I see from the BBC news bulletins this morning that the National Institute for Clinical Excellence (NICE) has issued new guidance on the risks of dangerous blood clots for hospital patients.
Blood clots can be fatal if the clot breaks off and travels in the blood up to the lungs and causes a blockage, known as a pulmonary embolism. An estimated 25,000 people die from the avoidable condition each year.
Certain people admitted to hospital are known to be at very high risk of problems - for example, those who will be bed-ridden for a long time, those undergoing extensive surgery and patients who are very overweight. Other risk factors such as dehydration or women being on the combined contraceptive pill may not be spotted.
NICE says all adult patients, without exception, should be assessed with a risk assessment / checklist on being admitted to hospital. According to Doctors, it will only a few minutes to do a risk assessment, based on things like the patient's age and what is wrong with them.
According to doctors, prevention is straightforward, involving leg compression stockings plus a small shot of a blood-thinning drug for those at high risk.
The guidance is a follow-up from 2007 guidance, which first advocated the approach of identifying at risk patient, counselling them of the risks and prescribing the appropriate treatment.
Helpfully in 2010 NICE have set out details of those they consider that Healthcare professionals should be particularly aware of . They single out in particular those patients who are undergoing surgery with a length of time of greater than 60 minutes in the case of lower limbs or 90 minutes for other. They also point out which patients are not suitable for blood thinning agents or leg compression stockings.
The new guidance is welcome, particularly in its detail . This new initiative however will come as no comfort for a recent client who developed DVT after a total knee replacement. He was offered neither leg compression stockings nor heparin.
I admire NICE’S practical approach, although I cannot help but think that in any other industry this sort of Risk assessing approach would regarded as self evidently necessary and implemented long ago.
Submitted by Marcus Weatherby
