Introduction
A sequential compression device (SCD), also called intermittent pneumatic compression (IPC) device or compression sleeve, is wrapped around the patient’s legs, and it inflates and deflates every 20-60 seconds. It consists of multiple compartments that are connected to an air pump via a tube. Air is pumped into each compartment, from bottom to top, inflating them. When all compartments are inflated, they deflate, and then the cycle starts again.
Definition
SCD is an inflatable sleeve that is worn on the lower legs and helps in preventing blood clots and venous stasis.
Purposes
- To maintain adequate perfusion of the lower extremity.
- To enhance venous return.
- To prevent deep vein thrombosis.
Indications
- Bedridden patients.
- Recent surgery-related immobility.
- Medical conditions limiting mobility (stroke, injury).
- At-risk patients (inherited blood disorders that increase clotting, obesity, smoking).
- Lymphedema.
Contraindications
- Severe peripheral vascular disease (PVD).
- Peripheral neuropathy.
- Severe peripheral edema.
- Soft-tissue diseases including dermatitis, cellulitis, or a recent skin graft.
- Major lower limb injuries.
Articles
| Articles | Purpose |
| Sequential compression devices | To apply for the patient. |
| Towel/gauze pad | To dry the skin. |
| Wrist watch with seconds | To assess the pulse. |
Procedure
| Nursing Action | Rationale | |
| 1. | Explain the procedure and obtain consent from the patient. | Alleviates anxiety and promotes cooperation. Serves as legal evidence and prevents litigation of the staff. |
| 2. | Ensure the correct size. | General preparation for the procedure. |
| 3. | Provide privacy and drape the patient. | Prevents embarrassment. |
| 4. | Wash hands. | Reduces the transmission of microorganisms. |
| 5. | Position the patient in a supine posture. Assess the leg for skin breakdown and palpate the peripheral pulses. | Provides comfort and identify any abnormalities. |
| 6. | Ensure that the feet are dry. | To prevent discomfort. |
| 7. | Untold the sleeve Help the patient wear one sleeve on his or her leg by wrapping it around. Note: The ankle should be lined up with the ankle opening and the back of the knee with the knee opening. There should be two finger spaces between the leg and the sleeve. | For accurately applying till the specified position. |
| 8. | Repeat the procedure on the other leg. | |
| 9. | Plug the tube to the air pump and activate the pump, a green light will typically turn on. Check that the compartments are properly inflating and deflating for a full cycle. | To verify the inflation of all the compartments. |
| 10. | Assist the patient into a comfortable position. | To ensure comfort. |
| 11. | Perform hand hygiene. | To prevent cross-infection. |
| 12. | Frequently assess the patient’s feet and toe’s color, temperature, mobility, sensation, swelling. pain or discomfort, for warmth, or sweating beneath the cuff, skin breakdown, and weakness (nerve damage). | To identify the adequacy of circulation. |
| 13. | lnstruct the patient to report immediately if warmth, pain, skin sore in any extremity, or shortness of breath is present. | To identify for complications. |
| 14. | Ensure to remove the sleeve at night and reapply in the morning. | To allow for adequate circulation. |
| 15. | Document the date, time, and reason for applying Sequential compression devices. | For continuity of care. |
Special Consideration
- Check for contraindications such as peripheral arterial disease, severe edema, or skin infections.
- Assess circulation by checking pedal pulses and capillary refill.
- Measure limb size to ensure the correct cuff size for optimal compression.
- Ensure correct sleeve placement with the tubing facing upward.
- Avoid excessive tightness to prevent circulatory compromise.
- Position the patient comfortably to prevent pressure injuries.
- Check device function regularly to ensure proper inflation and deflation cycles.
- Inspect skin integrity for signs of redness, irritation, or pressure sores.
- Ensure proper hygiene by cleaning sleeves regularly.
- Encourage mobility to enhance circulation.
- Advise on signs of complications such as numbness, pain, or discoloration.
- Ensure correct device use at home for continued prevention of DVT.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
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