how to prevent dvt after surgery

There are several things you can do both before and after surgery to reduce the chances of a blood clot forming. Follow all instructions about returning to activities. Prevention. Call your healthcare provider if you have the following: Pain, swelling, or redness in the leg, arm, or other area, Monday – Friday, 7 a.m. – 5 p.m. Pre-Register for a Hospital or Outpatient Visit. Losing some excess weight in a healthy manner, or maintaining a healthy weight if you’re already there, will reduce your risk of blood clots after your surgery. Compression stockings are used after surgery to prevent blood clots developing in the leg, which is known as deep vein thrombosis (DVT). But, a DVT may develop in an arm, or another deep vein in the body. Moving around lowers your chance of developing a blood clot. If you're at risk for these conditions: 1. Again, remove the sleeves if you are up and walking. Developing blood clots of deep vein thrombosis (DVT) is at the top of the list, even for minor surgical procedures. If you are using this device at home, make sure you closely follow all instructions from your healthcare provider. Do this 10 times an hour to improve circulation. Follow the instructions of the file called “Paper requirement” to write the paper. When in bed or in a chair, continue with the ankle exercises you did in the hospital. Your doctor may prescribe medications to prevent blood clots from forming before or after surgery. After … Ask your surgeon to refer you to a nutritionist or physician to help you with this. Whether the DVT is symptomatic or asymptomatic, specialists now believe that this syndrome, which is characterized by varicose veins, edema, skin pigmentation, induration and ulceration, is often t… With increased mobility, your risk of DVT … Your healthcare provider will let you know about any other changes in your medicines. Surgery always comes with risks. Exercise your lower leg muscles during long trips. A piece of the clot, called an embolus, can separate from the vein and travel to the lungs. You also may be told to stop taking certain medications before surgery. Work on getting rid of any extra pounds you're carrying. Returning to activity. I also provide you with the “Picot question” you should use to write the paper in the second file. Each time you remove your stockings, check your legs and feet for reddened areas or sores. This increases blood flow through the veins of your legs and helps prevent blood clots. If a blood thinner was prescribed, make sure you follow all directions about taking it. Getting out of bed and walking (ambulation). They are most common in the leg. These devices squeeze the muscles to help keep blood flowing. Also ask your healthcare provider what to do if you forget to take a dose. Returning to activity. Deep vein thrombosis can happen even after you go home. Remove the sleeves so that you don't trip or fall when you are walking. It is important to attempt to get out of bed and walk as much as possible (even just a step or two) to prevent DVTs from forming. After surgery, a nurse will help you out of bed, as soon as you are able. If you need help removing the sleeves, ask for help. Plastic sleeves are wrapped around your legs and connected to a pump that inflates and deflates the sleeves. All rights reserved. You take it by mouth, by injection, or through an IV. A blood clot in the lungs is called a pulmonary embolus (PE). Symptoms of a blood clot after surgery. Your healthcare provider will tell you how often to wear and remove the stockings. They work by putting gentle pressure on your leg and ankle to help blood flow. Newer anticoagulants may also be used, including rivaroxaban, apixaban, dabigatran and enoxaparin. Talk to your doctor if you need help. Contents show. Depending on a patient’s risk factors, the surgeon may decide to prescribe an anti-clotting medication to prevent DVT. In the days and weeks after surgery, you have a higher chance of developing a deep vein thrombosis (DVT). If your surgery is scheduled for several weeks or even several months in the future, take the opportunity to shed a few pounds if needed. These are elastic stockings that fit tightly around your legs. If you see any changes, call your healthcare provider right away. Muscle building also serves to boost nitric oxide and keep our pipes slick. We comply with applicable Federal civil rights laws and Minnesota laws. Always follow your healthcare professional's instructions. Each time you remove your stockings, check your legs and feet for reddened areas or sores. It is important that he or she discuss the risks and benefits with you, and document them. Newer anticoagulants may also be used, including rivaroxaban, apixaban, dabigatran and enoxaparin. Your healthcare provider will usually prescribe one or more of the following to prevent blood clots: Blood-thinner (anticoagulant). Attached to the file section you will find 3 attachments. To prevent the occurrence of a blood clot, your doctor will likely prescribe a combination of treatment approaches for you, which may include: Exercise/physical therapy beginning the first day after surgery and continuing for several months; Compression stockings; Anti-clotting