Guideline Development Group

Action Statement 11: CONSULT WITH THE MEDICAL TEAM WHEN A PATIENT IS NOT ANTICOAGULATED OR WITHOUT AN IVC FILTER.

When a patient with a documented LE DVT below the knee is NOT treated with anticoagulation and does NOT have an IVC filter and is prescribed out of bed mobility by the physician, the physical therapist should consult with the medical team regarding mobilizing versus keeping the patient on bed rest.

(Evidence Quality: V; Recommendation Strength: P – Best Practice)

Action Statement Profile

Aggregate Evidence Quality: Level V

Benefits: Mobility has demonstrated a decreased risk of VTE

Risk, Harm, Cost: Potential increased risk of PE should the LE DVT embolize

Benefit-Harm Assessment: Preponderance of benefit over harm

Value Judgments: As movement specialists, physical therapists recommend mobilization over bed rest due to the documented benefits of early mobilization.

Intentional Vagueness: Specific guidelines are not provided because it is rare that a patient will not have anticoagulants prescribed or an IVC filter in this country. Each patient should be considered individually.

Role of Patient Preferences: Patients should be informed of the risks and benefits of bed rest/inactivity and of mobilization.

Exclusions: Any LE DVT present above the knee