Ahead of long-distance travel, many patients—especially those with a history of DVT—ask what they can do to lower their risk of blood clots. Questions around prophylaxis often surface before long flights, where movement is limited, and routines are disrupted.
In a recent post on Healthcasts, clinicians weighed in on how they approach DVT prophylaxis for long-distance travelers. Comments from the community touched on everything from mechanical prevention and patient education to when, if ever, medication like aspirin, DOACs, or injectable anticoagulants plays a role.
What preventative measures would you suggest to a patient looking to prevent blood clots during a long flight? Log in or sign up to share your approach and view the consensus summary.
Post:
A 55-year-old male patient with a history of DVT in the past is travelling by plane long-distance. He is concerned about DVT and wants to know about any medication to prevent another episode of DVT.
Besides guidelines, recommendations of frequent ambulation and calf muscle exercises, are there any other oral medications recommended?
Key takeaways about preventing DVT during long flights:
Internal Medicine
"Ambulation frequently is the key, but as the patient has a history of DVT, I would recommend aspirin therapy on the day of long-distance travel and go over ambulating every hour, moving legs and feet while sitting, and signs and symptoms to watch out for."
Internal Medicine
"For a one-time episode, I used to and still do recommend a full-coated aspirin a few hours before the flight. A high-risk person is likely on a DOAC. Today's airliners really cramp your legs in, so if one can afford to pay for "extra leg room", I suggest that. You really cannot just get up and take a walk on these packed flights anymore."
Internal Medicine
"Patient can decrease risk of developing blood clots on a flight by taking short walks and shifting positions in his/her seat. If the patient notices warning signs such as redness or discoloration, increased warmth in the skin, or swelling of the leg, ankle, or calf, alert the flight crew.
Patients who are high risk, such as those with diabetes, obesity, or a history of DVT, may need to wear compression stockings, although not comfortable, in addition to taking apixaban, etc., from their PCP."
Internal Medicine
"1. If it were a non-provoking DVT, I would prescribe DOAC, compression stockings, and educate on staying hydrated with water (avoid alcohol). If DVT was from a provoking factor would consider low-dose ASA alone with the compression stockings and staying hydrated with water. Instruct the patient to do leg exercises during flight."
Internal Medicine
"Though there are not many medications approved, sometimes we can give them a prophylactic dose of enoxaparin sodium, which can be helpful, or recommending BS could be better, but a prophylactic dose of enoxaparin sodium is preferable."
What prophylactic medications do you recommend for preventing DVT? Visit the full post on Healthcasts to share your suggestion and read other perspectives from the community.