- Reference Number: HEY500/2026
- Departments: Orthopaedics
- Last Updated: 30 September 2026
Introduction
This leaflet informs you about Venous Thromboembolism (VTE). It explains what it is, why you are at risk and how you can reduce the risk. This leaflet does not replace advice from your doctor. If you have questions, please speak to a member of your healthcare team.
What is Venous Thromboembolism?
Venous thromboembolism (VTE) is a blood clot that can develop in the deep veins of the body, most commonly in the leg. A clot most often will remain in the leg where it can cause pain, redness and swelling. Sometimes the clot can travel to your lungs. This can cause breathlessness or chest pain and needs urgent treatment.
Why am I at risk?
You are at risk because you have suffered a leg injury, have been fitted with a cast, boot or brace and may be unable to walk around easily or have reduced mobility. Your leg muscles are less active, so blood does not move around your leg as well. Clots can occur in anyone at any age. However, it has been identified that there is a greater risk for people who are immobile (not walking around), those who have had a major operation, and those who have a variety of medical conditions requiring hospital admission.
What can I do to reduce the risk?
You may be given knee‑length anti‑embolism stockings to wear (TEDS). These will be measured to fit you. You may be prescribed anticoagulant medication (a blood ‘thinning’ drug) instead of, or in addition to the stockings.
Because anticoagulants thin your blood, it can make you bleed more easily and there is a relatively small risk of significant spontaneous bleeding. If you are already at risk of bleeding problems your doctor may decide not to prescribe this medication.
The anticoagulant currently recommended for use in the Trauma & Orthopaedic Department, Hull University Teaching Hospitals NHS Trust is called Apixaban. It is a capsule to be taken twice a day. You should also read the information leaflet in the packet as it will tell you more about the possible side effects of Apixaban.
Apixaban is approved for use to prevent blood clots in many situations, such as after hip or knee replacement surgery. It is not officially licensed for use in people with plaster casts, but senior doctors and pharmacists at this hospital have reviewed the evidence and agreed it is safe to use in this situation. This is called “off-label” use. This use is common in hospitals and is supported by clinical experience and national guidance. You can ask your doctor or nurse for a copy of the ‘Unlicensed and Off‑Label Medicines’ leaflet, or you can read it online at:
https://www.hey.nhs.uk/patient-leaflet/unlicensed-off-label-medicines/
If you are unhappy with taking Apixaban talk to your doctor, nurse or pharmacist. There are other medicines that could be used (such as low molecular weight heparin injections). Heparins are porcine-derived (from pigs) although a synthetic alternative, fondaparinux, is available for patients who cannot receive porcine‑derived products. Heparins are advised for those patients where surgery is planned and in this circumstance is used instead of Apixaban until after surgery has been performed.
You must not take apixaban if you are pregnant or have serious kidney problems. There are other medicines that should be used instead (such as low molecular weight heparin injections).
What do I do with blood thinning medicines once I go home?
Sometimes patients are advised to continue with blood thinning injections or capsules after they are discharged home. If you are advised that you need to give yourself a daily injection the ward or clinic staff will show you how to do this. If you are unable to do this, we will show a family member how to give the injections or arrange for a District Nurse to come to your home. Used needles should be placed in a yellow sharps bin which you will be given. Used sharps bins can be returned to hospital or community pharmacies for safe disposal or arrangement for collection can be made through your local council (Hull City Council: Tel: 01482 300300; East Riding of Yorkshire Council: Tel: 01482 393939).
Whilst you are receiving blood thinning medicines your blood is thinner than normal and so contact a doctor straight away if you notice:
- unusual bruising
- bleeding gums or nosebleeds
- bleeding that does not stop
- blood in your urine or stools
- coughing up blood
- a red patch on the white of your eye (a burst blood vessel)
- vaginal bleeding after menopause
- sudden severe back pain
What should I do if my calf becomes swollen, red and painful?
Contact the hospital ward or clinic where you were a patient via the switchboard Tel: 01482 875875 for advice. Alternatively, you can contact your GP or Emergency services (111).
You should in the meantime, remove stockings if wearing them and raise your leg slightly on a footstool to reduce swelling.
What should I do if I become breathless, develop chest pains or cough up blood?
Dial 999 or attend the Emergency Department immediately.
What will happen afterwards?
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Trauma & Orthopaedic Department on telephone:
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
