Blood-clot screening may save more than 10,000 lives a year

The National Institute for Health and Clinical Excellence (Nice) is publishing guidance today setting out how patients should be assessed for the clots, which kill an estimated 25,000 people admitted to wards in England each year.

It comes after the chief medical officer, Sir Liam Donaldson, announced in 2008 that all patients admitted to hospital should be screened.

Doctors are being told to take action to reduce the risk of clots developing, which can often strike without warning.

Measures include giving patients compression stockings, blood-thinning drugs such as heparin or using foot pumps to keep blood circulating.

The focus of the guidance is on those clots that occur in veins, most commonly in the leg, called deep vein thrombosis (DVT).

If such a blood clot breaks loose it can travel in the bloodstream to the lungs, causing a pulmonary embolism which can be fatal.

People who are unwell and who do not move around much are at greater risk of DVT.

Those who are overweight, who are dehydrated, aged over 60, and women taking the combined pill or hormone replacement therapy (HRT) are also at increased risk.

Pregnant women and those who have given birth in the previous six weeks should also be watched closely, as should those having a long operation or people who will be confined to bed for at least three days.

Doctors and nurses will assess everyone requiring inpatient care for their risk of DVT under the guidance which applies to England and Wales.

The risk of DVT will be set against the chance a patient may suffer internal bleeding, which can be a side-effect of blood thinning drugs.

Professor Tom Treasure, who chaired the guideline development group, described blood clots as a "silent killer".

He said doctors should be assessing people with a view to offering some sort of treatment or device, with even just one risk factor "triggering the question" of whether treatment is needed.

"It doesn't oblige the doctor to give treatment but it should ring an alarm bell," he said.

"I think it's an opt out situation. If you tick this box, what's your reason for not giving treatment? The default position should be giving (treatment)."