Virchow’s Triad review for nursing students!
This quick review will highlight the main concepts you need to know about Virchow’s Triad. It’s important to be familiar with Virchow’s Triad because it details the main factors for why a blood clot can develop. As the nurse you want to be able to identify those factors and take measures to prevent a blood clot in your patient.
Quick Lecture on the Virchow’s Triad
Virchow’s Triad
Virchow’s Triad gives us three main factors that can lead to blood clot formation within a vein. Remember there are THREE factors (hence why it’s called a Triad).
Anyone can develop a deep vein thrombosis, especially if these risk factors are present.
Remember: “SHE”
Stasis of Venous Circulation:
Blood cannot just hang out and become static within a vessel. If it does this the blood will start to clump up (due to the present of platelets) and form a clot. The venous system is responsible for taking deoxygenated blood BACK to the heart. Therefore, the blood has to flow back to the heart via the veins, and it does this with the assistance of healthy vein valves and the muscles within the extremity. If the vein’s valves are damaged or the muscles aren’t working (or being used) blood isn’t going to flow back very well and a blood clot can develop.
What are some conditions that cause stasis of blood flow?
- Immobilized
- Varicose Veins
- Surgery (hip or knee)
- Traveling for long hours without moving extremities
- Obstruction: late pregnancy, obesity
- Heart failure (left ventricular dysfunction)
- Atrial fibrillation
Hypercoagulability: let the name of this factor help you…hyper means increase or high and coagul refers to the coagulation process in the body (hence forming a clot). Therefore, the patient has a high risk of forming a blood clot. The main reason for this is due to a disease process, but it can be due to other reasons. NOTE: This list is not a complete list.
What are some conditions that cause an increased risk of forming a clot within the vessel?
- Cancer
- Severe illness (sepsis)
- Dehydration
- Usage of Estrogen (birth control)
- Heparin Induced Thrombocytopenia (HIT)
- Postpartum Period
Endothelial damage to the vein: This endothelial is a layer of cells that lines the inside of the vein. Damage to this layer can be from a direct or indirect cause, but regardless it stimulates platelets and the coagulation process. So think of anything that damages the lining inside the vessel.
What are some conditions that cause damage the endothelial lining?
- IV drug usage ( also venipuncture…drawing blood from a vein)
- Indwelling devices (central line catheter, IV line, or heart valves etc.)
- Medications that are damaging to the vein
- Trauma or injury to the vessel (surgery)
You may be interested in Deep Vein Thrombosis Review.
References:
Diagnosis and Treatment of Venous Thromboembolism | CDC. (2019). Retrieved 1 November 2019, from https://www.cdc.gov/ncbddd/dvt/diagnosis-treatment.html
Venous Thromboembolism | National Heart, Lung, and Blood Institute (NHLBI). Retrieved 1 November 2019, from https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism
What is Venous Thromboembolism? | CDC. Retrieved 1 November 2019, from https://www.cdc.gov/ncbddd/dvt/facts.html