advise against the oral contraceptive pill and may recommend compression stockings, especially on long flights and after surgery.

Your doctor might recommend you take a low dose of aspirin each day to thin your blood. They may also prescribe anticoagulants to help prevent thrombosis and reduce your risk of clots.

Blood Clot Diagnosis At Dignity Health Southern California

Our experienced doctors are excellent diagnosticians. In addition to capturing your health history and your symptoms, your doctor may request emergency imaging to precisely locate a suspected blood clot.

Blood clot symptoms vary depending on the location of the blood clot:

• A blood clot in your brain can cause symptoms of stroke
• A blood clot that travels to your heart can cause signs and symptoms of heart attack
• A blood clot in a leg vein, known as deep vein thrombosis, can result in mild cramping, tenderness, numbness, and even a bluish color around the clot area
• A blood clot in your lung, known as pulmonary embolism, causes shortness of breath, chest pain, and cough

Always call 911 for signs and symptoms of stroke, heart attack, or pulmonary embolism to receive immediate medical attention.

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What Are Blood Clots

Blood clots occur when a clump of your blood converts to a gel-like state. The blood can clot when blood vessels are damaged or if blood isnt flowing properly. This is because the platelets in the blood are more likely to stick together, causing a blockage. Clotting is a natural reaction of the body to protect damaged areas and prevent further bleeding, but sometimes the clot grows rather than dissolving on its own.

Other Causes Of Blood Clots

• Surgery Undergoing surgical procedures can raise a persons risk of developing blood clots. Many hospitals require patients to wear surgical socks or leggings to encourage normal blood flow during their hospital stay.
• Genetic mutations Some inherited genetic mutations and conditions, most notably Pseudoxanthoma Elasticum , raise the risk of clots and arterial hardening.

Think you have blood clot? Go to the nearest emergency room.

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The Risks Of Blood Clots

A blood clot is known as deep vein thrombosis and can be the result of surgery, an injury, certain genetic disorders, cancer, smoking, and obesity. Even sitting for a prolonged length of time can cause a clot to form because blood flow may be restricted during this time. Pregnant women are also susceptible to blood clots due to an increased level of estrogen and an expanding uterus.

A blood clot that starts in your calf can break off and travel through the bloodstream to the lung. Once there, the clot can become stuck and and block the flow of blood, causing organ damage and even death. This is called a pulmonary embolism . If you experience any of the symptoms below, call 911 or go the the emergency room immediately.

Symptoms of a pulmonary embolism:

• Shortness of breath
• A sharp chest pain that may get worse with deeper breaths
• A cough that sometimes produces a bloody mucus
• Low blood pressure

Blood clots that are left untreated can spread to other parts of the body and lead to more serious problems. In fact, up to 100,000 people die each year from blood clots.

Fortunately, most blood clots are easily treated when found early. If you experience swelling, pain, discoloration, or unusual warmth in your calf, see a medical professional immediately. FastMed Urgent Care is open seven days a week with extended hours Monday through Friday. Find a FastMed near you today!

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