Deep Vein Thrombosis (DVT)

Introduction

First recognized in 1946. Travel related DVT is an added potential problem for at risk travelers who are immobile for extended periods of time. The problem is often associated with air travel. The risk is equally reported among those traveling by car, coach and train.

DVT is a clotting of blood in any of the deep veins usually in the calf

Who is at risk?

Be aware of risk factors, cases of DVT may have an average of 3 factors:

  • Immobility for an extended period of time
  • An existing history of DVT
  • Malignancy
  • Recent surgery or leg surgery
  • Existing clotting abnormality
  • Obesity (BMI above 30)
  • Chronic or acute medical illnesses
  • Hormones or the oral contraceptive pill
  • Varicose veins
  • Pregnancy or 2 months post partum
  • History of cardiac problems
  • Dehydration
  • Over 60 years of age
  • Smoking

Sign & Symptoms

If the clots develop, it usually makes its presence known by an intense pain in the affected calf.

Complication

Fatal if the clots break off and make its way to the lungs where it can then affect the lungs ability to take oxygen.

Treatment

Aspirin has been recommended by some but there is no evidence it prevents blood clot. Consider subcutaneous injections of anti-coagulant while at risk (as long as it is not contraindicated).

See doctor for advise and further management

Prevention & Precautions

How can I reduce my risk?

  • Exercise at least every hour on long journeys. Exercise the calf muscles by rotating your ankles, or making use of the commercially available exercise equipment.
  • For long flights wear loose clothing.
  • Remain hydrated during a long flight by drinking plenty of water and fruit juices. Avoid too much alcohol, tea and coffee on flights (dry environment) which will give rise to problem of dehydration.
  • Correctly fitting In-flight stockings and socks increase blood flow, thus lowering the risk of DVT in those at risk.

Specific advise for those at minimal risk (Nil or one predisposing factor)

  • Exercise legs when possible
  • Maintain hydration and limit alcohol consumption
  • Take frequent walks in aisles
  • Do isometric exercises while seated. Point foot downward, clench toes and hold for three seconds. Do 10 repetitions with each foot every half hour.

Specific advise for those at low or moderate risk (e.g. 2 or 3 predisposing factors)

  • Exercise legs when possible
  • Maintain hydration and limit alcohol consumption
  • Take frequent walks in aisles
  • Do isometric exercises while seated. Point foot downward, clench toes and hold for three seconds. Do 10 repetitions with each foot every half hour.
  • Consider using below knee compression stockings. Wear fitted support stockings. Don’t wear knee socks that have a tight elastic band around upper calf.

Specific advise for those at high risk (e.g. more than 3 predisposing factors)

  • Exercise legs when possible
  • Maintain hydration and limit alcohol consumption
  • Take frequent walks in aisles
  • Do isometric exercises while seated. Point foot downward, clench toes and hold for three seconds. Do 10 repetitions with each foot every half hour.
  • Aspirin has been recommended by some but there is no evidence it prevents blood clot. Consider subcutaneous injections of anti-coagulant while at risk (as long as it is not contraindicated).

 

Last Reviewed : 26 April 2012
Writer : Dr. Norhayati bt. Rusli
Accreditor : Dr. Alias b. Abdul Aziz
Reviewer : Dr. Fitjerald Henry

 

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