Randall Children’s Hospital

• The diagnosis of a hypercoaguable condition in a relative sometimes leads to concerns for the possibility of a genetic disorder that could affect the pediatric patient. [...] • Fortunately, few children are affected by blood clots, and those who have clots usually have serious under- lying conditions or risk factors and are admitted to hospital. [...] Genetic tests are available for many clotting disorders, but this testing is expensive and in many circumstances may not be indicated. [...] • We recommend that such patients/families be referred to our clinic prior to embarking on laboratory test- ing, which often raises more questions than it provides answers. • Our expert staff will provide a thorough and detailed consultation and determine with the patient/family if testing should or should not be performed. [...] Elicit history regarding affected family member and patient Underlying conditions or risk factors (presence of central venous catheters, diabetes, Crohn’s disease, nephrotic syndrome, sickle cell disease or anemia, chronic inflammation, prolonged immobility), recurrent pulmonary embolus (PE) or deep venous thrombosis (DVT), myocardial infarction (MI) or stroke at ages 30s–40s, miscarriages Lab [...] Call for phone consultation with any questions, 503-276-9300. [...] Management while awaiting appointment • Avoid smoking, OCPs, dehydration and immobility • Ambulate hourly during prolonged travel • Educate regarding signs of deep vein thrombosis or pulmonary embolus (see below) Urgent (today) • Swollen, warm, painful, plethoric extremity • Cough with shortness of breath and/or hemoptysis Within two weeks • Family history and development of a co-morbidity [...] D., MHA Elissa Pocze, CPNP Ronald Prauner, M.D. Nameeta Richard, M.D. [...] Patricia Vrooman, CPNP How to refer Find this and other co-management/referral guidelines online at: www.legacyhealth.org/randallguidelines Updated February 2017