Dvt

louloubell1 · Sep 30, 2004

No is the short answer. :)

ERRN1028 · Sep 30, 2004

generally , scds are for pts on bedrest to prevent formation of clots, I've never seen a pt with scds on who already has a blood clot but I've only had 3 yrs ER/ICU exp.

My rationale is that you wouldn't want to use the massaging motion to return blood to the heart if a clot is present

only my two cents:)

ERteleRN · Sep 30, 2004

No, you would not put SCD's on a pt that already has a DVT. SCD's are to prevent clots. Once there is a clot, our pt's are placed on bedrest until the heparin has started working or until a IVC (greenfield filter) has been placed.

LydiaGreen · Sep 30, 2004

Nope - if the signs are present you tell the patient to stay put (just standing up and putting weight on the leg can dislodge the clot) and summon a doc to examine and (likely) prescribe heparin. Strict bedrest and NO, never massage the area!

PHTLS · Sep 30, 2004

Hmmmm...that's what I thought too, but this particular nurse suggested we put it on anyway.

zacarias, ASN, RN · Sep 30, 2004

Nope - if the signs are present you tell the patient to stay put (just standing up and putting weight on the leg can dislodge the clot) and summon a doc to examine and (likely) prescribe heparin. Strict bedrest and NO, never massage the area!

Once heparin level is therapeutic (happens usually pretty fast), how long do you guys have them on bedrest restrictions?

LydiaGreen · Oct 1, 2004

Once heparin level is therapeutic (happens usually pretty fast), how long do you guys have them on bedrest restrictions?

That's up to the doctor based on patient Hx, blood work, and the doppler study. They use the doppler study to determine exact location and size and that guides the course of action.

suebacon · Jan 1, 2005

I have just logged onto this site as I am starting a new job in a couple of weeks - DVT nurse and am interested in the discussion. I work in England and so may not understand some of your terminology - are scs's stockings? and am I right in understanding that you keep DVT patients on bedrest until you have sorted out their clotting times?

meownsmile, BSN, RN · Jan 1, 2005

Our orthos are now telling us that Homan's sign is actually dangerous in itself for a patient. If they have a clot, the change in pressure in the veins from the Homan's test itself can dislodge a clot. Reasonable thesis since pressure from standing or pressure from pushing on the plantar of the foot can both cause venous/arterial pressure changes, true?

If a patient develops calf pain, tenderness, warmth, redness, swelling, we go straight to doppler studies, followed by PT/INR monitoring with Heprin protocol. Strict bedrest until after followup dopplers and blood work is within theraputic ranges.

ER_RN21 · Jan 1, 2005

I thought heparin did not dissolve clots but just prevented new ones from forming? I never did understand how that works. . . Any thoughts?

I start as a new grad(RN-BSN) in an Adult Critical Care Unit on Mon, eeeek. Any and all prayers will be appreciated!

pinkiepie · Jan 2, 2005

I have just logged onto this site as I am starting a new job in a couple of weeks - DVT nurse and am interested in the discussion. I work in England and so may not understand some of your terminology - are scs's stockings? and am I right in understanding that you keep DVT patients on bedrest until you have sorted out their clotting times?

Suebacon

I am only a student, and 1st semester at that, but I can tell you that SCD's are Sequential Compression Devices. They wrap around the legs with velcro and are full of air pockets, they are hooked to a machine that inflates the air pockets at varying intervals, thereby massaging the leg. I saw them this semester on the ortho floor. At our hospital they are called Kendalls, which I think is a brandname. The stockings something different and are called TED hose where I am ( lso a brand name). I hope someone else answers your question about clotting times, I am interested to know also.