Deep Vein Thrombosis (DVT) & Pulmonary Embolism (PE)

Who can be treated through the Thrombosis Anticoagulation Program?

Anyone who has a confirmed or documented deep vein thrombosis or pulmonary embolism may be considered for outpatient treatment through the Thrombosis Anticoagulation Program. Often these patients are seen in the Emergency Department. Inpatients developing acute deep vein thrombosis or pulmonary embolism, who are otherwise ready for discharge may also be eligible for outpatient treatment.

How do I gain access to the Program?

Contact case management coordinators, Irene Yorke or Lisa Gray at (902) 473-7985, or the hematologist covering the consult service. For nights or weekends/holidays, contact the hematologist on-call through hospital locating (902) 473-2222. Once the patient is seen and assessed by a hematologist and case management coordinator, arrangements will be made for the patient to begin treatment immediately.

What is the current management of Deep Vein Thrombosis (DVT) & Pulmonary Embolism (PE)?

Deep Vein Thrombosis (DVT) must be confirmed by compression ultrasound or venography and Pulmonary Embolism (PE) is confirmed by either a VQ scan or a Spiral CT scan. In the not too distant past, patients were admitted to hospital and treated with unfractionated intravenous heparin for approximately seven to ten days. Thanks to research, new medications have been developed to treat acute DVT and PE. Presently at the QEII, Fragmin (Dalteparin), is the most commonly prescribed Low Molecular Weight Heparin (LMWH) used in the treatment of acute DVT and PE.

Once a patient is deemed eligible for outpatient management, treatment begins immediately. The case management coordinator will arrange for the patient to receive the fragmin injections, via self-injections, Home Care, or Medical Day Unit. Teaching, (verbal and written material), regarding potential side-effects of the medications is given. The patient is given a prescription for warfarin, with instructions to start the medication that evening. Patients with DVT or PE can expect to be on the LMWH for a minimum of five days, until their INR reaches 2.0 - 3.0. The case management coordinator monitors the blood results and manages the warfarin dosing in consultation with the hematologist. Once the patient is on a stable dose of warfarin, their management will return to their family physician.