Preventing Deep Vein Thrombosis (DVT) (Nursing)

by Samantha Rhea, MSN, RN

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    00:04 Lastly guys, let's talk about DVT prevention.

    00:07 Okay, what does DVT even mean? DVT means Deep Vein Thrombosis.

    00:13 All that means guys is a blood clot.

    00:16 So, you can imagine and hopefully, you've reviewed this already in your nursing courses but when we're talking about blood clots, those aren't fun.

    00:23 We don't want those for your patients nor are they safe.

    00:26 Those could definitely go to your lungs.

    00:28 They can go to your brain and cause serious issues post-operatively.

    00:33 Now, DVT prevention's going to look a little bit different for each patient, so, you need to assess and see what's the safest.

    00:40 Also know that when we're talking about DVT prevention, that's always ordered post-operatively unless the doctor for some reason says no.

    00:51 So, if a patient post-op does not have DVT prevention, you need to be looking for some and why if it's not ordered.

    00:59 So, this is really important for the patient.

    01:01 Now, again, patients having surgery, they're really at an increased risk of developing a blood clot for lots of reasons.

    01:09 The other reason, too, think about after surgery, if we don't get the patient up, they're not up and moving, they're usually going to be in bed more than they typically would at home, right? So, with them lying in bed, that blood can set there and pool and coagulate and clot.

    01:25 That can be really dangerous for a patient.

    01:28 So, this is something we want to avoid.

    01:30 Now, what we can do is to apply something like antiembolism stockings which means an anti-blood clot or moving blood clot stockings.

    01:40 And sometimes we may use a sequential compression device.

    01:44 That's a lot of words. We a lot of the time just call them SCD's.

    01:48 So, again, you're going to see either antiembolism stockings.

    01:52 They're also called TED hose, much easier, right? Or you may see SCD's. These are really common.

    01:59 Also, one thing to note, sometimes, your patient is on what we call a blood thinner.

    02:05 This goes back to your pharmacology. So, again, sometimes, you may see both.

    02:10 Sometimes, a patient may be on a blood thinner to reduce blood clots.

    02:13 Sometimes, they may not be because it's not safe for the patient.

    02:17 So, just keep that in mind.

    02:19 But now, let's take a look at when we're talking about SCD's versus antiembolism stockings or TED hose, let's look at the difference here before we go.

    02:29 Now, when you're looking at this image, you see those little white things with the little orange squiggly, some patients hate these. These things will wrap around your legs.

    02:39 They connect to a pump at the end of the bed. They inflate and they deflate.

    02:44 They inflate and then, they deflate.

    02:47 So, the reason why we're doing this is we're going to help promote circulation and move that blood flow when the patient's wearing these in bed.

    02:54 So, these are worked by a pump.

    02:56 However, some patients find they're very soothing.

    02:59 Now, if you take a look at the other image, see that big, tall white sock on this image here? These are really tight.

    03:07 These are meant to squeeze on the patient's' legs, keep that blood flow going and keep edema or extra fluid down out of those patient's legs.

    03:16 These I will tell you are pretty hard to get on sometimes.

    03:20 So, let's look at these and compare. Are they sized to the patient? Yes, luckily, of course, we come in all shapes and all sizes, so, there's different sizes for your patient needs.

    03:31 Also, which one requires the compression machine? Do you remember? Okay, so, the SCD. Notice the one up there with the orange lines on it? See those hoses that are coming out? Those are the ones that are going to be connected to the pump at the end of the bed.

    03:47 Now, one key thing to think about, these can be a tripping hazard for patients, so, make sure you unhook the SCD's before the patient gets up out of the bed.

    03:59 Something to be aware of as a nurse.

    04:01 Now, kind of on that same realm, which one can you walk down the hall in while they're in use? Notice, not that SCD, right? Because those are connected to the pump at the end of the bed.

    04:13 The antiembolism or TED hose are great for that.

    04:17 Also, which ones can be used at home? Again, those TED hose are the winner and those can be used at home.

    04:25 Much easier for the patient just to keep those on at all times and they don't have to think about any extra equipment.

    04:32 Thanks for looking at post-operative care with us today.

    04:40 Now, let's take a look at DVT prevention.

    04:43 So, if you remember when we were talking about SCD's or sequential compression devices which are long term or antiembolism stockings, so, that's what I've got in my hands here.

    04:54 So, let's take a look at the SCD's first. So, I'm taking a look at the SCD's.

    04:59 What I'd like you to see is these come in various sizes, small, medium, large, you want to size these to your patients. Also, take a look at these.

    05:08 These are going to unfasten really nicely and then, we're going to apply it to our patient.

    05:14 So, one thing to note when you're looking at these, inside here, the main thing to know is that these things are going to inflate with air and then, deflate.

