5.

anti embolic treatment ted stockings

Prevention
• Patients who are immobile are at risk for stasis of blood in the lower extremities and
development of thrombophlebitis.
• Contraction and relaxation of skeletal muscles helps to move blood through veins
toward the heart.
• Valves within the veins prevent the blood from slipping back toward the feet under the
influence of gravity.
• Stasis – slowing down or stopping.
• Thrombophlebitis – inflamed vein due to a blood clot
Formation of Clots & Emboli
• When circulation slows, clots (thrombi) are more likely to form.
• limited activity or incompetent valves are risk factors.
• A blood clot can break loose and travel through the blood stream as an embolus.
• potential severe complications.
Blood clots
• Venous thrombosis (VTE) is a blood clot in a vein
• 3rd leading vascular diagnosis after MI and Stroke
1. Deep vein thrombosis (DVT)
2. Pulmonary Embolis
• Thrombosis – blood clot in vein slowing or stopping blood flow.
Deep Vein Thrombosis (DVT)
• clot in the deep vein
• usually involving the leg or pelvis but can occur in the arms as well.
Signs and Symptoms
• usually affects one side of the body at a time.
• swelling
• Redness
 • Warm
• Cyanosis
• pain or tenderness
Pulmonary Emboli:
• a deep vein clot that breaks free from a vein wall and travels to the lungs
• blocks some or all the blood supply to the lungs
Anti-embolism Interventions
1. Promote the circulation of blood from the legs back to the heart- increasing venous return;
decreasing venous stasis.
2. Support valves within peripheral leg veins so that blood is less likely to pool in a dependent
position- decreases dependent edema.
3. Prevent thrombus formation.
4. Leg and Foot Exercises
5. Antiembolism stockings
6. Sequential Compression Devices
7. Avoiding compression of leg vessels
We will discuss exercises when we review ROM in this class
Thromboembolic Stockings (TEDS)
• Compression socks come in compression levels starting at 15-20 mmHg, ranging all the
way to 40-50 mmHg.
• TED hose are for immobilized or bedridden patients. They come in lower grade
compression, 8-18 mmHg,
• Antiembolism stockings are elasticized stockings that provide varying degrees of
pressure at different areas of the legs.
Ensuring Proper Fit
• To provide the optimum amount of pressure, the stockings should fit properly and be
free of wrinkles
• To ensure a proper fit, measure
1. Thigh circumference
 2. Calf circumference
3. Leg Length
• Refer to the manufacturer’s chart to obtain the correct hose size.
1. Come in knee or thigh length
Applying Elastic Stockings
• Apply in morning and remove at bedtime.
• No wrinkles.
• Should be removed at least 2X/day or once per shift for circulation purposes.
• Check CWCM of toes.
• Color
• Warmth
• Circulation
• Movement
Application of Elastic Stockings
1. Turn elastic stocking inside out up to the heel.
a) Place one hand into the sock, hold the heel and pull the top of the sock with the
other hand inside out over foot of the sock.
2. Place patients toes into the foot of the elastic stocking, make sure the sock is smooth.
3. Slide remaining portion of sock over the foot, ensure the toes are covered.
a) Make sure that the foot fits into the toe and heel portion of the sock.
4. Slide top of sock over the patient’s calf until sock is completely extended.
a) Be sure sock is smooth and no wrinkles are present, especially behind the knee.
Remember to…
1. Instruct patients not to roll socks partially down.
2. Record date and time of stocking application, and stocking length & size in MARS or
Treatment Record
• Location of charting depends on facility policy and procedure
3. 0Record condition of skin and circulatory assessment