This is a very interesting time to be an intensivist with a research interest in blood clots. As such I wanted to use this time to talk about how COVID 19 has changed our approach to diagnostics, therapeutics and even to evidence-based medicine.

This blog post accompanies the talk, highlighted on the thrombosis UK website, and contains hyperlinked references to the literature discussed. Like always at St Emlyns, we would strongly encourage you to review this literature for yourself and draw your own conclusions on the matter.

We have a long standing approach to acute VTE diagnosis across the world; brains and blood tests. We use our clinical experience to consider VTE within the differential of any presentation, and we then use our gestalt and objective clinical risk scores to try and estimate pretest probability.

Until March, the evidence base had been firmly supportive of this and had even been pushing us away from invasive testing, with new NICE guidance endorsing the PERC rule and supporting higher cut points for d-dimer rule out testing.

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