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Preventing Blood Clots During Travel

Travelling can be exciting, but sometimes long distance travel can have a negative impact on our health. Long distance travel, especially by air, has been associated with the development of blood clots and can be a serious medical emergency.

What is a DVT?

Deep Vein Thrombosis (DVT) is a blood clot that develops in the deep veins, most commonly in the legs. A blood clot in the leg can potentially break off and travel to the lungs, causing a Pulmonary Embolism (PE), which can be life threatening.

The risk of developing a DVT increases with long distance travel when a person is not moving for long periods of time. Immobility interferes with the blood circulation in the legs and causes the blood flow in the veins to slow down, and the blood to pool in the veins. The longer a person does not move, the higher the risk is for developing a DVT. It can occur in any mode of transportation when travelling for more than 4 hours, including by air, car, train, or bus. Most travel related blood clots occur within the first 1-2 weeks after long distance travel. Travel related blood clots are generally low risk but there are certain factors that can increase the risk of developing a DVT.

Risk Factors

  • Older age (>50 years of age)
  • Obesity (BMI ≥30kg/m2)
  • Estrogen-containing contraceptives (e.g. birth control pills, rings or patches), or hormone replacement therapy
  • Pregnancy and the postpartum period (up to 3 months after childbirth)
  • Blood clotting abnormalities
  • Previous blood clot or family history of a blood clot
  • Limited mobility
  • Active cancer
  • Serious medical conditions (e.g. congestive heart failure)
  • Recent surgery, hospitalization, or injury
  • Height (shorter than 5 ft, 3 in and taller than 6 ft, 3 in)
  • Varicose veins

 

Symptoms

About half the people who develop a DVT do not have any symptoms. If symptoms do occur it can include pain, tenderness, swelling, redness, or warmth in the affected area, usually the leg.

It’s possible to have symptoms of a PE without first having symptoms of a DVT. Symptoms of a PE include unexplained shortness of breath, chest pain, coughing up blood, and dizziness or fainting.

If you have any symptoms of a DVT or PE seek medical attention immediately. Treatment usually involves anticoagulant therapy.

Flying after a blood clot

If you have experienced a recent DVT or PE talk to your doctor before flying. It is generally restricted to fly if you have a DVT that is still active, or if it is within 4 days of experiencing a PE. Usually there are no restrictions after a DVT if it has been at least 5 days since it developed, and you do not have any symptoms and are stable on anticoagulant therapy.

Prevention

There are several prevention strategies that can help prevent blood clots during long distance travel:

  • Walk around as much as possible
  • Sit in an aisle seat on flights to promote frequent ambulation
  • Wear loose fitted clothing that is not tight at the knees or waist
  • Perform frequent leg exercises (see below)
  • Avoid sitting with legs crossed
  • Wear below-knee graduated compression stockings providing 15-30mm Hg of pressure at the ankle if you have risk factors of a blood clot (not recommended for those without risk factors)
  • Talk to your doctor before travel if you think you may be at high risk of developing a blood clot
  • Know the signs and symptoms of a DVT and PE

Here are 5 easy leg exercises you can do during long distance travel that can help prevent blood clots:

  1. Ankle circles–Lift one foot off the floor and circle your ankle in one direction for a few seconds. Then complete the same motion in the other direction for a few seconds. Repeat each direction several times with each foot.
  2. Foot pump – Place your feet flat on the floor. Lift your heels while keeping the balls of your feet flat on the floor and hold for a few seconds. Then lift your toes up while keeping your heels on the floor and hold for a few seconds. Repeat several times each way.
  3. Leg lift – Lift one leg off the floor and straighten your leg as much as possible while keeping your ankle bent and toes pointed upward. Repeat several times with each leg.
  4. Knee lift – While sitting, slowly lift your knee upwards. Repeat several times on each side.
  5. Knee hug –While standing, bend your leg and hug your knee to your chest as close as you can, keeping your back straight. Repeat several times on each side.

TravelSafe Clinical Educator – Kristin Cain, RN, BSc, MSc(A)

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