VTE – NICE guidance

Everyone with suspected VTE is now supposed to have some sort of investigation. This is where the ability to draw flowcharts would be really helpful:

Wells 2 or above – Doppler within 4 hours, or, if that’s not possible, get it within 24 hours and meanwhile do D-dimer test and start anticoagulant. If the D-dimer is positive and the scan negative, repeat it 6 – 8 days later (though that part won’t be my problem).

Wells <2 – D-dimer test, and, if positive, Doppler as per above timeframes (either within 4 hours, or within 24 hours with interim SC anticoagulant).

And lots of luck with getting that level of service in practice.

For suspected PE:

Wells score >4 – in practice, from my POV, comes down to ‘admit for immediate further investigation’. Wells score 4 or lower – D-dimer first, admit for further investigation if positive.

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About Dr Sarah

I'm a GP with a husband and two young children.
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