How to reduce sudden deaths from surgery, travel-induced immobilisation
A man admitted into hospital following a road traffic accident appeared to be making an excellent recovery. He was well-known locally and was chatting heartily with visitors one afternoon but by dusk he had died suddenly. A doctor recovering from an operation that went well died unexpectedly while in hospital. The clinical explanation for these deaths is Venous Thromboembolism (VTE). This is a condition in which a blood clot (thrombosis) forms in a vein. A chunk of this clot may break off and are carried in the blood stream to the lungs. Immobilisation due to surgery or other medical conditions predisposes to clot formation. Obesity and genetic factors increase the risk but VTE could happen to anybody. If the dislodged clot is large enough it will cause instant death.
It is not only after a surgical operation that VTE may occur. Resulting from prolonged immobilisation, it could occur after a long-distance travel (more than four hours by air or motor vehicle) or after a long period of bed rest in persons who are chronically ill.
Globally, venous thromboembolism (VTE) commands insufficient attention. This is regrettable because it carries a high mortality rate. The best treatment is prevention; this includes ambulation, hydration, use of compression stockings and blood-thinning injections. These measures have been shown to be very effective but under-utilised.
The first step towards reducing the number of deaths from thromboembolism is awareness. Unfortunately awareness of VTE in Nigeria is low, among health professionals and the public at large.
According to the Promoting Thrombosis Awareness in Nigeria (PROTRAIN) proposals for promoting awareness and good clinical practice include: a public campaign through the mass media and social media; a campaign targeting health professionals through professional and educational meetings; convening a multi-disciplinary national expert group to produce national guidelines for VTE prophylaxis; dissemination of good practice guidance through postgraduate medical colleges and national specialist societies