Deep Vein Thrombosis (DVT) OSCE Clinical Examination | Plus DVT risk factors, diagnosis & treatment
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- čas přidán 3. 09. 2022
- In this video Dr O'Donovan demonstrates how to examine a patient for a possible Deep Vein Thrombosis (or DVT) in the community.
A DVT is a clot that forms in one of the veins. This can dislodge, then travel into the bloodstream and towards the lungs, where it can cause a pulmonary embolism (PE); this is a blockage in the pulmonary circulation that can be life threatening!
This video contains the following sections:
1. A practical demonstration of how to carry out this focussed examination - including exemplar photographs of clinical signs of a DVT
2. Risk factors for developing a DVT
3. How a DVT is diagnosed
4. General information on treatment of DVTs
5. Tip on DVT prevention
Resources:
Examination resource page: almostadoctor.co.uk/encyclope...
NHS website - information on DVT: www.nhs.uk/conditions/deep-ve...
NICE Clinical Knowledge Summary on DVT (for UK users): cks.nice.org.uk/topics/deep-v...
Wells Score: www.mdcalc.com/calc/362/wells...
Research paper: cdn.ps.emap.com/wp-content/up...
Information on Well’s score sensitivity and specificity: gpnotebook.com/en-gb/simplepa...
If you enjoy this video please subscribe to the channel, like this video and if you have any questions after watching this video leave a comment - I will get back to you as I reply to all comments!
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Disclaimer:
The video is intended as an educational resource only. The information within this video or on this channel isn't designed to replace professional input, so if you have any medical issues please consult a medical provider. No professional relationship is being created by watching this video. 'Dr. O’Donovan Medical Education' cannot give any individual medical advice. All information should be verified for accuracy by the individual user. 'Dr O’Donovan Medical Education' accepts no responsibility for individual interpretation of data, although it is always accurate to the best of his knowledge at the time of the video being published. This is an EDUCATIONAL video. Images are used in accordance with fair use guidelines.
Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. 'Doctor O'Donovan Medical Education' accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.
Content provided via CZcams is for general information purposes ONLY. Information videos are not produced to provide individualised medical advice. Medical education videos on Doctor O'Donovan are not a substitute for professional professional medical advice, diagnosis or treatment. NEVER ignore professional medical advice because of something you have heard here. ALWAYS consult your doctor regarding any concerns about your condition or treatment.
Your advice to examine the patient standing, and from behind, is essential. I was examined, lying on my back, by a hospital junior doctor who missed upper rear leg swelling which of course was not visible when lying down. The doctor also missed an upper far left blackened vein area because she was standing on the right side. Practitioners often look for standard textbook symptoms, but forget to use their common sense.
Sorry to hear of your experience but thank you for taking the time to share it here. Wishing you the best
I have clots in my lungs they removed some of the clots from my legs and put me on Ellequis and said this should take care of the clots.but my legs keep sweep ing up very bad.and I can't walk right I'm hurting .😢
@@pata7957
How long did you take Eliquis ?!? And after sometimes, did you redo the ultrasound or not ?!?
@@DoctorODonovan Would DVT cause tremor or spasms in the calf? I Also feel a spasm like in my left glute. Any advice is appreciated
Had D Dimer test proved positive had pain in calf but person only checked from my groin to my knee ???
A week later returned to hospital and person was checking same area until I explained pain was in my calf , upon doing this she found clot
In other words it pays to speak up
Thank you for a very clear and precise informative approach to this presenting complaint.
Glad it was helpful!
Terrific video ! This Pharm.D. finds this presentation clear, insightful, and personable ! Cheers !
Thank you kindly!
This is the BEST video about DVT. The most complete one! Excellent!
Wow, thank you!
Wow, the best Dr. Ever.
Thanks.
I love your video 😍
Glad you enjoyed it!
This video deserves 373K views ...
This is most complete and well explained video I found on CZcams for DVT.
I wish you were my teacher ..
Subscribed.
Thank you so much Eddy. What a wonderful comment. This has made my day. I have another video in a few weeks on the abdominal exam.
I am in love with your detailed explanation... congratulations!!!!! You are awesome...
Ahh thank you Marcelo. That’s very kind of you.
Thank you for this great presentation!
My pleasure Diane !
Thank you for this helpful video. Can you please explain what differentiating information you are looking for when checking the pulse on each side?
Trainee ANP here. Really useful, thanks!
