Contraindications Deep vein thrombosis (DVT) and Pulmonary Embolism (PE) Treatment on Warfarin or other anticoagulants

DVT and pulmonary embolism (PE) are strictly contraindicated at the point of ongoing illness. But if it is something that has been in the past and is now stabilised due to medication then you can treat with the following caveats that: 1) Your clients anticoagulant medication is stable usually when on Warfarin for example, they have regular PT (prothrombin time)/ INR (International Normalized Ratio) tests which keep their medication to a stable level. This is so they are not under medicated so they produce more clots, nor over medicated so they bruise or worst of all bleed internally. As they get further out from the point of illness these tests become less frequent and the dosage of medication remains the same. This is when you can start to treat. See http://www.clotcare.com/ptinr.aspx for more info regarding PT/INR. 2) You are aware of what anticoagulants do and treat with care especially regarding bruising. Remember reading up about this sort of issue counts towards your CPD points. 3) You are comfortable to treat. 4) Your client is comfortable to receive treatment. 5) If your client is seeing her doctor or other health practitioner regularly they inform them they are having reflexology. The reason it is not advisable to treat during active illness is that it is believed that reflexology speeds up the circulation and this increase might cause small pieces of clot to pull away from the main clot and travel around the circulation to the next major port of call. If the medication is working properly then this should be prevented. There is some evidence that herbal medicines and supplements interfere with the action of anticoagulants but there is no suggestion that reflexology does.

Copyright of the Association of Reflexologists 2010