Taking a trip to the emergency department (ED) is stressful and potentially costly – but it can be lifesaving. For patients with deep vein thrombosis (DVT) or pulmonary embolism (PE), it’s especially important to receive treatment in a timely manner.
When should you go to the ED?
If you suspect that you have a blood clot or experience any of the signs and symptoms, you should consider going to the ED.
Signs of DVT include:
- Swelling of the legs, ankles, or feet
- Discomfort, heaviness, pain, aching, throbbing, itching, or warmth in the legs
- Skin changes in the leg such as discoloration, thickening, or ulceration
Signs of PE include:
- Sudden shortness of breath
- Chest pain
- Coughing up blood
- Rapid or irregular heart rate
What can you expect in the ED?
While every patient’s ED trip will be different, there are a several things that you can expect when you visit. First, a medical professional will take your health and medication history. The doctor treating you will need to know what medications you take and how often. This information is especially important if you end up at an ED away from your home, in another state, etc. After discussing your medical history, the doctor will examine you and may ask some more detailed questions about your symptoms. Imaging is typically the next step after the physical exam. An ultrasound is the most common diagnostic test for DVT and uses sound waves to create a picture of the arteries and veins in the leg. Doctors also can order a blood test known as the D-dimer test. Computed tomography (CT) scans are typically used to diagnose PE.
While you’re in the ED, you may be seen by multiple healthcare providers along the way, including doctors, nurses, and physician assistants. If you visit a large teaching hospital, you may also be seen by clinicians in training. All of these medical professionals are a resource for you. “Don’t be afraid to ask questions in the emergency room,” says Dr. Jeremiah Schuur, Chair of the Department of Emergency Medicine at the Warren Alpert Medical School of Brown University. “Since you may see multiple providers, it’s a good idea to ask questions or clarify things to make sure you understand what the doctor is considering and what the plan is.”
Will you be admitted to the hospital or sent home?
If a DVT is confirmed, you may be discharged and sent home with injectable or oral anticoagulant medication (sometimes called a blood thinner). That said, every patient is different, and you may be admitted to the hospital if the ER doctor believes it’s necessary.
Some patients with PE may also be sent home, according to Dr. Schuur, although the majority will be admitted. Studies have shown that it’s safe for certain patients to be discharged, such as those with a small PE and no other health risks. (This discharge practice is more common in Europe than in the U.S.) It’s safest to assume that you’ll be admitted to the hospital for treatment if you have a PE.
If I’m sent home, what do I do after my ED visit?
After your visit to the ED, it’s important to follow up with your primary care provider (PCP) within the next several days. Your PCP can help guide the next phase of your treatment and may refer you to a doctor who specializes in cardiovascular disease.
The bottom line
Take your symptoms seriously. The ED is there to help you in times of need. It’s always better to make the trip and have a blood clot ruled out than to stay home and potentially have complications.