These is best vedio of dvt
Great job... I really appreciate your efforts... keep it up ❤❤❤
It’s a pleasure
I have pbl tomorrow and this was absolutely useful !thank you
Glad it was helpful!
many thanks
It’s a pleasure
Tqs you sir your detailed explanation of procedure congratulations ......
A Pleasure
Thank you so much
You're most welcome
Thank you Doctor
A pleasure
Excellent explanation of a potentially serious condition hopefully I have caught. this early
Thanks Arthur.
Awesome video!
Thanks!
Thank you.
You're welcome!
Perfect Video - I wish you were my doctor!
Wow, thanks!
Great video
A great videographer
I went to A&E a few weeks ago with pain and 8cm swelling in my leg, I told the doctors that I hadn’t had an injury, that I had factor V Leiden but was already on warfarin because I’d had DVTs in the past. They did x-rays which turned out fine they said the chances of me having a clot whist on blood thinners was 1% but arranged a ultrasound sound the next day it was confirmed immediately during the scan that I had a clot in my thigh. It took another 3 hours before a doctor saw me to come up with a plan to change my blood thinners from warfarin to Apixaban and I had to inject myself with fragmin. They didn’t do any blood testing in A&E.
The thing is that at the time I was trying to lose weight and had lost 20kgs. I was going on 5 mile walks daily to help with it, and I had never smoked and still ended up with a DVT.
Beautiful video
Thank you
Most valuable Thank u
No problem
love your content sooperb videos love from india
Thank you !
Thank you for your informative video. Question, what type of doctor do you need to see? GP or a Cardiologist? TIA
I had a ankle fusion surgery on my right ankle on April 26 and 3 weeks after the surgery I had an ultrasound done and they found a DVT on my lower right leg, my doctor put me on blood thinners for 21 days. But my leg where the blood clot it at it still hurts and it burns very bad. How long does it take for a blood cot go away?
Love video. Im on Eliquixs for DVT the past five months. It is roughly $10 per tablet twice a day. If I am on long term, is it safe to change blood thinners which are less espensive? Are there risk factors?
Perfectly explained❤❤❤.Sir i want to ask can we put a warm bandage on calves and massage it for relieving pain. Also if could suggest suitable painkiller?
Thanks
I've recently been diagnosed with this. The doctor never touched me once in 7 visit is that normal I found out after hobbling back from the doctors and going to hospital I've still had no tests and I'm coughing up some small amounts of blood I can not walk 4 months ago I was very fit I trained very hard I thought it was a stran and without any examinations of any type until I was at the hospital wear I had only a blood test no scan I was told my blood work is bad do you think this is medical negligence I think I'm on a short string and would love to hear your thoughts I'm in a great deal of pain now can you tell me what to expect I'm 48 and was extremely fit all so I have not had the cv 19 vacation
1. How can we differentiate between DVT and cellulitis? 2. Is it possible to diagnose DVT and cellulitis at a time in a single limb?
شرح ممتاز ❤
Thanks for watching.
I have little random swellings on my leg on four different places but no pains...what could that be? Been that way for about 2 months now
Doctor, from some years to now stick shift transmissions have being almost banned, although it demands far more leg movements than automatic ones, like pushing the clutch pedal and moving the accelerator
Regarding people who need long driving time as a daily basis, including but not only truck drivers, would automatic transmissions presumably increase the risk of DVT?
Would be the case that this choice of the Automobile Industry will increase the incidence of DVT?
Does this same test apply if you believe you have a clot behind the knee. This just came on within a week and is getting worse. The pain is horrible and does not go away laying down or elevating
I was told I needed to use a vibration plate to help my lipedema/ lymphedema . My legs feel so much better. However I did have testing done a few years ago. I do have DVT. After my testing my doctor has not said a word about it. No treatment or anything was mentioned. So I have not taken it seriously. Is it safe to use a vibration plate? My leg that hurts the most feels amazing. However I'm not trying to dislodge anything. I take no medicine for it.
I'm suffering from dvt in both legs since 7 years due to APLA syndrome but this video is actually usefull
I am suffering too, can you advice me on this disease, anything will work...please...
@@user-ji1ge7hi7s it actually depends on the patient only that for which reason they are suffering from dvt because sometime it happens in pregnant women and some time due to blood clotting disorders or sometime due to long sitting
@@user-ji1ge7hi7s and I'm suffering from dvt Because I have blood clotting disorder so I'm taking blood thinner's since 7 years
If i sit at my.job all day, do compression soxks work?
