teds and scds

[jennifers]

Does anyone else put scds and teds both on all patients that have had surgery...and leave them both on. I just started a new job and this is the practice. Its different for me. I've used both before but not with each other. Its different for me and I wondered if any other hospitals did the same and what the reason for it was. I asked why but got the "because thats how we do it" answer.

[VORB]

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Since an M.D. has to order them, I would check the orders and follow them. Pretty straightforward.

[pandora44]

It depends on what surgery had ordered. Usually on my med-surg floor, we use just SCDs. If surgery doesn't specify we get knee high, but we also have thigh high availiable. Sometimes surgery orders both SCDs and TEDs, likely when they are more concerned about clots. I haven't seen any evidence that one or the other or both together are best.

[pinkypie]

When I was a nurse extern in a PACU I saw it ordered twice so I guess its to the surgeons discretion and the type or surgery performed

[jennifers]

i'm curious as to how much better both are as opposed to one. These are for c section patients by the way.

[silentRN]

Teds and SCD's do two different things. SCD's get the body to release antithrombin 3 into the system which Teds don't do. Antithrombin 3 only last in the body for about 1 hour. So I would put both Teds and SCDs on.

-David

[trixter]

On our med-surg floor, surgical patients typically have both, plus we change the teds every shift (at least on days and pm's) for comfort and to avoid having the teds "cut into" the patients' legs which of course would defeat the purpose of the teds!

[mcmike55]

Have not done a lit review in a while, so, I'm not sure of the latest numbers and findings.

I figure this is one of those, one is good, two is better type things. Especially in this case as the mechanism is somewhat different.

As I understand....

The SCD's mimick the natural action of you walking, in that it stimulates venous return, and the TED's assist that as well.

We use them a lot in OR for laparoscopic cases, longer cases, those in lithotomy position, etc.

I've seen TED's alone, or both, usually.

Again, not sure of any studies, though I've heard that they've not found any real difference between thigh high or knee highs.

Kind of think, as long as they are applied properly, it should help.

Mike

[miss81, BSN, RN]

Funny, at my last job we were told NOT to us two of them together, even if it is ordered. We were supposed to report it to the manager so she could address it with the Doc because they were not suppose to be ordering it like that anymore. I never got the reason though, I left soon after.

[mappers]

I did a paper last year and the research I found showed that there is no evidence that the use of TEDs and SCDs together decrease the incidence of DVTs or emboli. At my facility, we only use SCDs and use Plexi-pulses on ortho patients. (Note, I don't work on the ortho floor or the post-op floor. I only go by what I see when the come to us for telemetry.)

[mappers]

As a matter of fact (posted too soon), a lot of evidence showed that most TEDs are used incorrectly and cause more problems with pressure sores, etc than they're worth. The biggest problem is propper fit. But how do you get the correct fit when the measuring tape is inside the package with the hose? You can't measure them before you order them, etc.

[jennifers]

so if scd's release antithrombin what do the teds do?