Checking Homan's Sign

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    We learned in school that checking for Homan's Sign is controversial because you can throw a DVT in the process. Some instructors even said we should not check for it at all. The way my OB teacher taught me how to do Homan's Sign is to have the patient point their toes and then flex and ask them if they have any sharp pain when they do it. VS having the patient push down with their feet while you squeeze the calf. Do you check Homan's Sign, and if so what is your method?
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  3. 19 Comments so far...

  4. 0
    my instructor told my class that it is done the way your OB teacher described, but is it strictly against our school's policy to do it due to the danger of throwing a DVT.
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    I haven't checked for a Homan's sign in many years for the reason you cited. In most cases at risk patients are put on Lovenox prophyllaxis (sp?) unless their medical condition contraindicates.
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    I did a lot of clinical hours on postpartum as a student and we did Homan's on everyone -- I even remember an NCLEX practice question saying you were supposed to do it as part of a postpartum assessment. I've also heard the same stuff about it possibly throwing the clot though and wondered if Homan's is still considered evidence based practice. We were taught to do it by lifting the patient's calf with one hand, then pulling back on the foot (dorsiflecting) with the other hand. Thanks to the OP for posting this question...I've wondered about this myself for a while!
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    I was taught to support the leg with one hand and then dorsiflex the foot with the other. If the patient feels a sharp pain then it is a positive Homan's Sign, but I was also told a positive Homan's always isn't indicative of a DVT. I don't see these done very often.
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    From what I remember, a positive Homan's sign is when there is pain the calf resulting from dorsiflexion (toes towards knees). I've sort of intentionally let my memory of it go because it's supposedly of little clinical value if any. Many people with a DVT have a negative Homan's sign, and many people with a positive Homan's sign have no DVT. Ultrasounds with (or even sometimes without) a positive D-Dimer seem to be pretty common these days for detecting a DVT.
  9. 1
    Quote from HamsterRN
    From what I remember, a positive Homan's sign is when there is pain the calf resulting from dorsiflexion (toes towards knees). I've sort of intentionally let my memory of it go because it's supposedly of little clinical value if any. Many people with a DVT have a negative Homan's sign, and many people with a positive Homan's sign have no DVT. Ultrasounds with (or even sometimes without) a positive D-Dimer seem to be pretty common these days for detecting a DVT.
    I think this is becomming more the standard these days.
    WalkieTalkie likes this.
  10. 0
    I just asked my professor about this yesterday, as I thought we weren't supposed to perform Homan's on a patient. She said if there are no obvious signs and symptoms of a DVT such as the warmth, redness and swelling of the calf we can perform it, but if there are obvious s/sx of a possible DVT then don't perform it because that can cause the clot to dislodge.
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    Just a little friendly FYI, because this term is misspelled often...the term is actually Homans' sign, not Homan's sign. It is named for John Homans.

    http://www.whonamedit.com/synd.cfm/2371.html
    leslie :-D and ♪♫ in my ♥ like this.
  12. 0
    We were taught it (and even tested on it), but told we were not allowed to use it in clinicals for the reasons listed above.


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