Ali Ataya, MD The Story Behind the Law
The Act is named for Emily Adkins, a young, healthy woman whose sudden passing from a pulmonary embolism highlighted a dangerous misconception: that VTE is a condition that only affects the sick or elderly. Her story serves as a powerful reminder that VTE can affect anyone, regardless of age or health status, and underscores the urgent need for universal prevention protocols.
Clinical Vigilance: Recognizing the Signs of VTE
The law reinforces the need for high clinical vigilance. Healthcare teams must be prepared to act swiftly when a patient presents with signs of a VTE.
- For a suspected Deep Vein Thrombosis (DVT): Key indicators include unilateral leg swelling, pain, redness, tenderness, or warmth.
- For a suspected Pulmonary Embolism (PE): Concerning features include the sudden onset of shortness of breath, chest pain, palpitations, or any unexplained clinical instability.
- A prompt evaluation, incorporating pretest probability assessment and appropriate diagnostic testing, should follow any suspected event.
A Mandate for Proactive, Standardized Prevention
The core of the Emily Adkins Act is the shift from reaction to prevention. It requires hospitals and ambulatory surgical centers to implement policies that formalize this approach. This includes:
- Implementing Evidence-Based Protocols: Adopting and enforcing policies grounded in current clinical evidence for VTE prevention.
- Using Nationally Recognized Tools: Embedding a standardized risk assessment tool into clinical workflows to stratify all patients.
- An Annual Training Requirement: Ensuring non-physician personnel are trained annually on VTE prevention protocols.
Applying Risk Assessment in Practice
Risk assessment under the Act operates in two complementary domains: stratifying patients for prevention and guiding the workup of a suspected clot.
- Prophylaxis-Focused Models are used to assess an individual’s risk of developing a VTE during their hospital stay. Based on factors like prior VTE, active cancer, recent surgery, and immobility, these tools help determine if pharmacological or mechanical prophylaxis is warranted.
- Diagnostic Pretest Probability Tools are used when a VTE is actively suspected. These scores help guide the diagnostic workup for an acute DVT or PE.
By embedding these tools into facility-wide policy, the Emily Atkins Act formalizes the process of protecting every at-risk patient, creating a new standard of care.
Resources
This video provides a concise overview of the Emily Atkins Family Protection Act, a landmark law that shifts the focus of clinical care from reacting to blood clots to proactively preventing them. Triggered by a tragic and preventable death, the Act mandates that healthcare facilities use evidence-based risk assessment tools to identify and protect every at-risk patient.
Quality and Safety Unpacked: Emily Adkins Family Protection Act: Preventing Blood Clots
Watch this video to understand:
- The story behind the law and the dangerous misconception that VTE only affects the sick or elderly.
- The key clinical signs for a suspected Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).
- How the law requires facilities to use standardized risk assessment tools (like the CAPRINI and WELLS scores) to formalize a new, safer standard of patient care.