Perfecccct and brilliant ❤️❤️❤️❤️❤️❤️
Thank you 🙏🏻
Can you have this on both legs at the same time?
why are we checking between each toes? can DVT simply present as sudden pain, engorged superficial varicose veins, followed by localized swelling and bruising 2 days later with little to no pain, and no claudification???
I have DVT in my leg and thigh since last month, my leg and thigh swell too much, and I am getting treatment getting injection Enoxaparin sodium 0.8ml ever 12hrs, and tacking Warfarin 2mg 1 tablet every day, since 2weeks, so can I do light exercise little bit every day or what you recommend Sir. Thanks, from Bangkok Thailand
What are the medicines that can used for a dvt patient
Thanks a lot for a very informativ video! I have two questions Dr.O´Donovan and I hope so much you can give me some answers on those. My physicians cant or wont!
#1: I am a healthy person (52 yo.) without any diseases. (I eat healthy and do a lot of sports) Suddenly (3 weeks ago) I got a DVT (no sx than big respiracion problems) and multiple pulmonary emboli. All blood tests and analysis came out normal.
You suggest looking for hidden cancer ( positiv family-hx) and you suggest CBC, liver testing and the rest (I am sorry ) I diddent understood. Can you mention what kind of tests you would do on such a px?
#2: Several person are thinking my problems are caused by C19 vacccines (3x) or that I had Covid in february 2021 (sx like a mild flue and ridd of it after 2-3 days).
You think theres is a connection for my problems?
Greetings PG
C19 vacccines (3x) or that I had Covid. your answer
I am scheduled for ultrasound as my dimer levels are elevated (81 ) and there is an idea that I may be a candidate for a DVT.
I suspect I have DVT because I have pain in my calf when I stand up and walk but it goes away after about a minute or 2 of walking , also no swelling or redness at all, but as soon as I rest my leg for longer than 5 mins the pain comes back when I stretch or stand up again
Is there any examination at home to check the patient of LE DVT disappeared after taking Apixaban medication .
Thanks in advance
I believe I have a blood clot in my left foot. It’s swollen and hot. I went to the doctor and she ordered an x-ray and a sonogram. The x-ray was for my foot and sonogram was of my leg. The sonogram did not show any clots in my leg. But they didn’t sonogram my foot. It’s been a week today. It’s still sore, slightly, pink and warm. I’m taking an 81 mg aspirin daily. I’ve been less active because I’m severely anemic and need to take iron and vitamin c daily. The doctor didn’t tell me to take aspirin nor did she do anything but look at it, touch for temperature.
Can you do a video on swollen lymph nodes and how to treat them. Please Doc.😎
Yes I will be making a video on examination of the lymphatic system in the coming months . Thanks for the request
@@DoctorODonovan
Sounds great!
Dr I have no swollen or any redness on my right calf I'm 46 by the way. But I've been having for 3 weeks now the same achy calf I'm starting to get worried I do have vericose veins on thar right calf what can it be?
I cant give individual advice here I am sorry. Please speak to your doctor if you have concerns.
Would dvt interfere with vaccinations - like the rabies vaccination?
Hi am have dvt for 6 months now am taking warfarin .when I stop my blood count go down to zero.am very active. Always on my legs. During the my legs are paid full I try to elevate it for atleast half an hour. An my big toe is very painfully. When I take a off day an stay in bad it feel little better .but when am on my legs thenthe pain start all over again.an my leg always felt cold.
What is the right way do help
Hey here..my dad has difficulty walking after a pus removal surgery which made him immobile for 2 months he has colour change in leg, swelling, less sense in tip of toes, recently he has difficilty breathing and cannot even stand for 5 mins stright and doctors are not giving any conclusive answers and avoiding it what should i do and hw should i take it forward any suggestions?
I was pregnant a month and half ago. My feet and legs swelled up pretty bad and my OB kept saying it was normal eventhough this was my 4th baby and I'd never had swelling such as this time. They always check for protein in urine and BP and I was fine, until I wasn't, I was induced at 38 weeks due to BP being super high. I'm on BP meds but I'm still seeing swelling in my legs and ankles and feet. I don't have any pain on my calfs , however. I saw my pcp and asked about this and my pcp says it's more than likely not DVT but my BP ( which is now controlled) or my medication. Is it possible to not have any common symptoms and still have dvt
If you're obese you're likely to have chronic pelvic thromboembolism that many clinicians down think about and can be found on post mortem like recent UK case. So ask to check for D dimer at the very least
@user-do5ie4dw8s thank you! I've actually been following up with my pcp and have been off meds since December 22. Swelling has subsided and I've been doing well so far. They did do a D-dimer and everything was well thank God
@@maribelpacheco9851what is d dimer please?
