Here in outline is how we organize and manage our specialist and dedicated DVT Treatment Centre.

• A Nurse led service
• Operates between 9am to 19pm Monday to Friday
• On call Nurse designated on weekends to administer subcutaneous tinzaparin (LMWH) injections
• We only handle Luton Primary Care Trust(PCT) General Practitioner ( GP) referrals.
• Clinical responsibility remains with the GP until a DVT is confirmed
• Patient is seen the same day as referred by GP
• Patient must present with a GP referral letter detailing past and present medical history and a current medication list
• The patient’s suitability for the community pathway must be assessed by the GP prior to referral using the criteria assessment form
• If the DVT Nurse deems the patient unsuitable at any point on presentation to the LTC they will be immediately directed to the Luton and Dunstable NHS Trust hospital Haematology Dept.(Secondary care)
• Baseline observations are performed on arrival to LTC
• The patient is assessed using the clinical scoring form
• If there is a low clinical score (less than 2) a venous blood sample is obtained and a D-Dimer test is performed, if the test is below 450ng/ml the D-Dimer test is negative and the patient is referred back to their GP for follow up
• If the D-Dimer result is above 450ng/ml the D-Dimer test is positive subcutaneous LMWH is commenced and a Doppler scan is arranged. FBC, U&E, LFT and INR blood tests are sent to the path lab
• If the Clinical score is high (2 or above) Subcutaneous LMWH is commenced and a Doppler scan is arranged. FBC, U&E, LFT and INR blood tests are sent to the path lab
• If the Doppler scan which is performed at the hospital is negative to DVT the patient is discharged back to their GP from the ultrasound department
• If the Doppler scan is positive to DVT the patient is sent to the anticoagulant clinic also in the hospital to commence warfarin tablets and remain on subcutaneous LMWH until INR therapeutic.