This page is for information if you have been referred for investigation of a swollen and/or painful leg to see if you have a deep vein thrombosis (DVT). This will be done via the Medical Rapid Assessment and Care Unit (RACU) within Forth Valley Royal Hospital.
What happens after referral?
A RACU Staff Nurse will call you with a date and time for investigations or review. You should receive this call by the end of the day after your referral; this may be on a withheld number. If you do not receive a call, please call the RACU team on 01324 567077 to say you are waiting to be given an appointment.
What if my symptoms get worse?
You should attend the Emergency Department if any of these symptoms occur:
- Shortness of breath
- Racing heart (Palpitations)
- Sudden chest and/or back pain
- Blackout
- Coughing up blood
What is a leg DVT?
A leg DVT is a blood clot in one of the deep veins of the leg. This clot can block the flow of blood and may cause swelling, pain, redness, and/or increased heat in your leg. The symptoms can vary from person to person.
What causes a DVT?
DVTs are more likely in people who are immobile, such as after illness, an operation, hospital stay, or even a long journey. DVTs can be a complication of medical conditions, or medication like the contraceptive pill or other hormone treatments. A family history of DVT may also increase your own DVT risk.
Why do we need to treat it?
The main reason for treatment is to prevent the clot travelling to the lungs, causing a pulmonary embolism (PE), a blood clot in the veins of the lung(s). A PE can be life threatening. Occasionally, a DVT can lead to long-term leg issues, such as chronic swelling and venous ulceration, even if treated effectively.
Why have I been given a blood thinning medication?
Until we have test results, we treat patients as if they have a DVT, using rivaroxaban tablets, or sometimes enoxaparin injections. Some patients do not need more blood thinning medicine if they already use one. Rivaroxaban tablets are taken with food. If a tablet is missed, and it is the same day, take the missed dose once remembered, which might involve taking two tablets at once. If a missed dose is only remembered the following day, do not take an extra tablet.
Blood thinners rarely have side effects, however, you should report any of the following if they occur:
- Passing black stool, blood in the stool or urine
- Unusual bruising
- Vomiting brown coffee granule type vomit/fresh blood
- Nosebleeds
- Bleeding that does not stop itself
How do you know if I have a DVT?
A clinician will assess you and decide whether you require investigations such as a blood test or a scan.
What is a D-dimer blood test?
This is a blood test which can help to identify if it is likely you have a blood clot in your leg. A negative result usually indicates that you do not have a clot. A positive result means you may have a clot and need further investigations.
What does an ultrasound (Doppler) scan do?
A Doppler scan looks at the blood flow in the leg veins to see if you have a clot. This scan involves a smooth probe being moved over gel up and down your leg from the upper thigh to behind your knee, and sometimes also the calf.
What happens if I am diagnosed with a DVT?
If you have a DVT, you will be advised to start a blood thinning medicine. For most patients this will be with rivaroxaban tablets. The RACU clinician will discuss with you how long it is recommended you continue with the blood thinning medicine. You will also have a further assessment to rule out an obvious cause of the DVT.
What if a DVT is not found?
Most patients are found not to have a DVT and no other cause for their symptoms is found. The Symptoms often settle with time. If you continue to have troublesome leg symptoms, you should contact the original person who referred you if this was at an Outpatient appointment, or seek Primary Care review.