Wow. I am pregnant with my 4th currently and recently have seen some varicose veins that just look CRAZY! Red, Swollen, and was very painful. My OB refuses to test my urine because my BP is “Normal” and I have talked about my spider veins being a weird problem this pregnancy. And I just have a feeling this is something new.
Hi doc
I'm 39 and had a DVT and pe dvt in pregnancy and the PE out of pregnancy. I just had a baby 3 months ago via C-section but 4 days ago I start getting pain in my left knee it's a bit painful to walk or stand on it should I get it checked out??
What does alcohol to cause further problems to a DVT?
Hi Doc O'Donovan, is DVT completely treatable disease wherein the patient can go back to former self where he/she does not need to be dependent on medicines or does this need active management (chronic condition) for a long time?
See NICE guidelines: "Specialists will make clinical decisions such as the choice of anticoagulant and the duration of treatment.
Treatment is usually continued for at least 3 months, but duration may be longer depending on whether the DVT was unprovoked (no obvious, transient risk factor identified) or provoked (caused by an identifiable, transient, major risk factor). "
@@DoctorODonovan Thank you Doc 🙏
It's so confusing which order/what to do. The blue book doesnt have DVT, geekymedics has a typed up version that is different - eg. Radial pulse, BP, Upper limbs, Neck/chest inspection esp for foreign bodies
There’s not necessarily a “correct way” . Just have a methodical approach that captures all key components and make it slick and professional.
Hello Doctor.
Thank you for the helpful video.
Just have queries... In Year 2021, I underwent an operation,- polyps were removed from my colon. After operation, I suffered much.
I was diagnosed of provoked dvt (bilateral lower extremities) and P. E. Had d dimer, ptt test and had also IVC filter for 1 month, meds- apixaban for 6.mons.
Now, I'm cleared from P. E and dvt. After thorough blood test, procedures and medications.
My question is that.
1) Is there any possibility for recurrence of dvt and PE?
2) as per doctor advice to have prophylaxis injection 4 hrs before long hrs travels ( that is during flights which is usually 10 hrs direct flight to my country).Should it take the injections?
3) Why is it unti now I have difficulty walking, and still feel. Pain when I walk. Dr said it's. Post thrombo syndrome, just exercise as tolerated. I can't take pain killers always, as I should be careful w my kidneys
As after operation my kidneys shutdown and had emergency dialysis.
Appreciate your kind reply and advice. God bless!!
Thank you very much.
Thank you so much for watching the video and taking time to leave a comment. Unfortunately (and I know this will be frustrating for you), I am unable to give individual medical advice out on this channel. This is because of medico-legal reasons, not knowing your full case, circumstances and it would be unethical of me to do so. I have to advise that you speak to your own health provider (e.g. doctor, nurse) so that they can properly assess your case. Thanks for understanding.
I have superficial vein thrombosis. Is that as dangerous as dvt?
So check this out. Im 27 year old male. Had the worst leg cramp you could imagine the other night. 2 days later, my left calf is slightly swollen and very sore. The dr at my local ER brushed it off. Sent me home. Should i still worry?
Is it better now? If not maybe see another doctor
@@may04b35 yes it's better now🙌 thank you
Great Video
What Is the Wells cut off score please ?
Hi, I use this tool : www.mdcalc.com/calc/362/wells-criteria-dvt
hey doctor iam a dvt patient and i want to know that will my leg to become the same leg before dvt ? i mean that my leg always sweled does it become the same as it was before dvt ?
