Applying Sequential Compression Devices

Applying Sequential Compression Devices

Equipment
■ Compression pump, motor, or machine.
■ Connecting tubing, if applicable. (In some devices, the tubing is preconnected to the sleeves.)
■ Compression sleeve (knee-high or thigh-high, depending on the prescription and the type of device).
■ Elastic stockings (if prescribed).
■ Washcloth and towel as needed to cleanse the lower extremities.
■ Measuring tape.

Assessment
■ Assess signs and symptoms of severe peripheral arterial disease (e.g., weak or absent pulses, discoloration, cyanosis, or gangrene).
■ Assess the condition of the skin: note lesions, dermatitis, or major edema, as evidenced by shiny, taut skin.
■ Be Safe! Assess cognitive level and level of consciousness. Patients with altered cognition may be at higher risk for falls related to the presence of the connecting tubing and attachment to the compression pump. Patients who are unconscious will not be able to report a device that is creating too much pressure.
■ Be Smart! Increased compression of vessels by the sequential device may further impede arterial flow. If skin is overstretched by edema, the SCD may irritate or worsen skin conditions and cause skin breakdown.

Post-Procedure Reassessment
■ Assess inflation and deflation of the sleeve to be sure the device is working.
■ Monitor for kinking or pinching of the connecting tubing.
■ Monitor circulation, sensation, and motion of the foot, including:
■ Skin color.
■ Pulses.
■ Temperature.
■ Capillary refill.
■ Motion and sensation.
■ Patient comfort.
■ Skin condition.
■ Signs and symptoms of deep vein thrombosis.
■ Be Safe! Remove the compression sleeves at intervals so that you can inspect skin and evaluate the adequacy of circulation. Note: If elastic stockings are being used in conjunction with SCD, follow the recommendations in Procedure 37-2.

Key Points
■ Determine whether elastic stockings are to be used concurrently with the SCD. If so, apply them.
■ Place the regulating pump for the sequential compression in a location that will ensure patient safety.
■ Place the patient in a supine position.
■ If you are using SCDS or PAS brand thigh-high compression sleeves, measure the thigh.
■ Place the lower extremity on the open sleeve, ensuring that the compression chambers are located over the correct anatomical structure (e.g., knee opening is at the level of the joint).
■ Leave one to two fingerbreadths between the sleeve and the extremity.
■ Set the regulating pump to the correct pressure, as prescribed.
■ Be Safe! Instruct the patient to call for assistance in disconnecting the tubing from the sleeve.

Documentation
■ Document the date and time you applied the device.
■ Note the type and size (if applicable) of the compression sleeve used.
■ Document the skin condition, including any abnormalities.

Sequential compression sleeves