Ashley Clay, MSPAS, PA-C
Most long-distance travel involves sitting for extended periods of time. This sedentary situation can lead to blood clots, called deep vein thrombosis (DVT), most often in your legs. DVTs are a serious medical condition. Blood clots, characterized by a thickening of some of your blood into semisolid form, occur naturally as the body’s mechanism to stop bleeding. However, blood clots can also form in ways that cause harm, even death. Although rare, anyone traveling by airplane, car, bus, or train or any other transport that requires sitting for more than 4 hours can be at risk for developing a blood clot.
A DVT is a clot of blood that forms in a large vein, commonly in the legs, which can damage the vein and prevent blood from circulating past the clot. If some of the clot breaks off, there is a chance that the clot can travel to your lungs, causing a pulmonary embolism (PE), which can be fatal.
Who is most at risk?
Your chance of developing a travel-associated DVT increases with these conditions:
- Previous history of blood clots or clotting disorders in yourself or immediate family members
- Pregnant or within 3 months of delivery
- Recent surgery or hospital stay
- Active cancer or recent treatment for cancer
- Use of estrogen-containing birth control or hormone replacement
- Varicose veins
- Having an indwelling venous catheter such as a PICC line or dialysis catheter
- Having limited mobility (because of a leg cast, for example)
- Age older than 40
What are signs and symptoms of a DVT?
When a DVT develops the affected limb (usually the leg) is often red and warm to the touch (“feels hot”), and there is often pain and/or swelling. Swelling can be isolated to the calf area or may involve the entire leg. Typically, a DVT occurs in only one leg, but occasionally it can happen in both.
If you have symptoms concerning for a DVT, contact a doctor as soon as possible.
What are signs and symptoms of a Pulmonary Embolism (PE)?
Signs and symptoms of a PE can include shortness of breath (this is the most common symptom), fast heart rate (pulse >100 beats per minute), rapid breathing, lightheadedness, pain in your chest that increases when you take a deep breath or cough, and/or blood in your sputum when you cough. Shortness of breath can occur at rest or with exertion and usually begins suddenly.
A PE can cause your heart to suddenly stop beating (cardiac arrest). Eight percent of all cardiac arrests are caused by a PE. Not everyone with a PE has the same symptoms; some individuals may have nonspecific complaints or mild symptoms. You can have symptoms while you are traveling but also days or weeks after you have been traveling.
If you have any symptoms concerning for a pulmonary embolism (PE), call 911.
How can I prevent a DVT or PE when I travel?
Move! Get up and walk around every 2-3 hours. When flying, if possible, choose an aisle seat to make getting up and down easier. Change positions! Frequently stretch your calf muscles and legs by raising and lowering your heels while your toes remain on the floor. Tighten and then release your leg muscles during the trip. Wear loose clothing! Avoiding tight or restrictive garments can help to improve blood flow while you are sitting. If you are at risk for blood clots, it is important to discuss your options with your healthcare provider prior to travel. Your provider may recommend wearing compression stockings and/or prescribe medications that may prevent blood clots when you travel. Following a DVT or PE, you will likely be prescribed a blood thinner (anticoagulant) to reduce the risk of future clots.
B Taylor Thompson, Christopher Kabrhel, Constantino Pena, “Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism,” UpToDate, updated September 25, 2019.
Benjamin Wedro, “Blood Clots,” emedicinehealth, https://www.emedicinehealth.com/blood_clots/article_em.htm
Centers for Disease Control and Prevention, “Blood Clots and Travel: What You Need to Know,” https://www.cdc.gov/ncbddd/dvt/travel.html
Centers for Disease Control and Prevention, “Blood Clots During Travel,” https://wwwnc.cdc.gov/travel/page/dvt
Mayo Clinic, “Blood Clots,” https://www.mayoclinic.org/symptoms/blood-clots/basics/causes/sym-20050850
MedlinePlus, “Blood Clots,” https://medlineplus.gov/bloodclots.html