Preventing and Recognizing Blood Clots

These instructions are for caregivers of Children's Hospital of Philadelphia (CHOP) patients who are at risk for developing blood clots.

Important information about blood clots:

Blood clotting is an important process that is part of the normal healing of injured blood vessels. An imbalance in this process can cause too much clotting. When blood clots block normal blood flow, they can cause pain and swelling. A clot that occurs in the large veins of any part of the body (including the legs, abdomen or arms) is called a deep vein thrombosis (DVT), or venous thromboembolism (VTE). They can also break into pieces and go to the lungs, causing a pulmonary embolism (PE) which can be life threatening.

Certain people are at a greater risk of developing blood clots for a number of reasons. Hospitalized patients are at risk for clots because they are likely to have several risk factors. The more risk factors a patient has, the more likely they are to develop a blood clot. Risk factors include:

• Central lines

• A decrease in mobility (for example, lying in bed for long periods of time, not walking around, being in a cast)

• Dehydration

• Being overweight (obesity)

• Medicine containing the hormone estrogen (example: oral contraceptive pill)

• Surgery within the past 30 days

• Being 12 years of age or older

• Infection

• Active cancer

• Pregnancy

• Inherited problems that make a person's blood more likely to make an abnormal blood clot (thrombophilia)

• Smoking or vaping

Patient instructions:

Notify your healthcare team immediately if you have signs or symptoms of a blood clot or pulmonary embolism. Symptoms of a blood clot include:

• Pain

• Tenderness

• Swelling

• Change in skin color (red or blue/purple)

• Feels "tight"

• Feels warm to touch

A pulmonary embolism (PE), a clot that travels to the lungs, is a medical emergency. Symptoms include:

• Sudden shortness of breath (difficulty breathing)

• Feeling of doom (anxiety)

• Sharp chest pain (may get worse with deep breaths)

• Unexplained cough (may cough up blood, too)

• Rapid pulse (fast heartbeat)

• Sweating

• Fainting

Instructions for preventing blood clots:

Move around

Walk at least 3 times a day. Walking is one of the best ways to prevent blood clots. It helps the blood in the veins move through the body using muscle power.

Wear sequential compression devices (SCDs)

If you are unable to walk or walk long distances, you are at risk for blood clots. To stay safe, make sure you wear sequential compression devices (SCDs) while in bed or when sitting in a chair for long periods of time.

SCDs have two main parts, sleeves and a machine.

• The sleeves are worn on the lower legs.

• The machine inflates and deflates the sleeves.

When the sleeves inflate, they squeeze the legs and help move blood around, like muscles do when walking.

Talk to your team about medicine

If you are at high risk for clots, your team may order an anticoagulant, a medicine that decreases the chance your body will form a blood clot. Examples include heparin and enoxaparin.

To reduce the risk of getting a blood clot:

• Walk around as much as possible.

• Drink lots of fluids.

• If needed, wear SCDs whenever in bed.

• Have central lines removed as soon as possible.

Please contact your CHOP anticoagulation management team with questions or concerns.

Division of Hematology

215-590-3535

Hemostasis and Thrombosis Center

For non-urgent issues, send your team a message in the MyCHOP portal.

Reviewed on June 1, 2023, by Marilyn S. Blumenstein, MSN, CRNP