How should I approach the referral of a patient with suspected DVT to secondary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025Updated: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Refer patients with suspected DVT to secondary care if the clinical assessment indicates a high probability of DVT, such as a Wells score of 2 points or more, by offering a proximal leg vein ultrasound scan with the result available within 4 hours if possible .

If the ultrasound cannot be obtained within 4 hours, offer a D-dimer test, then interim therapeutic anticoagulation and a proximal leg vein ultrasound scan with the result available within 24 hours .

If the DVT Wells score is 1 point or less (DVT unlikely), offer a D-dimer test with the result available within 4 hours. If the D-dimer is positive, offer a proximal leg vein ultrasound scan with the result available within 4 hours, or interim anticoagulation and a scan within 24 hours if necessary .

In cases where DVT is confirmed by ultrasound, proceed with anticoagulation treatment or consider mechanical intervention if anticoagulation is contraindicated .

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Educational content only. Always verify information and use clinical judgement.