Deep Vein Thrombosis (DVT) is now a newly added OSCE scenario for the NMC (Jan 2026). This newly added APIE scenario on Suspected Deep Vein Thrombosis (DVT) will be assessed only for candidates appearing for the NMC OSCE from 23rd February 2026 onwards. The Wells score for Deep Vein Thrombosis is a clinical risk assessment tool to identify the probability of DVT based on patient history and physical findings. While addressing Deep vein thrombosis, candidates are expected to assess risk using the Wells score and explain safe management clearly and confidently.
This blog breaks it down step by step based on the Wells score.
What is Deep Vein Thrombosis?
Deep Vein Thrombosis is the formation of a blood clot in a deep vein, most commonly in the leg. If untreated, it can lead to pulmonary embolism (PE), which is life-threatening.
ASSESSMENT: 2-Level Wells Score for Deep Vein Thrombosis
The Wells score helps to decide the level of Deep Vein Thrombosis
Wells Score Criteria
| Clinical Feature | Points |
| Active cancer (treatment ongoing or within 6 months) | +1 |
| Paralysis/paresis or plaster immobilisation of lower limb | +1 |
| Recently bedridden ≥3 days or major surgery within 12 weeks | +1 |
| Localised tenderness along deep venous system | +1 |
| Entire leg swollen | +1 |
| Calf swelling ≥3 cm compared to other leg | +1 |
| Pitting oedema (symptomatic leg only) | +1 |
| Collateral superficial veins (non-varicose) | +1 |
| Previous DVT | +1 |
| Alternative diagnosis as likely as DVT | –2 |
Interpreting the Score
- 0 or less – Low risk of Deep Vein Thrombosis
- 1 or 2 – Medium risk of Deep Vein Thrombosis
- 3 or more – High risk of Deep Vein Thrombosis
This decision guides all further management in the NMC OSCE.
| Score | Management | Inform the patient |
| 1 or less medium risk of DVT (Unlikely) | D-Dimer test, Interim anticoagulation | Inform the doctor, and will perform a D – dimer test to identify body may be forming or breaking blood clot |
| 2 or More High risk of DVT (Likely) | Ultrasound, D-Dimer test, Interim anticoagulation | Inform the doctor, and will perform a D – dimer test to identify body may be forming or breaking blood clot |
D-dimer Result
Positive
- Continue interim anticoagulation or other recommended treatment
- Repeat ultrasound as per the doctor’s advice
Negative
- Stop interim anticoagulation
- Consider other diagnoses as per the doctor’s advice
Important OSCE Check Points
- A-E assessment remains the same as per the marking criteria
- Check the presenting complaint of the patient. It can include – leg swelling, pain or tenderness in the calf or thigh, warmth in the affected area, Redness or skin discolouration, a feeling of tightness or heaviness.
- Possible symptoms can be sudden shortness of breath, chest pain, and coughing.
- Holistic care – Assess for both legs, swelling, redness, discolouration, and Visible superficial veins.
- calculate the 2 – level Wells score and inform management.
This brief on Deep Vein Thrombosis will help you to manage the newly introduced Deep scenario in the NMC OSCE. By following a structured assessment approach, using the 2 – level Wells score, recognizing key risk factors, and providing appropriate care as per guidelines, you can demonstrate safe, evidence – based nursing practice. A systematic assessment carried out with patient – centric care not only supports safety but also meets assessment criteria during the exam. With Mock practice and a confident explanation of each step, you will be well prepared to approach this scenario calmly and successfully on the NMC OSCE day.
Key takeaways:
- What does each well’s score criteria mean?
- Why is it called the 2 – level Wells score, and how is it better than the 3 – level Wells score?
- Why is D-dimer skipped when the score is 2 or more?
- More details about the D – dimer test?
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