[passing thru]

What Is It Anyway?? I Never Can Remember...

[danfif]

The Homans Sign is the term used for the test used by nurses to indicate the possibility of a DVT or Deep Vein Thrombosis development in one of the deep veins of a patients leg.

In order to preform this test, place your hand under the patients knee having them relax their leg, then simply flex the patient foot toward their head. If the patient reports no pain, this would be a "Negitive Homans" result. BUT, if the patient reports pain when the foot is flexed toward the head this would be considered a "Positive Homans" result, at which time the Physician needs to be called immediately. The Physician will more than likely order a Doppler Ultra Sound of the patient's leg to rule out the presence of a DVT. Until a DVT has been ruled out, or the patient is cleared by the Physician, keep the patient on strict bedrest. If not the DVT may become dislodged causing a whole lot more problems than you or the patient want to have.

Hope this helps,
Dan

[barefootlady]

Good post Dan. If positive Homan's sign, nurse should check bilateral pulses, note foot/ankle for edema or discoloration too. Make sure these findings are charted in case you are not present when physician makes rounds, returns call, or next shift has come on.

[mommatrauma]

There have been multiple studies however that show that not only is the Homan's test not very "sensitive" it is a poor predictor of DVT, and considered an unreliable test. Just an FYI

[danfif]

As unreliable as this test might be, which I agree it probably is, I will still virge on the better safe than sorry side of the road, this test is better than no test at all. If my patient were to expess pain when the foot is flexed toward the head, I would just as soon find out that it was a false positive result if you will than to have not done it and had the die of a PE because I didn't do it in the first place.

Dan

[mitchsmom]

Originally Posted by mommatrauma

There have been multiple studies however that show that not only is the Homan's test not very "sensitive" it is a poor predictor of DVT, and considered an unreliable test. Just an FYI

I just read the same thing about the meningitis tests (Kernig's, Brudzinski's, etc.)...

[AlishaNHayzley]

Originally Posted by mommatrauma

There have been multiple studies however that show that not only is the Homan's test not very "sensitive" it is a poor predictor of DVT, and considered an unreliable test. Just an FYI

So how would you document it, if either positive or negative?

[General E. Speaking, RN]

Originally Posted by mommatrauma

There have been multiple studies however that show that not only is the Homan's test not very "sensitive" it is a poor predictor of DVT, and considered an unreliable test. Just an FYI

i agree, had a 2 day post op pt w/ a total hip replacement. he was having calf pain in the non-operative leg. + homan's but doppler showed - for DVT.

[plumrn]

Our vascular surgeon scoffs at nurses who report +homans sign. But, if they have other signs/symptoms along with it, he will follow up. (redness,pain,tenderness,swelling,etc)