    05:24 So, some patients again love these and they feel really good on their calves.

    05:28 Sometimes, it can keep patients awake. So, just keep that in mind.

    05:32 But again, these are going to inflate and get really tighter or tighter around the patient's leg and then, they're going to deflate.

    05:40 Again, this is going to help move that blood flow, that circulation for your patient and to prevent DVT's or blood clots.

    05:47 Also know, these are going to hook with a hose into a machine on the bed.

    05:54 That machine is what's going to help inflate and deflate these SCD's.

    05:59 Now, as you can imagine like we talked about earlier, a hose, the patient trying to get out of bed, these can be a fall risk hazard, so, please make sure you educate your patient that they don't run off and run to the bathroom with these things hooked on.

    06:14 Now, these are usually just in the hospital and we usually don't take these at home with patients.

    06:20 So, just to take a look, this is our SCD and you're going to see variants on these about what they look like but essentially, it's all the same device. This one has three flaps.

    06:31 As you can kind of see here and then, some of them just have one flap that fold-over.

    06:38 So, again, you'll see some variants on this.

    06:40 So, before we move off SCD's, let me show you on our patient, Brandon here about how those are applied.

    06:46 So, I'm going to move this one to the side. So, on Brandon, I've got this on here.

    06:51 The nice thing, these SCD's will usually tell you, this side goes to the ankle or this one goes to the calf, so, just to take a look so you can see that, I'm going to fold this around his ankle and apply this and this actually has ankle goes down here.

    07:06 So, this gives you a little cheat guide.

    07:08 And again, I'm just going to simply wrap these around and secure these and it's usually Velcro or sticky stuff that's going to help adhere to the other side to keep those closed.

    07:20 Now, we don't want these super, duper tight. We want maybe a couple of fingers in there.

    07:25 We want them to be somewhat snug but again, not super tight because these will inflate on their own and deflate.

    07:33 So, again, that's how we're going to apply our SCD on our patient and these are really useful in the hospital to prevent DVT's.

    07:40 You're going to see these quite a bit.

    07:42 Now, let me show you what we usually send home with our patients.

    07:47 So, these are antiembolism stockings or what we call a TED hose.

    07:53 You're going to hear that a lot. Sometimes, there may be a nude color or white.

    07:57 These also come in various sizes, so, that's really helpful for different sizes for your patients.

    08:03 Great thing with these, it's just this, no cords, there's no machine and these are really easy for the patient to keep on for quite a while, walk around without worry of a fall risk and these definitely can be used at home.

    08:17 Most oftentimes, you'll see a patient go home with these.

    08:20 Now, again, see how long these are, these can get pretty tight on a patient and they're very long.

    08:27 So just know and educate your patient that these may take a little time to put on.

    08:33 One real quick tip before we go, instead of trying to do this, kind of roll it like a sock if you will and just roll it all the way to the end and gather it to where your fingers get to the end and then, have the patient apply it and then, you're going to roll it up.

    08:53 Now, some people with maybe arthritis or just grip is kind of hard for these because you really got to pull these up, there's extra devices out there that will help you to apply the antiembolism or TED hose.

    09:06 Thanks for watching.

    About the Lecture

    The lecture Preventing Deep Vein Thrombosis (DVT) (Nursing) by Samantha Rhea, MSN, RN is from the course Postoperative Care (Nursing).

    Included Quiz Questions

    1. Blood clots that can travel throughout the body
    2. Pain
    3. Pneumonia
    4. Bleeding
    1. Check the surgeon’s orders and if nothing was ordered clarify with the surgeon
    2. The surgeon did not order DVT prevention, the nurse follows the orders as is
    3. The patient takes motrin at home as needed; the patient does not need any other DVT prevention
    4. If the nurse can walk the patient, no further DVT prevention is needed
    1. SCDs, early ambulation, anti-embolism stockings
    2. Delayed ambulation, SCDs, anti-embolism stockings
    3. Ted hose, early ambulation, continuous compression device
    4. SCDS, delayed ambulation, compression machine
    1. Requires a compression machine
    2. It does not require a compression machine.
    3. The client can ambulate while they are being utilized.
    4. Able to be utilized at home
    1. Can be utilized at home
    2. Not sized to the patient
    3. Requires compression device
    4. The client cannot ambulate while they are in use.
    1. SCDs are hooked to a hose and that they need to be removed before the client gets out of bed to prevent a fall
    2. SCDs are for massaging legs
    3. SCDs prevent pain
    4. The client can ambulate at home with SCDs.
    1. Ted hose are long and come in various sizes.
    2. Ted hose can be only kept on for short amounts of time.
    3. Clients should not wear ted hose when walking.
    4. A client who suffers from arthritis cannot wear ted hose.

    Author of lecture Preventing Deep Vein Thrombosis (DVT) (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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