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Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Venous Thrombosis IV: Nursing Management01:30

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Venous Thrombosis I: Introduction01:30

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulmonary Embolism III: Nursing Management01:27

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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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A Roadmap to Implementing Venous Thromboembolism Risk Stratification and Mitigation.

Gabriella E Glassman1, Michael Z Zhang2, James R Patrinely2

  • 1From the Department of Plastic Surgery, Vanderbilt University Medical Center.

Annals of Plastic Surgery
|August 13, 2021
PubMed
Summary
This summary is machine-generated.

Implementing a modified Caprini risk assessment for venous thromboembolism (VTE) in outpatient plastic surgery significantly improved protocol compliance. Tailoring the VTE prophylaxis protocol to institutional workflow is key for successful patient safety initiatives.

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Area of Science:

  • Plastic Surgery
  • Thrombosis Research
  • Patient Safety

Background:

  • Venous thromboembolism (VTE) poses a significant risk for plastic surgery patients, impacting morbidity and mortality.
  • Despite recommendations for VTE prophylaxis, successful implementation of protocols remains challenging.
  • An academic center sought to reduce VTE burden through a structured risk assessment protocol for outpatient procedures.

Purpose of the Study:

  • To implement and assess the compliance of a modified Caprini risk assessment protocol for VTE in outpatient plastic surgery.
  • To evaluate the impact of protocol modifications on screening compliance rates over a 12-month period.

Main Methods:

  • A modified Caprini risk assessment was applied to all eligible outpatient plastic surgery patients over 12 months (August 2018-July 2019).
  • Chart reviews were conducted monthly to assess compliance, defined as documented VTE Caprini screening.
  • The study involved three phases, correlating protocol changes with compliance rates.

Main Results:

  • Overall VTE Caprini screening compliance reached 44.8% over the 12-month study period.
  • Compliance increased from 11.1% (initial visit screening) to 47.1% (day of surgery screening) and finally to 61.3% (electronic medical record integration).
  • The median Caprini score for the patient population was 4, indicating a moderate risk.

Conclusions:

  • Standardizing VTE risk assessment is crucial for enhancing patient safety and outcomes in plastic surgery.
  • Adapting VTE prophylaxis protocols to institutional workflow and needs is essential for successful implementation and sustainability.
  • Continuous review and modification of protocols are vital for maximizing departmental engagement and ensuring long-term success.