Audit raises concern over blood clot risk assessment numbers


Almost three-quarters of patients with a broken leg who have a heightened risk of blood clots are being sent home from A&E without a risk assessment, a new audit has found.

People who have their lower limbs put into plaster casts are at a significantly higher risk of developing a venous thromboembolism (VTE).

A new report from the Royal College of Emergency Medicine (RCEM) found 72% of these patients across the UK are not being risk assessed for VTE prior to discharge.

Meanwhile, only 13% are being given written information highlighting the risks of the condition while in plaster cast.

"Only a small minority of patients are receiving written information outlining the risks of VTE whilst their lower limbs are immobilised. This is clearly an issue that needs addressing," the report states.

VTE is the collective name for deep vein thrombosis - a blood clot in in one of the deep veins in the body, usually in one of the legs - and pulmonary embolism - a blood clot in the blood vessel that carries blood from the heart to the lungs.

The audit, which collated information from almost 10,000 adults presenting to 167 emergency departments, concluded more needs to be done to minimise the risk of in-patients with lower limb injuries who are discharged from emergency departments after being put in a plaster cast.

RCEM president Dr Clifford Mann said: "In the course of the last 30 years, we have seen venous thromboembolism evolve from being a 'silent killer', largely the product of misfortune, to recognition that our own actions can both promote and diminish the risk substantially.

"We know that patients with lower-limb fractures are particularly vulnerable to thromboembolism and we have a responsibility to ensure that the risk of harm from the treatment we provide - the plaster cast - is minimised.

"Reducing harms to patients before they occur, rather than reacting to consequential emergencies - in this case pulmonary embolus - is an excellent example of pro-active emergency care."