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Phlebitis (cont.)

When to Seek Medical Care

It is reasonable to seek medical care if there is swelling or pain in an extremity. This is especially true if there are risk factors for deep vein thrombophlebitis including prolonged travel, bed rest, or recent surgery.

Deep vein thrombophlebitis requires immediate medical care especially if the patient has any of these signs and symptoms.

  • High fever with any symptoms in an arm or leg
  • Lumps in a leg
  • Severe pain and swelling in an arm or leg
  • Chest pain and shortness of breath, which could be the symptoms of pulmonary embolism (blood clot in the lung).

Phlebitis Diagnosis

The initial assessment of a swollen arm or leg begins with the health care professional taking a patient history and physical exam. The diagnosis of superficial phlebitis is often made clinically and no further tests are needed.

If there is concern about deep vein thrombosis (DVT), further tests may be ordered.

  • D-dimer is a chemical that is released by blood clots as they begin to disintegrate. If this blood test is normal, then a blood clot is not present. Unfortunately, the test does not tell the doctor the location where a blood clot might be. For instance, it will be positive in people with a bruise or those who have recently had surgery. This blood test needs to be ordered only when there is a low risk of DVT being present. A positive test usually requires that some imaging test of the arm or leg be ordered to look for a potential blood clot.
  • Ultrasound can detect clots or blockage of blood flow, especially in larger, more proximal (upper leg) veins. A small hand-held instrument (probe) is pressed against the patient's skin to help identify blood clots and the location of the obstruction. This is a non-invasive test which is relatively painless.
  • Sometimes the ultrasound test cannot adequately "see" the veins and determine whether a clot is present. Venography may be required in which dye is injected directly into the vein and X-rays are taken to evaluate the vein.

Phlebitis Self-Care at Home

Self-care at home can be accomplished for superficial phlebitis by taking the following steps.

  • Apply a warm compress to the affected area.
  • Ibuprofen, an anti-inflammatory medication may help lessen the pain and inflammation of superficial phlebitis.
  • Prescription leg compression stockings (knee or thigh high) improve blood flow and may help to relieve pain and swelling, and decrease the risk of developing DVT.
Medically Reviewed by a Doctor on 2/9/2016

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