DVT sleeves and technology

[bjsmsn]

In our merged hospital system, we are in a quandry about DVT therapy with the question being sequential vs. uniform compression. Each vendor is representing his technology as effective. I would like input from all you nurses about how your institution decided on which DVT sleeve and system to use and the clinical issues you see with the effects of your decision. Thanks.

[stevierae]

here's the lowdown on these things.

The physical action of the squeezing effect has no bearing on DVT formation. What it does do, and per one of our vascualr surgeons via research article.

By intermittently squeezing the leg or feet, it artificially makes the body think it's using it's muscles.

The increased incidence of clots while labile, or sedentary life style, bedbound etc, is d/t the lack of muscle use.

Really? I've never heard this. I'd like to see this article. I always thought that DVT was directly linked to blood pooling--and forming clots-- in the extremities due to immobility or staying in one position, such as occurs on long drives or on long airplane rides. I've never heard it linked back to lack of muscle use. If that was true, why don't they encourage patients to do, say, leg curls or some other sort of calf exercises--in other words, exercise those muscles-- while they are sedentary, bedbound, or confined to a sitting position for hours at a time, such as on a plane? Why do they tell them, instead, to do ROM or take breaks, walk up and down the aisles, etc. to keep the blood from pooling? Not denying it might be true--but this info sure doesn't seem to be very widely disseminated.

Also, if that was true, how do you explain the fact that paraplegics, quadriplegics, and victims of MS, ALS, cerebral palsy or other neuro disorders which limit mobility and affect the muscles--and in fact cause atrophy--are not at any particularly increased risk of DVT or PE than are other people? Or are they? I've never heard that they are, but i could be wrong.

[grimmy, RN]

just wanted to mention that some of the gyn docs i work with with give a preoperative dose of enoxaparin so that the scds won't have to be worn with the stirrups. just another option.