Intermittent Compression (Week 11)

Question 1

What is Compression

Answer 1

Mechanical force that increases external pressure on the body or a body part

-Used to improve fluid balance and circulation

Question 2

What is Intermittent Compression

Answer 2

Pressure applied to the entire limb, all at one time or sequentially

-Apply pressure distal to proximal

Question 3

What is a Jobst Intermittent Compression

Answer 3

Electrically driven rotary pump inflating a sleeve which covers the extremity giving uniform and intermittent pressure

Question 4

What is the mechanism for Jobst intermittent compression

Answer 4

• Intermittently applied air into the inflation sleeve

-Air pressure surrounding the extremity increases the pressure of interstitial fluid to a level higher than the lymph and blood vessels

• Interstitial fluid return to the venous and lymphatic vessels

Question 5

What are the indications for Intermittent compression

Answer 5

-Post-phlebitic syndrome
-Prevention of thrombophlebitis

-Lymphedema
-Traumatic edema
-Stroke Edema

-Post-op edema- venous stasis ulcers, burns, post mastectomy
-Varicosities due to pregnancy
-Amputee stump edema

-Postural hypotension
-Venous Insufficiency

Question 6

What are the contraindications for intermittent compression

Answer 6

• Cardiovascular disease (CHF)

-Pulmonary Edema

-Any active infection in the edematous extremity

-Ulcers before debridement

-Acute thrombophlebitis (DVT)

-Circulatory obstruction (thrombus, embolus)

-Active Malignancy in edematous extremity

-Neuropathic disease

-Any undiagnosed edema

-Unstable or acute fracture

Question 7

What are the precautions for compression

Answer 7

-Impaired sensation or mentation

-Uncontrolled hypertension

-Cancer

-Stroke or significant cerebrovascular insufficiency

-Superficial peripheral nerves

-Wrinkling of stockinette may cause high pressure areas and subsequent bruising as the pressure in the appliance increases.

-Application over superficial nerves may result in neuropathy and or nerve palsy

Question 8

What are the treatment parameters for compression in the upper extremities

Answer 8

-Sitting or supine

-UE elevated above heart level, slightly abducted (supported by pillows)

• If facing the plinth, shoulder is flexed to 90 degrees

Question 9

What are the treatment parameters for the Lower extremities

Answer 9

• Supine

-Hip flexed to about 45 degrees

-Slightly abducted (supported by pillows)

Question 10

In relation to treatment parameters, what are the inflation pressures

Answer 10

• Pressure should be lower than the diastolic pressure

UE: 40-60 mmHg

LE: 60-80 mmHg

Question 11

in relation to the treatment parameters what are the on-off cycles (inflation-deflation)

Answer 11

• 3:1 ration

ex:
30 seconds ON ; 10 seconds OFF
45 secs ON ; 15 secs OFF
90 secs ON ; 30 secs OFF

Question 12

In relation to the treatment parameters what are the typical treatment durations

Answer 12

-2-4 hours (depending on diagnosis)

• 20 minutes (clinic)

Length of treatment time for compression pumps varies

Question 13

in relation to the treatment parameters, how frequently should the patient be getting their compressions done

Answer 13

• 3x per week to 3x per day
• Depending on diagnosis

Question 14

What are the treatment applications

Answer 14

1) explaining procedure, vital signs

2) Position and drape ; application of compression

3) Extremity is leveled or elevated above heart

4)Adjust controls

5) Periodically monitoring

6) Conclusion

7) Examination and documentation