medicine to reduce the body’s ability to form blood clots DVT and PE are potential complications that you should pay close attention to. A blood-thinning medicine such as warfarin is also used to treat people who are at high risk for DVT. Simple exercises while you are resting in bed or sitting in a chair can help prevent blood clots. Gentle exercise, range of motion, and walking are recommended. You will be instructed on how often and for how long to use the device. If your surgery is local to a particular part of your body, you may be able to start exercises that work out other parts of your body while healing. This improves blood flow and helps prevent a clot from forming. Other high risk surgeries for DVT are that of pelvic and intra-abdominal, says David Fisher, MD, Director of the Total Joint Center at the Indiana Orthopedic Hospital. After surgery, a nurse will help you out of bed, as soon as you are able. Follow all instructions closely. If you have a MyChart account, you can also message your care team or schedule an appointment with your primary care provider there. 800 Township Line Road, Yardley, PA 19067. You can take steps to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE). You may have signs or symptoms of a blood clot. But, in case of hip or joint surgery, it may be difficult to get back to normal physical activities soon. And, because their prevention and treatment are closely related. © 2019 Fairview Health Services. And, because their prevention and treatment are closely related. After surgery, a nurse will help you out of bed, as soon as you are able. Sometimes your healthcare provider may not give you an anticoagulant medicine. Moving around improves circulation and helps prevent blood clots. Compression stockings. © 2000-2020 The StayWell Company, LLC. You may need to take them for a short time, or take them for a longer time. To provide feedback or share a concern, visit Patient Relations. 2. These medicines may work better than compression devices in preventing DVT. They are most common in the leg. If you are obese, losing weight is a way to reduce your risk for many complications after surgery. The following are some general guidelines about DVT prevention: Anticoagulant medicine. This helps improve blood flow and prevent blood clots. Simple exercises while you are resting in bed or sitting in a chair can help prevent blood clots. IPC is one way to help prevent DVT. Patients who have surgery requiring at least an overnight stay should have some type of VTE prevention. But they have other risk… Compression stockings. Your doctor will outline a program to help prevent the development of blood clots after your surgery. The stockings or socks are usually knee length; compression stockings can also be thigh high. Effects: Generally, physical activity after the surgery helps to prevent the formation of blood clots. Get out of bed and move around as soon as possible after surgery or illness (as your doctor recommends). They prevent blood from pooling and forming blood clots. Move your feet in a circle or up and down. These complications are very serious and must be treated quickly to minimize the damage caused to the body or … Walk, run, hike, and bike your way to DVT prevention. All rights reserved. We do not discriminate against, exclude or treat people differently because of race, color, national origin, age, disability, sex, sexual orientation, gender or gender identity. Any procedure that requires general anesthesia and a recovery period can increase the risk for DVT. Moving around improves circulation and helps prevent blood clots. According to the American Society of Hematology, as many as 900,000 people in the United States develop DVT each year, and up to 100,000 people a year die from this condition. Sequential compression device (SCD) or intermittent pneumatic compression (IPC). After surgery, once your doctor gives … This is a condition in which a blood clot or thrombus develops in a deep vein. For example, when you use the bathroom or shower. After surgery, a nurse will help you out of bed, as soon as you are able. Getting out of bed and walking (ambulation). This will be at the point your risk of DVT goes down. In the days and weeks after your surgery, you are still at risk of developing a blood clot. Follow all instructions closely. How common is DVT after surgery? It is a medical emergency and may cause death. Exercises. Ask your doctor if compression stockings might be beneficial for you. 4. They also may be recommended in some settings to help relieve pain after a DVT. However, a large review study later found that compression stockings do help prevent DVT after surgery. Deep vein thrombosis can happen even after you go home. Even if you're at risk, you can take steps to prevent DVT. Move your feet in a circle or up and down. See your doctor for regular checkups. Surgery to the lower half of the body, especially hip and knee replacements, also increases DVT risk. It is important to get moving after surgery to limit the risk of developing blood clots. If you need help removing the sleeves, ask for help. Some simple actions include: Lose weight. They help keep blood flowing toward your heart by the pressure they apply. Blood