VTE

vte

The King's Thrombosis Centre provides comprehensive care for patients with suspected/confirmed venous thromboembolism (VTE). We offer a fast-track nurse-led DVT (deep vein thrombosis) clinic which assesses patients who present directly to the hospital from the community. Patients are referred to a nurse-led clinic for rapid assessment of suspected DVT and are usually seen on the day of referral. Following clinical assessment and diagnostic testing, those with confirmed DVT are assessed for outpatient management and then transferred directly to our anticoagulation service when appropriate. Time to diagnosis is now under two hours and patients requiring treatment are home within four hours.

 

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In conjunction with the Acute Medical service, we provide an early discharge programme for low risk PE (pulmonary embolism). Patients are evaluated for suitability for outpatient management and may be referred to the anticoagulation clinic on the day of PE diagnosis, for outpatient initiation of warfarin. Patients with PE at high risk of adverse outcome are considered for thrombolytic therapy, and remain in hospital until clinically stable. All patients with VTE are reviewed soon after diagnosis by a Consultant Haematologist in a dedicated follow-up clinic where an individualised approach to management is agreed. Investigations to ascertain an underlying cause of thrombosis are performed and optimal duration of therapy is decided upon taking into account patient preference. This clinic additionally provides advice on reducing the risk of complications, such as post-thrombotic syndrome and recurrent VTE, in addition to treatment when these events occur. After stopping anticoagulation therapy, patients are tested where appropriate for thrombophilia.

 

The following guidelines are used at King's College Hospital for the management of VTE:

pdfDeep vein thrombosis proforma

pdfDiagnosis and management of suspected non-massive pulmonary embolism

pdfLonger-term investigation and management of VTE in the out-patient thrombosis clinic

pdfManagement of upper-limb deep vein thrombosis and superficial vein thrombosis

pdfProtocol for the management of massive pulmonary with thrombolysis

pdfPrimary care treatment summary for Venous Thromboembolism Management

docAcute DVT treatment summary

docDVT checklist rivaroxaban

docLSL notification

docRivaroxaban for DVT GP letter

docRivaroxaban treatment for DVT patient letter

docxRivaroxaban and transfer of care