There are a few simple, minor modifications to the pathway that GPs could make which would really help both patients and the Ultrasound dept match capacity and demand.
The delay between clinical assessment and the scan, although an irritation, does allow a negative d-dimer to test to weed out unnecessary scans and free up valuable capacity, and ‘holding anticoagulation’ can keep patients safe.
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GPs are therefore encouraged under the 2014 Locally Enhanced Service scheme to manage newly presenting DVTs in primary care according to the following pathway.
Please click the relevant flowchart box to be taken directly to textual information.
To access the AEC pathway for Upper Limb DVT please follow the link to the Urgent Care section.
A diagnosis of DVT is usually suspected in patients who complain of a painful swollen limb. However, the clinical picture can vary widely and none of the clinical features are sufficiently specific to be a diagnostic. Less than a third of patients referred for tests after initial history and clinical examination prove to have a DVT.
Consider the following in your differential diagnosis:
Patients with a diagnosed unprovoked DVT will need further assessment for a possible underlying cause.
Please see the Patient and Carers Information and Leaflets section.
Please see the National and Nice Guidance section.