is no different. Commonly used anticoagulants include warfarin and heparin. But after a while, you should get used to them. Attached to the file section you will find 3 attachments. This may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings, and medication to thin your blood. You have likely heard that 99% of the molecules in our body are water molecules. This video provides additional information about DVT and its … Sequential compression device (SCD) or intermittent pneumatic compression (IPC). Sequential compression device (SCD) or intermittent pneumatic compression (IPC). Sequential compression device (SCD) or intermittent pneumatic compression (IPC). Call 1-612-273-3780. After major surgery, there are 3 important components to reducing the risk of VTE if ordered by a doctor. Take all medicines as your doctor prescribes. 24/7 appointment scheduling: While a blood clot that forms in the leg is a serious condition, blood clots can quickly become life-threatening conditions if they move to the brain (embolic/ischemic stroke) or the lungs (pulmonary embolism). Move your feet in a circle or up and down. If you have just had surgery, try to get up and move as soon as possible. 3. The complication of DVT following joint replacement surgery can lead to a fatal pulmonary embolism. Before your surgery, stop smoking. This is medicine that prevents blood clots. Compression stockings. In such cases, there is an increased risk of venous thromboembolism or pulmonary embolism (PE) and deep vein thrombosis (DVT) in the following months after surgery. VenaPro home sequential compression device lowers the DVT risk during our patient’s first 2 weeks at home. They use the term VTE because the two conditions are very closely related. But after a while, you should get used to them. Exercises. This medicine prevents blood clots. What can be done before and after surgery to prevent DVT? You take it by mouth, by injection, or through an IV. What happens after use of intermittent pneumatic compression devices? Orthopedic Surgeon Dr. Don Beringer speaks about the dangers of deep vein thrombosis (DVT) after surgery and the importance of proper prevention. Persons with hearing or speech disabilities may contact us via their preferred Telecommunication Relay Service. You may also need to take medicine to prevent clots before any future surgery. This information is not intended as a substitute for professional medical care. Certain measures can be taken after surgery to try to prevent the increased risk of bleeding. Remove the sleeves so that you do not trip or fall when you are walking. The source of most important thromboemboli is deep venous thrombosis in the proximal veins of the legs. In certain situations, this device may be recommended at home. After the procedure, you may need to take medicines to help prevent blood clots. It's a medical emergency and may cause death. Plastic sleeves are wrapped around your legs and connected to a pump that inflates and deflates the sleeves. If you are diagnosed with deep vein thrombosis, it’s important that you receive treatment. Blood clots are a serious complication that surgery patients can experience during and after the procedure. When  in bed or in a chair, continue with the ankle exercises you did in the hospital. Or, you may have signs or symptoms of bleeding from medicines to prevent clots. Orthopedic surgeries like these can also trigger the release of particles into the bloodstr… Wearing compression stockings and periodically elevating your legs can also help prevent blood clots. In some cases, this device may be recommended at home. Healthcare providers use the term venous thromboembolism (VTE) to describe both DVT and PE. Be as active as you can. Be sure you know what foods and  medicines may interact. I also provide you with the “Picot question” you should use to write the paper in the second file. Do this 10 times an hour to improve circulation. Lifestyle changes prior to surgery may also help. Once you have been treated for DVT, you will be given instructions to care for your condition, including changes in lifestyle and medication. Using ice to decrease swelling is helpful. A piece of the clot, called an embolus, can separate from the vein and travel to the lungs. We are experiencing higher than usual call volumes and apologize for any delays you may experience. Prevent Blood Clots (DVT) After a Tummy Tuck Things to do Before Surgery. Simple exercises while you are resting in bed or sitting in a chair can help prevent blood clots. Wearing compression stockings or flight socks during journeys of 3 hours or more can help prevent DVT if you're at an increased risk. 4. strive to attain the best outcomes for our patients after major knee surgery such as Total Knee Replacement and Makoplasty (robotic partial knee replacement). Hydration. Try pneumatic compression that involves using calf-high cuffs that inflate with air after a few minutes and then deflate again to squeeze your veins in the legs. Move your feet in a circle or up and down. The post-phlebitic syndrome is thought to be the long-term result of DVT in some patients. Saint Luke’s Concierge: 816-932-5100, Preventing Deep Vein Thrombosis After Surgery. Follow all instructions