There may be times when a patient has a diagnosed LE DVT but no medical interventions are initiated. The patients may have contraindications for receiving anticoagulant medications or they do not meet the criteria for an IVC (e.g. in Palliative Care or Hospice Care). In these situations, a consult with the primary physician or medical team should guide the decision to mobilize the patient. Continuing to remain on bed rest will only increase the risk of additional VTE and other adverse effects of immobilization. At some point, the patient needs to return to daily activities and it might be appropriate to begin mobilization even though an untreated LE DVT is present. In other situations, the reason for not addressing the LE DVT may be short term. It may be wise to wait until anticoagulation can begin. The physical therapist needs to discuss all of these factors with the inter-professional team and the patient when making a clinical judgment about mobilization.
Although a physician may order physical therapy to increase the physical activity level of a patient, it is the physical therapist’s clinical decision whether or not to mobilize the patient based upon the available information about the patient’s LE DVT and risk status.
