Researchers at the IWK Health Centre developed a screening tool that aims to reduce the chance of blood clots after pediatric surgeries, and they are hoping it becomes the nationwide standard tool.
Venous thromboembolism (VTE), or blood clots in the veins, is a rare but potentially serious or life-threatening complication in pediatric ortho-surgical patients.
Dr. Ketan Kulkarni, IWK hematologist, said that although this condition is rare, it is important to address as it can be potentially dangerous.
"The risk with venous thrombosis or venous thromboembolism is that the blood clots most commonly happen in the leg veins and can also form in the pelvic veins. But the even bigger risk is that part of that clot or the whole of the clot can break off and go to the lungs causing a pulmonary embolism that can be potentially very life-threatening," said Kulkarni.
Thromboprophylaxis—the medical treatment to prevent the development of thrombosis—often involves injections and there can be possible pain and risk of bleeding. Not all children undergoing surgery need thromboprophylaxis, as the risk of blood clots in pediatric patients is much lower than that in adults.
"In the adult population, it affects thousands of patients every year. But in the pediatric population, specifically in the pediatric orthopedic population, the data suggests that one in 500 patients undergoing orthopedic surgery will probably develop a clot. We shouldn't be using prophylaxis to treat all those 500 patients to prevent that one clot—there has to be a better way."
Kulkarni said the screening tool was first implemented at the IWK six years ago. Over the years, it showed that they can use the protocol to eliminate the need for prophylaxis in at least 50 per cent of their patients.
He added the screening tool consists of a one-page algorithm that is easy to use, and can be administered before and after surgery by any healthcare provider. The researchers’ next goal is to see the algorithm used at a national level.
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