Rapid Care for DVTs at the Vascular Surgery Clinic

The Vascular Surgery Clinic is able to rapidly assess and treat patients for deep vein thrombosis (DVT) as an alternative to referring them directly to the emergency department. This care process will allow the patient to be diagnosed and treated at the same visit. The guidelines are below:

What are the symptoms and/or conditions of a possible DVT?

• Acute onset extremity edema, discoloration, and pain
  • Edema can become progressively worse and more extensive
  • Unilateral limb
• Often a known provoking event, such as decreased mobility, long distance travel, recent surgery/trauma, or hypercoagulable state
• Prior DVT or SVT increased the risk especially if not on anticoagulation.

What are the next steps for the referring provider?

• When index of suspicion is high, order a venous ultrasound of the affected extremity. For example, in a patient with suspected lower extremity DVT, you should order: VUS extremity venous abbreviated of the affected limb.
• If there is a positive result; DVT or SVT in a long segment of GSV or closer to the deep system, the vascular tech will notify the ordering provider while the patient is in the vascular clinic.
• The provider at that time may choose a vascular surgery evaluation including starting anticoagulation therapy. This will require a referral to be sent to the vascular surgery office.
• If there is a need to have further work up for hypercoagulable state, the vascular surgeon will refer the patient to Oncology & Hematology clinic.

Are there situation when you should send the patient to the ED instead of to Vascular Surgery?

Indications for sending the patient to the ED include:

• Chest pain and/or shortness of breath with recent diagnosis or suspicion of DVT
• Signs of limb ischemia
• Bleeding while on anticoagulation for DVT
• Weekend, or Weekday after 4:00 PM*
  • If ultrasound can be completed by 4:30 PM on a weekday, a vascular surgery provider will make a reasonable attempt to evaluate the patient in clinic.

Who should you contact if you have immediate concerns about the patient?

Providers can call the vascular surgery clinic at 425.690.3498 and will be connected to a provider if there is one available. The back line for the vascular clinic is only accessible to providers on the VMC main campus. It is 125.0560. (Note: If you’re calling from outside Valley, call 425.228.3440 then enter that number when prompted for the extension).

Where are the Vascular Surgery and Pacific Vascular Imaging locations?

The Vascular Surgery Clinic is located on the main Valley Medical Center campus, on the 4^th-floor of the Talbot Professional Center. The clinic space is shared with Pacific Vascular Imaging, allowing for streamlined patient service and convenience. The address is: 4011 Talbot Rd S, Suite 430, Renton, WA 98055.