Deep Vein Thrombosis (DVT)

• In suspected DVT, If the patient can have doppler USS performed within 4 hours then no anticoagulation is required prior to imaging
• If rapid imaging is not possible, and the patient is suitable to be ambulated, the patient can be discharged with apixaban 10mg BD, or Dalteparin (as per weight).
• As of November 2023, the preferred therapeutic option for suspected DVT who are being ambulated to SDEC for doppler USS is apixaban.
• The inclusion/exclusion criteria for apixaban is on the second page of the guideline in the 'Can patient be treated with Apixaban' box. There is no benefit in stopping antiplatelets for this short a period.
• Special groups to consider in this are those with active cancer (refer to the oncology pathway on OOQS), those at risk of falls, and those with alcohol problems (should have dalteparin).
• If in doubt about suitablity to ambulate, speak to a senior clinical decision maker - the alternative may be for admission under general medicine for further investigation.
• If a patient is going to be ambulated, please follow the advice on the suspected DVT protocol, as well as on the separate SDEC ambulatory pathway.

Please see the 2nd page of the suspected DVT protocol.

Patient’s with confirmed DVTs or PE can be followed up in Dr Harmouche’s clinic after initiating therapy by emailing beth.love@nhslothian.scot.nhs.uk.