Because assuming they’ll take care of all of it is how we fall into healthcare gaps!
This post is a continuation of Sepsis: Questions to Ask Your Doctors and Nurses but blood clots can be an issue with any hospital stay. Read more for blood clot warning signs, what you can do, and questions for your provider about blood clots.
- Sepsis and blood clots
- Medical jargon for which you’ll need to listen
- The big picture Sepsis danger with clots
- Blood Clot Warning Signs
- Key labs
- What the team is doing
- Questions to keep everyone on track
- Quick list
- Take home message
- More resources
Sepsis is the fire. Clots are a part of the fire spreading.
By knowing the basics, spotting red flags, and peppering the team with clear questions, you become the extra set of eyes every sepsis patient needs. The basics are below along with some more questions you can use to keep your ever changing medical team focused.
Try to remember: the team is made up of humans doing their best. They can make mistakes. This post will hopefully help you help them give the best care possible. Please share with anyone you know caught up in the hospital.
Words you’ll hear the team saying:
- “Thrombus”: this is a clot stuck in one place
- “Embolism”: this is a clot that has moved
📣 The Big Picture of the Danger:
Sepsis trips the body’s “all-hands-on-deck” immunity alarm. When this happens, two cascades flare up at once:
- Runaway inflammation – germs battle immune cells, vessel walls get hot and leaky.
- Clotting switch flips on – the body slaps clots (think of them like patches) everywhere trying to help, but those clots can cause new trouble if they become too big or move somewhere in the body they shouldn’t be.
- Micro-clots can choke off organ oxygen
- Macro-clots (DVTs) that can launch toward the lungs leading to Pulmonary Embolism (clot that’s moved).
Blood Clot Warning Signs Families Can Spot
- New swelling, warmth, or color change in an arm or leg
- Sudden shortness of breath or chest pain
- Cool, blotchy fingers or toes
- Small red dots forming in groups on this skin
- Unexplained bruises or bleeding (IV site, gums)
- Sudden anxiety burst or panic attack out of nowhere
Pro tip: Snap a quick picture of skin changes to show the team trends over time.
Key Labs & Tests to Watch
| Test | What It Shows |
| Platelet count | Low platelets, or a large change in platelet numbers hint a large bleeding risk is brewing. |
| PT/INR & aPTT | Long clot-times = factors running low. |
| D-dimer | High numbers scream “clot breakdown happening.” |
| Fibrinogen | Drops as the body burns through clotting protein. |
| Ultrasound / CT | Confirms DVTs or PEs when symptoms flare. |
How the Team Fights Back
- Nail the infection fast – broad antibiotics + source control (drain abscess, pull infected line).
- Keep blood moving – IV fluids, pressors if BP sinks.
- Clot-prevention basics – low-dose heparin shots or leg-squeezing sleeves (SCDs).
- Full-dose blood thinners – if a real clot shows up.
- Top-up the tank – platelets, plasma, or cryo when bleeding becomes the issue.
Questions to Ask the Care Team 🗣️
- “What are today’s platelets, INR, and D-dimer numbers, and how have they trended over the last 24 hours?”
- This is something your ICU nurses should be keeping up with, so asking them helps them stay on top of it when they forget.
- This is something your ICU nurses should be keeping up with, so asking them helps them stay on top of it when they forget.
- “Is my loved one on preventive blood-thinner shots or compression sleeves right now?”
- These help lessen the risk of clots growing and migrating.
- Note that if there’s already a clot found in someone’s leg (DVT), intermittent compression devices might increase the danger of that clot moving. Make sure the doctor has cleared the continuation of those devices when there’s a known DVT present.
- “If you confirm a clot, how long will blood thinners be required?”
- This will help you know what to be prepared for when your loved one is discharged home.
- This will help you know what to be prepared for when your loved one is discharged home.
- “Are there any medicines (like estrogen or steroids) that could raise clot risk? Should they be paused?”
- This will help remind staff to look for meds that increase the risk of clotting.
- This will help remind staff to look for meds that increase the risk of clotting.
- “How often are you checking fibrinogen and coag factors to stay ahead of bleeding?”
- These things do get missed if the practitioners are having a busy day.
- These things do get missed if the practitioners are having a busy day.
- “What warning signs should we call out between nurse rounds?”
- You can get a sense of what the staff is looking for. If they miss any of the blood clot warning signs listed above, ask them about those. They may have missed a step and will be more vigilant moving forward.
- You can get a sense of what the staff is looking for. If they miss any of the blood clot warning signs listed above, ask them about those. They may have missed a step and will be more vigilant moving forward.
- “If low blood pressure keeps pooling blood, are there positioning changes or early-mobility plans we can help with?”
- Repositioning and early mobility are great in keeping blood from pooling.
- Repositioning and early mobility are great in keeping blood from pooling.
- “Once home, what signs and symptoms should I stay alert for that mean there are more blood clotting issues?”
- There will be plenty. I’ve got the generic ones for this issue above but your loved one is more than the sum of one complication. Your medical team will have the whole picture. Use your notebook!!!
- There will be plenty. I’ve got the generic ones for this issue above but your loved one is more than the sum of one complication. Your medical team will have the whole picture. Use your notebook!!!
- “What question would you be asking if you were in my shoes?
- There may be something we’ve missed above. Better to ask because your caregiver may have an insight we’ve missed!
Quick list for copy/pasting:
- “What are today’s platelets, INR, and D-dimer numbers, and how have they trended over the last 24 hours?”
- “Is my loved one on preventive blood-thinner shots or compression sleeves right now?”
- “If you confirm a clot, how long will blood thinners be required?”
- “Are there any medicines (like estrogen or steroids) that could raise clot risk? Should they be paused?”
- “How often are you checking fibrinogen and coag factors to stay ahead of bleeding?”
- “What warning signs should we call out between nurse rounds?”
- “If low blood pressure keeps pooling blood, are there positioning changes or early-mobility plans we can help with?”
- “Once home, what signs and symptoms should I stay alert for that mean there are more blood clotting issues?”
- “What question would you be asking if you were in my shoes?
Take-Home Message
Remember: everyone’s doing their best! Despite that, and their expertise, mistakes will happen. Don’t be too hard on your team members who appear to make them. Support them by knowing the blood clot warning signs and communicating with these questions. Help them give the care your loved one deserves!
📄 Want more help? See my posts regarding preparing for a stay in the hospital and managing your care while in the hospital: “Hospital Stay Checklist,” and, “The Notebook.” You can always contact me with questions on the contact page. Also check out the National Blood Clot Alliance.
Thank you for reading! Please share this site with anyone you think could benefit from it! What questions do you have? Do you have any suggestions? Or did this bring up any stories you want to share? Reach out to me through the contact page, or leave a comment below. I’d love to hear from you!
Leave a Reply