Measures of thrombosis prophylaxis

The measures depend on the risk profile of developing a thrombosis and on the willingness of the affected person to cooperate (compliance).

Note

General information on the topic of thrombosis prophylaxis can be found on the homepage on the topic: Thrombosis prophylaxis

Mobilization

A significant risk factor for the development of a blood clot is immobility. Immobility causes the blood flow to slow down, thus increasing the blood’s propensity to clot. The aim is therefore to increase the blood flow, especially the blood return flow to the heart.

Immobility affects, for example, the earlier mobilization begins, the sooner the risk of thrombosis is reduced. Mobilization stimulates the circulation and activates the muscle pump. For the muscle pump to function properly, the venous valves must be intact.

The veins are embedded between muscles, especially in the extremities. During muscle contraction, the muscle shortens and thickens, compressing the vein. If the venous valves are intact, the blood can only flow in one direction, namely back to the heart.

  • Bedside cabinets,
  • Wheelchair users,
  • People after an operation,
  • People with fractures,
  • People with (chronic) pain etc.

Storage

Another simple measure to promote venous return is storage. For example, if a patient is strictly bed-ridden due to his or her illness, the legs can be raised, e.g. with a pillow, to increase the return flow. An angle of about 20° is recommended.

This is a simple and generally well accepted measure. The backflow can be increased by 20 – 30% due to gravity. Elevation is also useful for conditions such as fractures or paralysis. This applies not only to the legs, but also to the arms. Elevation should not be used if the patient suffers from a disease that hinders the blood flow (e.g. arterial occlusive disease).

Brushing out the veins

In addition to the other measures, stroking out the veins has a supporting effect. The leg is lifted slightly and then passed on to a second person, e.g. nurse, physiotherapist, etc. Starting from the heel and moving towards the hip, the leg is gently lifted and spread out by a second person, e.g. nurse, physiotherapist, etc., applying slight pressure.

A contraindication is given for varicose veins (varices). There are three options for venous compression: With venous compression therapy, the pressure in the periphery, i.e. at the foot, must be higher than proximally (towards the thigh), because the blood should not be compressed but the flow should be promoted. After performing venous compression, it is important to control the blood flow.

If “tingling” or pain occurs, a doctor must be consulted to control the blood flow in the legs. In addition, the type and pressure of venous compression must be selected in such a way that sufficient blood supply is ensured. Vein compression is often perceived as unpleasant and requires a high degree of willingness to cooperate (compliance).

  • Antithrombosis stockings
  • Compression stockings
  • Compression bandages through elastic bandages