Cardiovascular: Applying antiembolic stockings and sequential compression devices (for nursing assistant training)

As a nursing assistant, you will be asked to apply antiembolic stockings and sequential compression devices or scds in clients that are at risk for deep vein thrombosis or DVT, such as those who are recovering from a major surgery or have heart and circulatory problems, make sure you know how they work and how to apply them.

But first things first in deep vein, thrombosis, deep vein refers to veins that run between the muscles as opposed to superficial veins that you can see on the surface.

And thrombosis refers to blood clot formation. So, a DVT is a blood clot in one of those deep veins and it typically involves the deep veins of the lower legs or thighs.

An individual with DVT will often complain of rapid swelling, redness and pain on the lower leg. The bad news is that it can lead to life threatening conditions such as pulmonary embolism where a broken off piece of the clot called an embolus, travels to the lungs and causes respiratory problems.

All right, antiembolic stockings and SCD S can be used to prevent DVTs. They both work by exerting pressure on the veins of the lower legs, promoting blood return to the heart instead of pooling in the legs.

Thus, they decrease the risk for blood clots. Now, antiembolic stockings look similar to conventional stockings, but they are much more elastic.

They can extend from the foot to the calf or thigh level. They can provide different levels of pressure.

So it's important to make sure the ones prescribed for the client aren't so tight that they cut off blood circulation, but also not too loose because they won't promote blood return to the heart.

They also leave an opening over or under the toes, which can be used by the health care team to check blood circulation in the lower leg as well as the color and the temperature of the skin.

Now, sequential compression devices are plastic sleeves that wrap around the client's legs and consist of multiple compartments that are connected to an air pump via a tube.

Air is pumped into each compartment from bottom to top inflating them. When all compartments are inflated, they deflate and then the cycle starts again.

This cycle helps push the blood from the legs back to the heart. Now, before applying the antiembolic stockings and SCD S here are some general considerations.

Be sure to check with the nurse. So you know what size and length of antiembolic stockings to use for your client also make sure that the legs are dry before applying them because this will make it much easier.

Keep in mind that antiembolic stockings and STD S are contraindicated in clients with ulcers, sores, areas of skin breakdown dermatitis or significant edema in the lower legs.

Also, they should not be applied in clients with impaired arterial circulation in the lower legs as indicated by cold or pale skin.

If you notice any of these, let the nurse know, make sure to ask the nurse when you should remove the stockings and the STD S.

And for how long, typically you will remove them every eight hours for about 30 minutes. Often a client is allowed to remove them for the night.

Be sure to reapply them in the morning before the client gets out of bed. Otherwise the legs can swell from standing or sitting and it will then be difficult to put them on.

Ask the nurse how often you should check the client's feet and toes for color, temperature, mobility, sensation, swelling and pain or discomfort.

All right. Now, let's discuss the procedure of applying antiembolic stockings and SCD S step by step, start by making sure that the wheels on the bed are locked and raise the bed to a comfortable working height.

Next, lower the side railings on the working side of the bed with the client in a supine position, expose one of their legs hold the antiembolic stocking with both hands and turn the stocking inside out down to the heel, slip the foot of the stocking over the client's toes, foot and heel, making sure that the heel pocket is properly positioned on the client's heel, pull the top of the stocking up the leg and the stocking will turn itself right side out as you pull the stocking up the leg gently pull the remaining stocking up over the leg.

Depending on the type. It will either stop at the knee or the thigh.

Remember that the heel pocket should be over the client's heel and there should be an opening either over or under the toes.

Make sure the stocking doesn't have any twists or wrinkles, repeat the procedure on the other leg. All right.

Now, for the S EDS first, remove the sleeves from the plastic cover and unfold them. Put one sleeve under the client's leg.

The ankle should be lined up with the ankle opening and the back of the knee with the knee opening, wrap the sleeve around the leg and make sure that it fits correctly.

You should be able to fit two fingers between the leg and the sleeve, repeat the procedure on the other leg. Now, plug the tube to the air pump and activate the pump.

A green light will typically turn on check that the compartments are properly inflating and deflating for a full cycle. Once you're done with applying the stockings or se D assist the client into a comfortable position, return the side rails to the raised position and lower the bed.

Now, when assisting a client with antiembolic stockings and STD S there are a few things you should report to the nurse right away.

First, if your client complains of rapid swelling, redness, pain, increased temperature or numbness on the lower leg, also inform the nurse if the client with ST DS shows any signs of allergic reaction to the elastic, such as swelling, redness or itching.

Next while applying the antiembolic stockings or EDS to a client report. If the skin of their legs is dry, cracked, irritated or bruised, also inform the nurse if the client reports any numbness, pain, discomfort or inability to move their toes.

Next, inform the nurse if you notice the skin is pale, cold swollen or if there's an absence of the pedal pulses. Also for clients with antiembolic stockings, you can use the toe opening to see if the skin is pale cold or swollen and let the nurse know the nurse could also ask you to report if the client feels that the stockings or the EDS are too loose or too tight after the procedure.

Document the date, the time you apply the antiembolic stockings or the C DS. And when you remove them also document if you noticed any unusual observations regarding the skin of the client's legs and feet.

Finally, if you applied antiembolic stockings, document the size and length of stockings you applied. All right.

As a quick recap, antiembolic stockings and sequential compression devices are used for clients that are at high risk for DVT.

Such as those recovering from a surgery, they work by exerting pressure to the veins of the lower legs, causing the blood to return to the heart instead of pooling.

Make sure you know how to apply antiembolic stockings and C DS after the procedure. Remember to report any unusual signs or symptoms to the nurse and document your observations.