This document discusses methods for preventing venous stasis when mobility is limited. Venous stasis can lead to blood clots and leg swelling. To prevent this, proper positioning, leg exercises, anti-embolic stockings, and sequential compression devices are recommended. Anti-embolic stockings help circulation by compressing the legs to push blood back to the heart. They are useful after surgery or for those with limited mobility. Sequential compression devices work similarly by alternately filling and deflating sleeves on the legs to mimic muscle pumping action.

1. Preventing Venous Stasis
• When clients have limited mobility or are
confined to bed, venous return to the heart is
impaired and the risk of venous stasis
increases.
• Venous stasis can lead to thrombus formation
and edema of the extremities.
• To prevent venous stasis:
- Positioning and leg exercise
- Use of anti embolic stocking
- Sequential compressiondevices

2. ANTI EMBOLIC STOCKING
 Anti embolic hose, or elasticized stockings
 PUROSE:
• Used to promote circulation by compression of the
veins of the legs thereby facilitate the return of venous
blood to the heart, prevent venous stasis and
thrombosis.
• Useful to prevent thrombophlebitis and reduced
peripheral edema.
• They are used on the legs of a client after surgery, in
clients who are immobile, and in clients who have
vascular disorders such as thrombophlebitis, varicose
veins, and other conditions of impaired circulation of
the lower extremities.

3. Assessment
 1. Assess the condition of the client’s lower extremities,
noting edema, color, temperature, intact skin, ulcers, or
infections. Establishes a baseline for comparison.
 2. Assess the quality and equality of peripheral pulses in
the legs (either dorsalis pedis or posterior tibial pulses) to
determine circulatory status.
 3. Assess the client’s understanding of the reasons for and
the use of the antiembolic stockings to determine the
amount of client teaching required.
 4. Assess the client for signs and symptoms of deep vein
thrombosis such as a positive Homan’s sign and increased
calf size to determine the appropriateness of the stocking
placement.

4. Expected Outcomes:
 1. The client will not experience any signs or
symptoms of deep venous thrombosis or
thrombophlebitis.
 2. The client’s venous return will be improved.
 3. The client’s popliteal, posterior tibial. and dorsalis
pedis pulses will remain intact while stockings are in
place.
 4. The client will have good circulation while
stockings are in place, as evidenced by warm skin
temperature, capillary return is within normal limits,
sensation is present, and no edema is present in both
extremities.

5. Equipment Needed
 Antiembolic stockings
and package directions
 Powder or cornstarch (if
client is not allergic)
 Tape measure

6. Measurement
With the client in a supine position in bed, measure
the client’s leg for the correct size:
 Thigh-high stockings: from the Achilles tendon
(heel) to the gluteal fold, circumference of the
midthigh
 Below the knee stockings: from the Achilles tendon
(heel) to the popliteal fold, circumference of the
midcalf

7. When to apply
 Apply in the morning. Before the client arises from
bed.
 When client has been ambulated without the anti
embolic stocking
 Assist the client to lie down
 Elevate the legs for 15 to 30 minutes before applying the
stockings.

10. Nursing Responsibilities
 Ensure that the stocking is free from creases.
 Remove the stockings for 30 minutes every 8 hours
 Inspect the legs- note the appearance of the legs, skin
integrity, edema, peripheral pulses, skin color
temperature
 Provide instructions about:
Laundering the stocking
Replacing the stocking when they lose their elasticity.

11. Sequential Compression Device
Also known as Lymphodema pumps
Purpose:
To promote venous return from the legs
To decrease risk of deep vein thrombosis and / or
pulmonary embolism
Assessment:
Cardiovascular status, including heart rate and rhythm,
peripheral pulse and capillary refill.
Color and temperature of extremities
Homan’s sign

12. Sequential Compression Devices
 Designed to limit the development of DVT and
Peripheral Edema in immobile patients. Increasing blood
flow in the extremities through sequential (and
intermittent, using optional accessories) compression
 When a patient is immobile for long periods of time, as in
recuperation from an injury, blood tends to pool in the
calf area of the lower leg.

13. Equipment Needed
 Antiembolic stockings and package directions
 Powder or cornstarch (if client is not allergic)
 Tape measure
 Sequential Compression Device, including sleeves, air
pump and tubing
 Available units include the Kendall 5325and Jobst
7500

14.  The affected leg or arm is placed inside the
appropriate sleeve which has three independent
inflation segments which alternately fill and
deflate, pushing the blood supply through the
veins and arteries in the extremity. This
consists of an air pump connected to a
disposable sleeve by a series of air tubes. The
sleeve is placed around the patient’s leg. Air is
then forced into different parts of the sleeve in
sequence, creating pressure around the calves
and improving venous return.

15. THANK YOU