Download and print the checklist [PDF – 631 KB]
Headed to the Hospital? Discuss this Prevention Plan Checklist with Your Doctor.
Get Better. Don’t Get a Blood Clot.
Before You Enter the Hospital
Before You Leave the Hospital
When You Return Home
- Discuss blood clot risks and family history with your doctor.
- Ask if you will need treatment to prevent blood clots in the hospital.
- Make sure all your doctors know your blood clot risks and ask for a prevention plan.
- Ask your doctor how to prevent blood clots when you are at home.
- Discuss the signs and symptoms of blood clots.
- Make sure you know what to do if you experience the signs or symptoms of a blood clot.
- Follow instructions and take medication as prescribed.
- Move around. If confined to bed or a wheelchair, have someone help you move your arms and legs.
- The risks for blood clots remain 90 days after a hospital stay or surgery. Notify your doctor if you experience signs or symptoms of blood clots.
Risk Factors
Signs and Symptoms
My Notes
Check risk factors that apply to you and discuss with doctor:
- Hospitalization, physical trauma, surgery
- Lack of mobility, inactive lifestyle
- Pregnancy and up to 3 months after the baby is born
- Cancer and its treatment
- Family or personal history of blood clots
- Birth control or hormone therapy with estrogen
- Smoking
- Overweight
- Age 55 or older
- Long-term medical conditions, such as heart or lung conditions, or diabetes
Seek immediate medical attention if you experience blood clot signs or symptoms:
Blood clots in the legs or arms:
- Swelling of your leg or arm
- Pain or tenderness not caused by injury
- Skin that is warm to the touch or red or discolored
Blood clots in the lungs:
- Difficulty breathing
- Chest pain, worsens with a deep breath
- Coughing, or coughing up blood
- Faster than normal or irregular heartbeat
Visit www.stoptheclot.org/spreadtheword for more information.