Examine the legs for color, capillary refill time, and tissue integrity when evaluating a client at risk for thrombosis.
Deep vein thrombosis is a condition when a blood clot (a thrombus) develops in a vein (DVT). This can dislodge and go into the bloodstream prior to reaching the lungs, where it can cause a pulmonary embolism (PE), a blockage in the pulmonary circulation that can be fatal.
In both primary and secondary care, nurses will be required to recognize and screen for deep vein thrombosis, therefore they must have the ability to evaluate the patient's clinical risk.
To utilize the Wells screening equipment properly, the leg must be extensively checked. Nurses ought to:
- Find any asymmetry or unilateral swelling, skin changes, wounds, oedema, erythema, or varicosities on both legs by keeping an eye out for them.
- Before palpating both legs, feel for heat with your hand over the suspected DVT location. Also feel for pain and any cracks in the skin.
- DVT symptoms can include deep venous system-specific pain.
- The difference in the calves' circumference is measured 10 cm below the tibial tuberosity.
- A DVT is the likely diagnosis if there is a discrepancy of more than 3 cm from the asymptomatic side.
- Check capillary refill time is between two and three seconds; this is a sign of peripheral perfusion by palpating the foot pulses.
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1. George O’Malley (Season 5, Episode 24)
The world collectively gasped when George was revealed to be on the other side of the elevator doors, dressed in his Army uniform, ready to guide Izzie (Katherine Heigl) to the afterlife. This intense Season 5 ending was the audience’s first time witnessing the death of a main circle doctor, forever raising the stakes to come. From Callie recognizing the freckle, to John Doe tracing “007” into Meredith’s palm, each moment created goosebumps. The underdog of the interns didn’t deserve to go out being dragged under a bus, but it’s only fitting that he did it to save someone else’s life.
2. Denny Duquette (Season 2, Episode 27)
Love makes people do crazy things; but, unfortunately cutting L-Vad wires, breaking the law, and Izzie almost losing her job couldn’t save Denny Duquette from death. Isabel and Denny’s love story was the first flame that could’ve shone brighter than Meredith and Derek’s. It’s largely why the death of Denny was so heartbreakingly tragic. Although Izzie seemed to move on, Denny’s ghostly cameo in Season 5 made it clear the love story was always doomed.
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