Authors (including presenting author) :
Chung YS(1), Lai KW(1), Tsui YC(1), Siu HK(1)
Affiliation :
(1)Physiotherapy Department, Prince of Wales Hospital
Introduction :
Deep vein thrombosis (DVT) is the formation of blood clot(s) in deep veins, primarily in the lower limbs. It can cause pain, swelling and redness in the affected area. DVT may dislodge and travel to other body parts, leading to life-threatening complications like pulmonary embolism (PE). Screening patients’ risk of DVT and managing correspondingly are essential. Therefore, physiotherapists at the Prince of Wales Hospital (PWH) have structurally screened and documented patient’s DVT risk since May 2024.
Objectives :
1. Assess the adherence of physiotherapists to the DVT/ Venous Thromboembolism (VTE) screening checklist, which includes:
* Checking medical history and mobility
* Identifying the risk of DVT/VTE through subjective and objective examinations
* Utilising screening tools for DVT/VTE when applicable
* Implementing follow-up actions and appropriate management
2. Evaluate the completeness and accuracy of documentation about the DVT/VTE screening performed and the subsequent actions taken based on the screening results
Methodology :
All cases eligible for the inclusion and exclusion criteria were audited. All referred cases in oncology and post-operation patients in orthopaedic and surgical specialties were included. Patients with lower limb amputation or burn injury, lower limb in cast or external fixation or skin/skeletal traction and paediatric cases were excluded. To evaluate the compliance of physiotherapists to DVT risk management, DVT documentation audits were conducted twice in PWH, from 27th May to 7th June and 14th to 25th October 2024 respectively.
Result & Outcome :
A total of 299 cases were audited. A 100% compliance rate was recorded with physiotherapists' initial documentation of screening for DVT. Within the total cases, 9 cases were screened positive by physiotherapists with positive signs and symptoms of DVT. Four out of the 9 cases had undergone lower limb Doppler ultrasonography as further investigation. Two out of the 4 cases were confirmed with lower limb DVT.
All cases, as recorded in the DVT screening form, were made alert to case MO/nurses and mobilisation was suspended until further investigation proved either DVT negative or appropriate treatment (e.g. anticoagulation) was given.
Physiotherapy, together with the multidisciplinary team, with validated assessment tools, assume a significant role in recognising DVT/VTE risk
