I have to say, anytime TED hose comes into view, I groan. Getting those suckers on a pair of edematous legs is a real workout. Sweating, grunting and groaning included.
This video, however puts us all to shame. It doesn’t have to be that hard.
Who'd a thunk, huh? A simple pair of donning gloves and your fingers won't ache anymore. And don't try to get the heel on at first!
A few things about TED hose in general that you may not know, in addition to the video on proper application of TED hose:
It is primarily for non-ambulatory patients to reduce the incidence of DVTs while immobile. Because of its very specific use, the compression is at or below 20mmHg. The most compression is, understandably at the calf where DVTs tend to occur.
Something I didn’t know (wh-a-a-a-t? Me, not know something?! Shocking, simply shocking!) was that these hose are meant to last only about 3 weeks because usually most non ambulatory patients are up and about in that amount of time.
So, do you have a patient with an old pair? Throw them out and order two new pairs. (One to wear, one to wash).
They should be air dried, not placed in the dryer or they will lose their elasticity.
Different compression hose needs to be utilized for ambulatory patients to reduce edema in the lower extremities. These compression hose, (a common brand name is Jobst) have the most compression at the ankle where edema tends to be greater. These hose can last only about 6 months.
So when you see a patient with loose hose, it’s time to tell them they are doing no good and to throw them out.
When you see an ambulatory patient with TED hose it’s time to call the doc and ask for a different prescription to be sent to the DME (Durable Medical Equipment) company, or to central supply if you are in a facility.
Some TED hose have a hole at the toes. This is for you, nurse, to assess the color, temperature, and capillary refill of the extremities. There is such a thing as being too tight.
If the patient complains of pain, tingling or loss of sensation, they are too tight.
ALL compression hose needs to be fit correctly. You, as the nurse can measure for TED hose by measuring around the calf and from heel to toe. These measurements will tell you what size to get the patient for knee highs.
Do this first thing in the morning while the patient still has his legs elevated. This is usually when there is the least amount of edema in the legs and measurements will be the smallest.
The Jobst stockings need to be measured by the company that is selling them.
I rarely see any thigh high stockings. Quite honestly most don’t fit over normal people’s thighs, nor do they stay up.
Stockings that are too long will cut circulation off at the knees when the stocking bunches up there. Any creases elsewhere will also cut off circulation.
The proper application of TED hose includes making sure there are no creases. The ankle is a particularly common place for creases.
Poorly fitting TED hose will do more harm than good. So keep an eye on your patient’s hose all… day… long.