SCD's post op~routine or only for the high risk?

  1. I have been working on a med-surg floor for a few months now and if we have a post op patient who is on bedrest they automatically wear spontaneous compression devices...TED hose in the very least! I had a family member who recently had surgery in another hospital (hemi-colectomy) and was very surprised to see him without the scd's 24 hours post op. I asked the nurse about it and she acted like I was speaking Greek. I requested TED hose in the very least because of his history of serious venous insufficiency. I want to reiterate that I did not go there with the attitude of "this is the way we do it" but was very surprised to see it not done and just wondering how it is in your hospital?
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    About nursenatalie

    Joined: Jan '03; Posts: 203; Likes: 14
    RN, surgical floor


  3. by   sbic56
    SCD's are ordered by our OB's on our Total Abdominal Hysts until they are ambulating. I find it's an easy intervention for such a severe complication. Teds are a PIA to put on and take off, but these things are great.
  4. by   jayne109
    Aanyone that comes to the floor following surgery (ELC, colectomies, ANYTHING) SCD's are ordered until ambulatiing several times and then are to be worn at night. The only exception is those who have had a Greenfield filter placed previoously. Our docs get pretty mad if they don't find them on the pt. Most docs also order heparin sc for those that are anticipated to stay more than one day. Our docs are pretty cautious.
  5. by   gwenith
    I would find them ordered on patients who would only need to be in bed 12 -24 hours and not ordered for patients that were on bedrest for weeks!!! GGGRRRRRRR!!!

    I used to query the use of them in short term patietns anyway because occasionally they stop the patient from moving around the bed as much. You have to be careful to explain that they can mobilize they should mobilize and yes if you want to jog around the hospital ground - just take them off first!!!!
  6. by   nursenatalie
    Thank you guys for your responses...It is hard to be "the granddaughter" and not the nurse. I felt like SCD's were a fairly benign intervention considering the history with my grandfather...I was up at 4 am wondering and worrying about this, I decided to go on to the hospital to be there when doc made rounds and he didnt mind ordering them one bit...the nurses kinda cringe when they see me coming but I have been nothing but nice to them...very hard to be in this situation! Puts things in perspective when I am caring for pts and the family starts getting on my nerves. I will be much more tolerant from now on im sure.
  7. by   MishlB
    I guess it depends on the surgery. Most surgeons want patients up and walking right away, to prevent clots, which is probably better than laying in bed with SCD's on. TED hose are fine, but I am surprised at how many people use them incorrectly. Either they don't fit right, or they are never removed.
  8. by   webbiedebbie
    Geesh, we get them on C/Sec's. What a waste! We even have to order teds on pt's who we have not seen yet (therefore, they are always the wrong size!)
  9. by   TinyNurse
    hi, i'm Jen, a new grad
    in the hospital I did clinicals at, they required SCDs on 24/7 unless the client was up and ambulating.
    i think it is a good idea.
  10. by   janleb
    We automatically put ted and SCD's on post op pt's. To prevent DVT. We have to get a physicians order to remove them and that don't happen until the pt is ambulating quite frequently during the day. Really important with hip and knee replacements, along with any type of surgery. PT that are bedriden need them especially.
  11. by   janleb
    While I am still thinking, with the ted hose it is important that they fit right. I had one pt when I went to assess the pt, the ted hose were so tight that they caused skin breakdown on a certain pt. So take them off and do skin care and really look at the skin.
  12. by   ?burntout
    At the hospital where I am...a lot of the time, the docs will order if they want SCDs and TEDs; but usually if it is MAJOR surgery-ortho, abd/gyn/urology-we get them and put them on...

    If the patient is just going for something under MAC, we don't use the TEDs or SCDs.

    We encourage the patients to use the SCDs until they are up ad lib...get the TEDs off at least once or twice a day to check the skin.

    I had a diagnostic laparascopy in April 2003 and my doc wanted me to have them because of my HTN....
  13. by   casim02
    i work on a orthopedic/neuro floor and all it is automatic that the patients wear them.. the docts are pretty good about ordering them too...
  14. by   altomga
    Gosh, I even had SCD's on after my tubal was done!!! I personally thought it was silly and a waste of my money, I was up walking around a few hours after baby was not even 12hrs old!!

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