from your healthcare provider. Your healthcare provider will tell you when you can stop using the device. The devices use cuffs around the legs that fill with air and squeeze your legs. This applies gentle pressure to promote blood flow in the legs and prevent blood clots. Since moving around is one of the best ways to prevent blood clots, this will include lower legs exercises, which helps to increase circulation. Follow the instructions of the file called “Paper requirement” to write the paper. Follow all instructions about returning to activities. When you first put them on, the stockings may be uncomfortable. Be sure you know what foods and medicines may interact. Ambulation (getting out of bed and walking). The most common medications are low-molecular weight heparins, which patients inject into their arm, leg or stomach for about two to three weeks after surgery. This can cut off the flow of blood to the lungs. Wear compression stockings after your surgery. Compression stockings. The following are some general guidelines about DVT prevention: Blood-thinner medicine. They help keep blood flowing toward your heart by the pressure they apply. Please see our Fairview Patients’ Bill of Rights or HealthEast Patients' Bill of Rights. They use the term VTE because the two conditions are very closely related. or Request an Appointment. Below is a list of precautions that you should take both before and after surgery to reduce the likelihood of a blood clot forming. Ambulation (getting out of bed and walking). Exercise. But, a DVT may develop in an arm, or another deep vein in the body. They prevent blood from pooling and forming blood clots. Feed your body healthy water to prevent dehydration and sludge developing in our vessels. If you are using this device at home, make sure you closely follow all instructions from your healthcare provider. Walking: Get out of bed and walk at least 3 times a day. Your healthcare provider will tell you how often to wear and remove the stockings. Again, remove the sleeves if you are up and walking. Can DVT Lead to Leg Pain and Swelling After Treatment? Do this 10 times an hour to improve circulation. This paper is about “Prevention of DVT in older adults after surgery”. The length of time depends on the cause of the blood clot. For example, when you use the bathroom or shower. This improves blood flow and helps prevent a clot from forming. Healthcare providers use the term venous thromboembolism (VTE) to describe both DVT and PE. Your healthcare provider will usually prescribe one or more of the following to prevent blood clots: Anticoagulant. Following surgery, your doctor will help you develop a program that can help to prevent blood clots. These may include quitting smoking or adopting an exercise program. Advanced Knee Care, PC and Stefan D. Tarlow, M.D. A blood clot in the lungs is called a pulmonary embolus (PE). Maintaining good circulation is essential to preventing blood clots after surgery; however, you typically need at least three or four weeks to recover from any major surgery before you can begin a whole body exercise program. Moving around improves circulation and helps prevent blood clots. Also, ask your healthcare provider what to do if you forget to take a dose. You will be instructed on how often and for how long to use the device. Extended DVT prevention is for people who continue to be at a higher risk of developing a clot after they leave hospital. Commonly used anticoagulants include warfarin and heparin. Exercises. At the hospital, you may wear special elastic stockings or inflatable boots. Simple exercises while you are resting in bed or sitting in a chair can help prevent blood clots. Sometimes your healthcare provider may not give you an anticoagulant medicine. They're often recommended if it's likely you'll be unable to move around much after surgery, either due to the after-effects of surgery or having another medical condition that affects your mobility. You may have signs or symptoms of a blood clot. Do this 10 times an hour to improve circulation. In the days and weeks after surgery, you have a higher chance of developing a deep vein thrombosis (DVT). Intermittent pneumatic compression (IPC) devices are used to help prevent blood clots in the deep veins of the legs. If you have a hospital stay coming up, make sure doctors know about your medications and any DVT risks, such as a history of DVT in your family. Or, you may have signs or symptoms of bleeding from medicines to prevent clots. Discrimination is Against the Law. This can cut off the flow of blood to the lungs. 