[miko014]

Hello! We were having a discussion about Homan's sign yesterday at work, and I was wondering what anybody on here thinks of this...Is having the pt actively dorsiflex the foot an accurate homan's check, or does the foot have to be passively flexed?

[wannabesedated]

Good question.. My text says that "you" must dorsiflex the foot, so I'm assuming it has to be passive. If active was ok to use, you would think my text would say to ask the patient to flex their foot, because it's less invasive then you doing it for them?.. If we don't have an answer by monday, I'll ask my assessment instructor..

[adria37]

Originally Posted by AshleyDawn20

Good question.. My text says that "you" must dorsiflex the foot, so I'm assuming it has to be passive. If active was ok to use, you would think my text would say to ask the patient to flex their foot, because it's less invasive then you doing it for them?.. If we don't have an answer by monday, I'll ask my assessment instructor..

I was taught not to try to elicit a Homan's because of the risk of embolization.

[cdnstamper]

I work in L and D and to complete a post partum assessment the pt must actively doesiflex their foot.

[TazziRN]

Actively.

[P_RN]

BUT it's not a very accurate predictor. Something like less than 50%, if I remember correctly.

[Faeriewand]

At my school we are taught active. My instructor says she has never seen a positive Homan's sign.

Good question. Hope this will get a discussion going. I would like to learn more about this.

[ibnathan]

I don't see the point in my textbook it says that it is only about 10% effective. Just last wk pt was admitted to ED- DKA, Pneumonia. Went to the ICU after a wk was transferred to Tele. I assessed the pt, was fine, did a Homans everything was fine. That night around 1200 pt went to go to the bathroom came back from the bathroom with SOB few minutes later Asytole.
Patient had a PE. Pt also had doppler on both lower extremities 2 days prior to the event. Sucks

[georgy]

yet to have a credible info rom that..

[miko014]

I've seen a positive once. I usually see the whole swelling, redness, warmth, pain thing. I think we were taught in my assessment class to do it passively, but most of the RNs I work with do it actively if at all. I usually do it actively, but now I can't rememebr what they taught us. I agree though, I don't know how effective it really is.