How should I approach the referral of a patient with suspected DVT to secondary care?

Refer patients with suspected DVT to secondary care if the clinical assessment indicates a high probability of DVT, such as a Wells score of 2 points or more, by offering a proximal leg vein ultrasound scan with the result available within 4 hours if possible ³.

If the ultrasound cannot be obtained within 4 hours, offer a D-dimer test, then interim therapeutic anticoagulation and a proximal leg vein ultrasound scan with the result available within 24 hours ³.

If the DVT Wells score is 1 point or less (DVT unlikely), offer a D-dimer test with the result available within 4 hours. If the D-dimer is positive, offer a proximal leg vein ultrasound scan with the result available within 4 hours, or interim anticoagulation and a scan within 24 hours if necessary ³.

In cases where DVT is confirmed by ultrasound, proceed with anticoagulation treatment or consider mechanical intervention if anticoagulation is contraindicated ³.