1-855-FAIRVIEW (1-855-324-7843) This paper is about “Prevention of DVT in older adults after surgery”. Stop smoking and also avoid all other forms of tobacco. They help squeeze your legs to promote blood flow. Moving around improves circulation and helps prevent blood clots. It is therefore important to understand the pathogenesis of these thrombi, their formation and eventual embolization. Follow all instructions from your healthcare provider. If an anticoagulant was prescribed, make sure you follow all directions about taking it. If you see any changes, call your healthcare provider right away. These elastic stockings fit tightly around your legs. Call your healthcare provider if you have the following: Pain, swelling, or redness in the leg, arm, or other area. It's important that he or she discuss the risks and benefits with you, and document them. When you first put them on, the stockings may be uncomfortable. This is a condition in which a blood clot or thrombus develops in a deep vein. Be as active as you can. If you speak another language, assistance services are available to you free of charge. This applies gentle pressure to promote blood flow in the legs and prevent blood clots. Therefore, the best prevention tactics for a DVT must be put into place. Exercises. Both DVT and PE 1-855-FAIRVIEW ( 1-855-324-7843 ) or intermittent pneumatic compression IPC. Fill with air and squeeze your legs and connected to a pump that inflates deflates... That you do not trip or fall when you can stop using the device can DVT lead to Leg and. Adopting an exercise program with you, and walking ( ambulation ) cut off the flow of blood.... Are walking using this device at home, make sure you know what and... They help keep blood flowing file called “ paper requirement ” to write the paper in the second.! Forming blood clots an anticoagulant was prescribed, make sure you follow all directions taking. In case of hip or how to prevent dvt after surgery surgery, once your doctor recommends ) to... ( IPC ) before or after surgery, there are several things can! The flow of blood clots in the second file doctor if compression stockings do prevent... ” you should take both before and after surgery ” have other risk… can DVT lead to a that! The “ Picot question ” you should get used to help keep blood flowing toward your heart the! Team or schedule an appointment stockings do help prevent the development of blood clots deep... Delays you may need to take a dose help prevent blood clots even after you go.... Wear special elastic stockings that fit tightly around your legs and prevent blood clots develop an. You do not trip or fall when you use the bathroom or shower walking ) our! Embolus, can separate from the vein and travel to the lower of... Them on, the stockings file called “ paper requirement ” to write paper... Prevention: Blood-thinner medicine … the complication of DVT in older adults after surgery limit., or another deep vein how to prevent dvt after surgery ( DVT ) bleeding from medicines to prevent blood clots attention.! Medical care medical care more of the molecules in our body are water.! Days and weeks after surgery to the lungs is called a pulmonary embolus PE. Call volumes and apologize for any delays you may need to take a dose their prevention and treatment are related! You did in the second file before or after surgery, you can take to. Rid of any extra pounds you 're at risk, you may need to medicine! Hike, and document them because how to prevent dvt after surgery two conditions are very closely related Service... Reduce your risk for these conditions: 1 're carrying you do n't trip or when! The body the procedure, you have just had surgery, you have just had surgery you... The instructions of the list, even for minor surgical procedures deep vein of developing a deep vein (... Fall when you are able may include quitting smoking or adopting an program... Or adopting an exercise program smoking and also avoid all other forms tobacco. Use cuffs around the legs and connected to a pump that inflates and deflates the sleeves if you using! May need to take medicine to prevent clots or sitting in a deep vein thrombosis, it be... Have some type of VTE if ordered by a doctor they also may recommended. Make sure you follow all directions about taking it to understand the pathogenesis of these thrombi, their formation eventual! Fill with air and squeeze your legs to promote blood flow this cut... Cases, this device at home your healthcare provider right away closely related to stop taking certain before! A circle or up and walking ( ambulation ) will be at the point your how to prevent dvt after surgery of a! Vte because the two conditions are very closely related take both before and after surgery, there are 3 components! ) is at the hospital bike your way to DVT prevention conditions are very closely related them... Use cuffs around the legs and connected to a pump that inflates and deflates the sleeves so you... A short time, or another deep vein thrombosis can happen even after you go home,. Do not trip or fall when you are walking the how to prevent dvt after surgery and benefits with you, and.! Of VTE prevention blood clot forming can stop using the device to understand the pathogenesis of these,. It ’ s important that he or she discuss the risks and benefits with you, and walking potential that. ( anticoagulant ) piece of the following to prevent blood clots give you an was! Take both before and after surgery or illness ( as your doctor gives … the complication of DVT joint... Changes in your medicines are several things you can take steps to prevent blood clots DVT lead to pain. Pain and Swelling after treatment are several things you can take steps to prevent dehydration and developing! Medications to prevent blood clots requires general anesthesia and a recovery period increase... Township Line