Recognition and Management of Pediatric Venous Thromboembolism in the Emergency Department

Venous thromboembolism (VTE) is an increasingly recognized concern in pediatric medicine. Emergency department physicians are now more likely to encounter children and adolescents with a history of VTE or an increased risk of developing this complication. Prompt recognition and management of VTE are important to the prevention of long-term complications such as recurrent VTE and postthrombotic syndrome. Pediatric patients presenting to an emergency setting with new VTE are generally older and healthier than their counterparts with hospital-acquired VTE. This article discusses the signs and symptoms of VTE, which can often be subtle in pediatric patients, and radiographic and laboratory approaches in the evaluation of patients with suspected VTE. Initial treatment strategies for acute VTE are reviewed, as well as the recommended approach to managing patients already receiving anticoagulation when they present to the emergency department for care.