How to re­duce sud­den deaths from surgery, travel-in­duced im­mo­bil­i­sa­tion

The Guardian (Nigeria) - - PANORAMA -

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

Newspapers in English

Newspapers from Nigeria

© PressReader. All rights reserved.