Wells' Criteria

Question 1

What are you going to ask in HPC for wells’?

Answer 1

LEG

1. Pitting oedema confined to symptomatic leg +1
2. Entire swollen leg +1
3. Tenderness along the deep venous system +1
4. Swelling >3cm more than other leg +1
5. Superficial veins present +1

Question 2

What are you going to ask in PMH for wells’?

Answer 2

BEFORE LEG

1. Bedridden recently >3 or recent surgery within four weeks +1
2. Active cancer or treatment in the last 6 months +1
3. Alternative diagnosis to DVT as likely or more likely -2
4. Paralysis, paresis, or recent plaster immobilisation of the lower extremity +1
5. Previously documented DVT +1

Question 3

What investigations do you do for patients with a Well’s score of >2?

Answer 3

Offer people with a likely DVT Wells score (2 points or more):

1. A proximal leg vein ultrasound scan, with the result available within 4 hours if possible
   (if the scan result cannot be obtained within 4 hours do a D-dimer test, then interim therapeutic anticoagulation and a proximal leg vein ultrasound scan with the result available within 24 hours)
2. A D-dimer test if the scan result is negative

Question 4

What investigations do you do for patients with a Well’s score of 1 or less?

Answer 4

Offer people with an unlikely DVT Wells score (1 point or less):

1. A D‑dimer test with the result available within 4 hours or
2. If the D-dimer test result cannot be obtained within 4 hours, offer interim therapeutic anticoagulation while awaiting the result