DVTs

Of course I learned a lot in PT, or I wouldn't have my license, but I think the thing that stuck with me the most is CHECK FOR DVT. I remember sitting in the hallway at Belmont waiting to take many a lab practical.I would always be running through a mental check list of things I had to make sure to do in order not to fail. One of the things that was on my list was checking for DVT (deep vein thrombosis aka a deadly blood clot). It didn't matter what the lab scenario was....I was checking for DVT. If they had knee surgery - check for DVT. If they had Shoulder Sx - check for DVT. If they had a headache -- Check for DVT. Of course those last two are overkill but I was making sure I wasn't going to fail.

Also, we are taught to touch the patient...meaning the problem may be a simple as fracture that of course is painful to touch.

Today today those two principles came into play. One of my previous patients came into the clinic from the plant floor complaining of having a charlie horse in his calf for 4 days. I leaned down to touch it and knew immediately that is was not a cramp. I was sure it was one of two things: a blood clot or compartment syndrome. Both are not good and need immediate medical attention. The Goodyear nurse and I finally convinced him to leave work and go either the ER or to his primary physician. Later in the afternoon the nurse came to tell me that the patient was admitted to the hospital with a blood cot. The scary thing with those is they can dislodge and he could be dead within seconds.

So thank you Dr. KRob for failing us when we forgot to test for DVTs. Here is an illustration of a DVT and some common signs and symptoms.

When blood clots outside a blood vessel, this is a normal process which protects the body against losing blood. If the blood clots inside a blood vessel however (as with DVT), this can be dangerous.

Symptoms of DVT:
In most cases of DVT, the clots are small and do not cause any symptoms. The body is able to gradually break down the clot and there are no long-term effects.
Larger clots may partially or totally block the blood flow in the vein and cause symptoms such as:
1. Swelling of the calf

2.Pain in the calf: calf pain that is noticeable, or worse when standing or walking

3. Redness and/or a glossy appearance to the skin

4. Pain in the calf when squeezed

5. Warmth to the touch

These are not always a sign of a DVT, but if you experience them, you should seek medical advice. Like my patient today he only had swelling and pain.

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