I had thought that a D-dimer should not be
requested on a patient with a clinical scoring of 3 or more as this was a high
risk group for DVT. The patient should instead have a doppler etc. A
normal D-dimer test in a high risk group would not be a 100%
reassuring.
However a trend has developed locally for all
patients to need a D-dimer before any further investigation. So a Doppler may be
refused even if the patient obviously has a DVT. e.g. drug addict injecting into
groin with leg twice normal size.
What is happening in other hospitals?
Ray McGlone
A&E Consultant
Royal Lancaster Infirmary /
Westmorland General Hospital