Compression Flashcards
What is the standard compression pressure recommended at the ankle?
30–40 mmHg at the ankle is the standard pressure.
What compression pressure is recommended for patients with severe venous insufficiency?
40–50 mmHg can be used for severe venous insufficiency.
What compression pressure is recommended for patients with mild arterial insufficiency?
20–30 mmHg is recommended for mild arterial insufficiency.
What are the three primary effects of compression on the venous system?
- counteracts gravity
- removes fluid from tissues
- improves venous return
What are the dynamic effects of compression during movement?
Dynamic effects include changes in leg circumference, when walking, that promote fluid movement out of the limb.
How does external pressure improve microcirculation?
External pressure increases limb pressure, enhancing the force needed to push fluid out and improving microcirculation.
What are the primary indications for using compression therapy?
Compression therapy is indicated for peripheral edema, scar management, and promotion of venous return.
What is the ABI threshold below which compression is contraindicated?
Compression is contraindicated if the ABI is < 0.7.
What conditions require caution or are contraindications for compression bandaging?
Conditions include:
- uncompensated CHF
- severe PAD
- untreated DVT
- active infection
- septic phlebitis
Why is compression therapy initiated slowly in patients with CHF?
Compression is initiated slowly to ensure tolerance and avoid overloading the compromised cardiovascular system.
What is a contraindication for compression if absolute ankle pressure is considered?
Compression is contraindicated if absolute ankle pressure is less than 60 mmHg.
What are the general guidelines for tension in compression bandaging?
- Tension is inversely related to bandage width and leg circumference
- Narrow bandages and smaller limbs result in higher compression
What is the primary force created by the elastic recoil of a compression product?
Pressure is the primary force created by the elastic recoil.
What does higher stiffness in a compression product indicate?
Higher stiffness indicates greater physiological impact and resistance to expansion.
How does external pressure affect venous return?
External pressure increases limb pressure, facilitating venous return by pushing fluid out of tissues.
What law explains the relationship between tension, radius, and pressure in compression?
Laplace’s law
What is the difference between short stretch and long stretch compression bandages?
- Short stretch bandages provide high pressure during movement and low pressure at rest.
- Long stretch bandages provide mild compression and lower working pressure.
What is the advantage of multi-layer bandages over single-layer bandages?
Multi-layer bandages maintain a pressure gradient for a prolonged period and are recommended as first-line treatment for venous leg ulcers.
What materials are used in paste bandages like Unna’s boot?
Paste bandages use gauze impregnated with zinc oxide, calamine, glycerin, and gelatin, forming a semi-rigid support.
What are the characteristics of tubular bandages?
Tubular bandages provide graduated compression, but their generic shapes and sizes may not fit all patients and lose compression over time.
What is the typical compression provided by compression stockings?
Compression stockings typically provide 8–50 mmHg, with pressure greatest at the ankle and decreasing superiorly.
- Used for long-term management
What are Velcro compression garments, and what is their main advantage?
- Velcro compression garments are removable orthotic devices that provide sustained compression and are easy to apply.
- Disadvantages
- High one-time cost
- Need for patient adherence for daily wear
What type of compression bandage is recommended for lymphedema management?
Short stretch bandages are commonly used for lymphedema as they work with the calf muscle pump.
What are toe wraps, and what condition are they commonly used for?
Toe wraps provide compression for localized edema management, especially in toes and feet.
What is the difference between flat-knit and circular-knit compression stockings?
- Flat-knit stockings are stiffer and better for lymphedema but more difficult to don.
- Circular-knit stockings are less stiff and easier to apply.
What is the purpose of anti-embolism stockings?
Anti-embolism stockings (16-18 mmHg) are used for non-ambulatory patients to prevent deep vein thrombosis and manage edema.
How often should compression garments be replaced?
Compression garments should be replaced every 3–6 months.
When should custom compression garments be used?
Custom garments are used when standard sizes do not fit or for patients with unique limb shapes or severe lymphedema.
What are the compression levels for managing venous insufficiency and associated edema?
Low to moderate compression (25-35 mmHg) is used for edema secondary to venous insufficiency, while moderate to high compression (30-50 mmHg) is for persistent edema or lymphedema.
What is the key feature of gradient compression stockings?
Gradient compression stockings exert the greatest pressure at the ankle, decreasing as they move upward.
Why are donning aids recommended for compression garments?
Donning aids make it easier to apply compression garments, especially for patients with limited mobility.
What type of compression stockings is suitable for long-term management of venous insufficiency?
Knee-high gradient compression stockings are generally sufficient for long-term management.
What is the purpose of compression pumps in lymphedema management?
Compression pumps remove fluid from the area but do not remove protein, which can lead to fibrosis if not addressed.
When are compression pumps recommended as an adjunct to manual lymph drainage?
Compression pumps are used when constant compression is not tolerated or manual lymph drainage is unavailable.
What are intermittent pneumatic compression devices used for?
They stimulate venous return and are typically used for recalcitrant ulcers unresponsive to standard compression therapy.
What is the recommended dosage for lymphedema treatment with compression pumps?
The recommended dosage is 45–60 minutes at 30–60 mmHg sequential pressure.
What is the limitation of compression pumps in long-term edema management?
Residual protein after pump use can draw fluid back, necessitating additional treatments like manual lymph drainage.
What insurance criteria must be met for intermittent pneumatic compression device coverage?
Patients must have a recalcitrant ulcer for over 6 months and have received adequate compression therapy.
What patient factors should be considered when selecting a compression product?
- edema presence
- venous return impairment
- arterial perfusion adequacy
- open wounds
- limb shape
How should compression therapy be adjusted for patients with arterial disease?
The degree of compression should be modified, with lower levels used to ensure tolerance.
Why are leg elevation and calf muscle exercises recommended alongside compression therapy?
These interventions enhance venous return and complement the effects of compression.
What type of compression is typically used for patients with significant drainage from wounds?
Products with absorptive inner layers, such as multi-layer bandages, are used to manage excess wound drainage.
Indication / Compression
- lymphedema = ?
- Moderate to severe UE lymphedema = ?
- Moderate to severe LE lymphedema = ?
- Stage 3 LE lymphedema = ?
- 10–21 mmHg = lymphedema
- 15–32 mmHg = Moderate to severe UE lymphedema
- 30–40 mmHg = Moderate to severe LE lymphedema
- < 40 mmHg = Stage 3 LE lymphedema
Pressure vs. Stiffness
- Pressure: force that is created by the elastic recoil of the product on the tissue
- (Dosage (mmHg) / Resting pressure (IP) = Therapeutic Dosage
- Stiffness: force that is created by the resistance to expansion of the product - Currently not stated.
* Higher stiffness greater physiologic impact.
