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About 25,000 people die in English hospitals every year as a result of blood clots. This is as many as fall victim to breast and prostate cancer, HIV and Aids-related illnesses and road traffic accidents put together. Blood clots account for 20 times the number of fatalities from MRSA, the superbug associated with lax standards of cleanliness in hospitals.
Blood clots, or venous thromboembolisms, will kill some patients whether they are in or out of hospital, and whether or not they are being treated for a medical condition. Some patients will die even if they receive the best possible care from the wisest and most dedicated medical practitioners. It is apparent, however, that too little is being done to stop thickened knots of blood causing massive pulmonary or coronary failure in thousands of individuals ever year. Sir Liam Donaldson, the Chief Medical Officer, said last year that “there is no systemic approach to identifying and treating those patients at risk from blood clots in hospitals”. He added: “There is significant room for improvement.” Beverley Hunt, the medical director of Lifeblood, the thrombosis charity, says that it is “nothing short of a public health emergency”.
Blood clots are a serious danger partly because hospitals fail to assess patients properly. Blood clots are not, it seems, a priority concern amid the pressures of hospital work and that patients are often suffering from other, perhaps unidentified, ailments. Yet international research that was published in The Lancet last month suggests that half of all those receiving acute hospital treatment may be struck by a venous thrombo-embolism. In the circumstances a preoperative blood clot assessment could be carried out as a matter of course. It is not.
Blood clots kill as many people as they do also because the accepted current treatment is prone to failure. Drugs such as warfarin – still better known as a rat poison – are often used. These drugs can thin the blood too much, causing dangerous haemorrhages. Meanwhile, alternative drugs must be injected, which is unpalatable for sufferers, and expensive where medical staff are employed to handle the syringe.
The health of the many cannot be undermined because limited funds are hoovered up by the demanding few. But patients can expect medical professionals, and administrators, to avoid unnecessary risk. Minds, perhaps unfortunately, are being focused by the growing number and size of compensation payments arising from medical negligence claims. The Corporate Manslaughter Act, which comes into force next month, may increase the number of suits. Encouragingly, a new drug, which can be taken as a pill and is thought to be more reliable than warfarin, is on the verge of securing approval. This is an important step, but only one of many that are necessary.
It is a sad inevitability that doctors and hospitals create medical problems as well as cure them: few treatments are entirely free of side-effects. One of the most valuable skills of a physician, alongside accurate and early diagnosis, is to balance the potential benefits of surgical, medical or pharmaceutical action with the risk that it will make matters worse. At the heart of the blood clot problem lies an unquestioning acceptance of a commonplace killer. It cannot be tolerated as an excuse for the deaths of thousands.
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Because if you're going to be cut open, having your blood flowing out too fast is not a good idea ...
Jane Wickenden, Wincanton, UK
Why is it then when one goes for operation that you have to stop taking aspirin , a known anti-clotting molecule, for seven days beforehand?
M. Cawdery, Portadown, UK ( if it still exists)