Homan's Sign: Useful or Useless? What's your opinion?

[UM Review RN]

Do you perform Homan's sign on all of your patients? Do you find it accurate or not?

[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]

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, RN]

Actively.

[P_RN, ADN, RN]

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

[Faeriewand, ASN, RN]

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.

[MedSurgLPN2005, LPN]

I had a patient with cellulitis of the leg. Anytime we moved her leg it hurt her. I guess you could say she had a positive homans... but a clot?? I think not!

[abundantjoy07, RN]

I was taught not to assess with Homan's sign. Something about the risk of dislodging the clot and causing a PE. I assess by feeling for excessive warmth/heat, swelling, discoloration and pain. Then I'll call the doctor and get an order for the doppler to see if it really is a DVT.

[Elvish, BSN, DNP, RN, NP]

I used to do it when I started out in 2001. I've since learned better and no longer do it, for all the reasons mentioned above.

Plus, my new postpartum moms would probably be Homans + just after delivery anyway, from dehydration & pushing (= muscle cramps).

Most of the DVTs I've seen weren't Homans + anyway. Just heavy, red, shiny, and/or swollen.