SQUEEZE PLAY Applying sequential compression devices during surgery effectively prevents the physiological risk factors of clotting.

Although it's preventable, almost 300,000 Americans die annually from deep vein thrombosis (DVT) and its primary complication, pulmonary embolism. Fortunately, if caught in time, DVT is completely treatable. The classic signs of DVT, especially if it occurs in the lower extremities, are leg pain, swelling, tenderness, and redness or discoloration of the skin. The bad news is that, about half of the time, DVT has no symptoms at all. The first and most important step in protecting your patients from a potentially fatal DVT is to know whether they are at risk.

I'm the creator of the widely used Caprini DVT Risk Assessment, which generates a total clotting risk score ("Caprini Score") based on a patient's health history and comorbidities (osmag.net/6cywtg). Your surgical team has complete control over identifying the factors that can lead to DVT, and should use Caprini Scores to guide their prophylaxis efforts.

Scores ??? 5. Patients require basic prophylaxis with pneumatic compression stockings or sequential compression devices.

Scores of 5 to 8. Patients are at heightened risk of clotting and require a week of post-operative anticoagulant prophylaxis.

Scores ??? 8. Patients are at significant risk of post-op clotting and should receive a month of anticoagulant therapy.

Patients with a history or family history of thrombosis and abdominal surgery for cancer should receive 30 days of prophylaxis, even with scores < 8.