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Applying Sequential Compression Devices

Purpose: To prevent postoperative complications, (i.e., thrombophlebitis). To promote comfort in lower extremities.

Preparation
● Review history related to recent surgical procedure, peripheral vascular disease, and thrombophlebitis.
● Determine patient’s ability to understand, cooperate, and participate in the procedure.

Special Considerations
• Any patient may need additional assistance, support, and teaching to understand the importance of using SCDs and keeping them on as prescribed.

Elderly, Physically, and Mentally Challenged Patients
• May require more assistance to apply SCDs.

Relevant Nursing Diagnoses
● At risk for altered peripheral tissue perfusion related to immobility
● Impaired gas exchange related to pulmonary embolus
● Impaired physical mobility related to injury and/or surgery
● Pain/discomfort related to injury and/or surgery

Expected Outcomes
● Patient will have improved circulation in lower extremities postoperatively and without developing thrombophlebitis
● Patient expresses increased comfort

Implementation
1. Check doctor’s order; identify patient; explain purpose, procedure, and how patient can assist if indicated. Assess patient’s or family member’s ability to participate.
Rationale: Confirms order; meets patient’s right to be informed; encourages cooperation and participation.

2. Wash hands and don clean gloves.
Rationale: Reduces transmission of infectious microorganisms.

3. Measure around the largest part of the thigh.
Rationale: Ensures correct sizing of stockings/hose.

4. Obtain equipment from central supply.
Rationale: It is not usually on the supply cart on the nursing unit.

5. Gather equipment and place at bedside and adjust lighting.
Rationale: Enhances organization; ensures good visualization to apply stockings/hose.

6. Position patient in bed in Fowler’s position.
Rationale: Patient comfort and easy access to lower extremities.

7. Wrap stockings/hose around the leg, starting at the ankle, with the opening over the patella.
Rationale: For correct positioning and optimal compression to promote circulation by sequentially compressing the legs from the ankle upward.

8. Attach the stockings/hose to the insufflator, and make sure the intermittent pressure is between 35 to 40 mm Hg.
Rationale: Ensures stockings/hose are correctly placed and a constant intermittent pressure is maintained for optimal circulation.

9. Remove gloves and wash hands.
Rationale: Prevents transmission of infectious microorganisms.

10. Check stockings/hose and compressor equipment periodically.
Rationale: Ensures proper functioning of stockings/hose and equipment.

11. Conduct patient and/or family teaching about removal and application of stockings/hose as indicated.
Rationale: Promotes participation from patient and/or family in the use of these stockings/hose.

Evaluation and follow up activities
● Evaluate patient compliance and ability to participate
● Sequential compression devices (SCDs) are applied correctly.
● Patient’s circulation is improved and without postoperative thrombophlebitis
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