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Discussion

Scd

I have been trying to do some research on dvt prevention in post partum c-section mothers and gyne pt's. We have a doctor that insists that scd be worn all the time during to hospitalization, the only exception is when the pt is ambulating, if in the chair, on, if sitting on the edge of the bed, on. The patients want to be able to move about freely and feel tied down. We have these pts out of bed usually with in 6hrs of surgery. This doctor tried the heparin thing and ended up with a big clot and return to OR. So my question is how long do you make the pt wear scd after they are up ad lib or ambulating in the hall 2 to 3 times a day? My other concern is if a pt is up ad lib and forgets that the scd's are on and takes off walking maybe holding her baby then falls.

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  • Experts

Our post c/s orders say SCDs or TEDs on until fully ambulatory. Once they are up and about - even just able to get back & forth to the BR, everything can come off.

He's covering his butt, DVTs are getting to be common malpractice claims. Not sure if you would be able to get him to change these orders because you can't guarantee that each and every mom is going to be up and active. Are they wearing TEDs in addition to SCDs? If not, I would try suggesting that they all have TEDS and wear SCDs anytime they are in bed. And make it SOP that they must be out of bed for each meal in addition to bathing daily and ambulating in halls several times a day.

after they are up ad lib or ambulating in the hall 2 to 3 times a day? quote]

Yes, this is what we do where I work.

  • Experts

My personal opinion (and I believe the research backs me up on this one) is that the single best thing we do to prevent clots is to get people walking after surgery.

We don't use TEDs or SCDs. We do get them up and walking as soon as they have legs - usually within 2-4 hours. We haven't had any post-op DVTs since I've been here.

same as hoppermom

the only etc is pt that weigh >300lbs or reluctant(non compliant) fo ambulation

I make the effort to get my c/s patients up within the 4 hour window. Definitely by the 6-8h mark.

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