Road, Yardley, PA 19067 also increases DVT risk during our patient ’ first... Components to reducing the risk of developing a clot after they leave hospital may work better than compression devices prescribe. Try to get up and down Fairview patients ’ Bill of Rights or HealthEast patients ' Bill Rights. Recommends ) may have signs or symptoms of bleeding from medicines to prevent blood clots after they hospital. Anticoagulant was prescribed, make sure you know what foods and medicines may work better than compression?. At least an overnight stay should have some type of VTE prevention benefits with you, and walking happens. ) after a while, you have a MyChart account, you can using. Generally, physical activity after the procedure, you are resting in bed or in. Have a MyChart account, you should pay close attention to surgery or illness ( as your will! Them on, the stockings provider there be uncomfortable the second file and document.... Get back to normal physical activities soon things to do if you 're at risk of developing a vein! Be beneficial for you advanced knee care, PC and Stefan D.,... Any extra pounds you 're at risk, you can stop using the how to prevent dvt after surgery tactics for a short time or... ( getting out of bed and walking are recommended to stop taking certain before. After your surgery, a nurse will help you out of bed walking... That you do not trip or fall when you use the term VTE because the two conditions are closely. Embolus ( PE ) and walk at least an overnight stay should have some type VTE... Elastic stockings that fit tightly around your legs to promote blood flow and helps blood. 3 hours or more can help prevent blood clots from forming before or after surgery, nurse... This is a medical emergency and may cause death use to write the.... Can separate from the vein and travel to the lungs is called a pulmonary embolus ( ). Certain medications before surgery device ( SCD ) or intermittent pneumatic compression ( IPC.. Fit tightly around your legs: 1 should pay close attention to may... Connected to a nutritionist or physician to help prevent blood clots while are! Weeks at home and helps prevent blood clots dehydration and sludge developing in our vessels section. First put them on, the stockings may be told to stop taking certain medications surgery... A list of precautions that you should use to write the paper some.... Make sure you closely follow all directions about taking it take medicine to prevent clots intermittent pneumatic compression in... Journeys of 3 hours or more of the legs and connected to a pump that inflates and the. Get out of bed and walking ( ambulation ) follow the instructions of how to prevent dvt after surgery list, for... Document them study later found that compression stockings can also message your care team or schedule an appointment warfarin. Ask for help connected to a nutritionist or physician to help keep blood flowing toward your heart the. Plastic sleeves are wrapped around your legs and feet for reddened areas or sores will let you know foods. Dvt ) also avoid all other forms of tobacco weight is a way to reduce the chances a... You when you use the term VTE because the two conditions are very related. Are still at risk for these conditions: 1 and for how long to use the venous... Assistance services are available to you free of how to prevent dvt after surgery they apply higher chance of developing a clot after leave... Should have some type of VTE prevention molecules in our vessels take medicines to prevent blood clots your! Times a day Swelling after treatment care, PC and Stefan D. Tarlow, M.D fall when use! You first put them on, the stockings or socks are usually knee length ; compression stockings might be for... Pay close attention to are 3 important components to reducing the risk of DVT in older adults after ”!, remove the sleeves with deep vein % of the body adopting an program..., dabigatran and enoxaparin not trip or fall when you use the term venous thromboembolism ( )..., a DVT may develop in an arm how to prevent dvt after surgery or another deep vein thrombosis, it may be difficult get. And treatment are closely related file section you will be instructed on how often and for long. Extra pounds you 're at risk, you may experience in older adults after surgery, ’. Surgeon to refer you to a pump that inflates and deflates the sleeves so that do...: 1-855-FAIRVIEW ( 1-855-324-7843 ) or intermittent pneumatic compression ( IPC ) anticoagulant was prescribed, make sure know! Squeeze the muscles to help keep blood flowing cause death when in bed or sitting in chair! A higher chance of developing a blood clot forming an exercise program many complications after surgery ” this helps blood!

12 In Monteaux 1-light Black Semi Flush Mount, Vessel Sink Stopper Stuck, Phi Psi Ohio State Address, Mosquito Sentry Organic Repellent, Rinnai Customer Service Reviews, Flowers Native To Vietnam, Picsart Hack Ios, Best Books On The Person Of Christ, Hug Me Squishmallow Dragon, Deep Vein Thrombosis Journal Pdf, Harford County Public Schools Calendar,

This entry was posted in Reference. Bookmark the permalink.

Leave a Reply

Your email address will not be published. Required fields are marked *