Following
I add a blood clock in the back of my knee ... I don t smoke, not over wait plenty of exercise and i have a drink on occasion but that all . Never enough to get drunk .. so why did i have this ??? Good thing that i felt it
Hello Dr. Please how long can it take me to start walking briskly. Am diagnosed of an DVT. A male of 39yrs. I have no history of DVT. Nor family history. The hospital started a fragmanine 5000 IU for 4 days. Am on xaralto 20mg. Pls how long can I do exercise and active work life. Am from Ghana
Thank you so much for watching the video and taking time to leave a comment. Unfortunately (and I know this will be frustrating for you), I am unable to give individual medical advice out on this channel. This is because of medico-legal reasons, not knowing your full case, circumstances and it would be unethical of me to do so otherwise. I have included the general resources I used to make this video in the description box but I have to advise that you speak to your own health provider (e.g. doctor, nurse) so that they can properly assess your case. Thanks for understanding.
Dr. Am agyemang Badu and have been diagnosed of DVT, I have been put on warfarin, but my left leg keep swelling during the day while am not sleeping but the swelling reduce when I take the warfarin at night, I want to know how dangerous my situation is.
Please speak to your doctor
can a dvt happen in the front of the leg like in the middle ?
In theory yes
Sir my daughter is dvd patient. Pleas
My nerves are swelling under my stomach at top of my dvt leg
Sir i can feel like ihave dvt iam very much tenced.
Hi sir
We need u r help
It’s happened with my friend on 2411/2023 and call 999 and lady didn’t operater said call 111 and he called 111 they said someone will call u back. And he was in full of pain when no one call back him then he call Bridges lane GP Battersea and lady Dr required. If person he can come so she can exam his leg as soon she was around 1512 she called. ECU for his DVT .
They gave him Rivaroxaban for3 months and done cheats X-ray 2nd day 25/11/23
Please advise us for his life or where we have to control if someone think happ
Can A DVT patient conceive ??? Along with complete abservatio..please tell me I am a DVT patient and taking xerlato table 10 mg daily
I am sorry but for medico-legal and ethical reasons I can't give individual clinical advice on this channel. This is designed as a general education channel. Please consult your doctor or health provider for individual questions and concerns. I hope you found the video informative nontheless. Best wishes.
Please i need your help
?
Heparin usage?
Sorry I don’t understand the question…
Thanks Doctor I have a DVT to my left leg now is about 3 yrs no change and I am on warfarin please help me does operation necessary or not
Can large fibroids cause swelling in the legs and lead to developing a DVT?
American Doctor: " Oh really, ok, you need MRI/CT Scan, see me when done, Then MRI comes, He/she says: You need surgery... but Doctor, I cam here for my Bald spot!
Sir, I am 20 years old male And I have DVT and had Surgery on IVC Filter please help me to recover as soon as possible
Can you feel this worse when sitting for hours straight?
Possibly
I wiil go to urgent care ed tomorrow morning for ultra sound but until then should i stay off my feet or keep moving
I have calf pain R more like soreness unilateral
Soreness like muscle strain slight swelling
Do i keep moving or restrict walking til i see my provider???
I have an active DVT in my left leg.
One of the clots is just above my calf and the other one is behind the knee.
My leg is in constant pain. I'm on pain killers and Eliquis/Apixaban 5mg twice a day.
I've been on the tablets for 3 weeks now and I've been told to be on bed rest by my GP.
My partner and kids are getting cranky with me because I missed a few events as it is December the festive season. My eldest daughter had a fight with me because I didn't go to my twins last day at primary school today. I was really upset already but I felt really stressed, sick, headache etc.. I checked my stress level on my smart watch and it was 99bpm.
My question is..
Is it ok for me to go for walks, drives..
What's the meaning of bed rest, what can and can't I do..?
I have an appointment with my GP in one weeks time, I couldn't get in contact with my GP to ask him if it would it be ok for me to go out or how strict is bed rest..?
I have obviously been walking around the house to get things and my leg throbs/aches all the time.
What are the right things to do..?
I wish you could be my doctor where are you located?
U.K. based
@@DoctorODonovan awwww too bad I’m in Canada too far thank you for replying anyways 🥰👍
Doc,please help me,I go to doctor but they just gave me medicine,diosmin hesperidin I know it's dvt,cause of my varicose vein,what shall I do? Pls help me,
Hi I’m sorry but I can’t provide individual medical advice online
You also get DVT by sitting too much and playing fortnite days and nights without any sleep
Yes
Hello sir i am from pakistan,,i am very happy and hopefull to hear you here,,sir my wife suffring with DVT from last 8month in Left leg repots and treatment record i have but still not recoverd ,,i wish to show you her reports for better curement i hope you will help me,,through e mail or whats we may connect please help us,
Never do clinical examination in an suspected DVT case.🦵
Thanks for watching.