Applying Pneumatic Compression Devices
Goal: The patient maintains adequate circulation in extremities and is free from symptoms of neurovascular compromise.
1. Review the medical record and nursing plan of care for conditions that may contraindicate the use of the PCD.
2. Identify the patient. Explain the procedure to the patient.
3. Perform hand hygiene.
4. Close the room door or curtains. Place the bed at an appropriate and comfortable working height.
5. Hang the compression pump on the foot of the bed and plug it into an electrical outlet. Attach the connecting tubing to the pump.
6. Remove the compression sleeves from the package and unfold them. Lay the unfolded sleeves on the bed with the cotton lining facing up. Take note of the markings indicating the correct placement for the ankle and popliteal areas.
7. Apply antiembolism stockings if ordered. Place a sleeve under the patient’s leg with the tubing toward the heel. Each one fits either leg. For total leg sleeves, place the behind-the-knee opening at the popliteal space to prevent pressure there. For knee-high sleeves, make sure the back of the ankle is over the ankle marking.
8. Wrap the sleeve snugly around the patient’s leg so that two fingers fit between the leg and the sleeve. Secure the sleeve with the Velcro fasteners. Repeat for the second leg, if bilateral therapy is ordered. Connect each sleeve to the tubing, following manufacturer’s recommendations.
9. Set the pump to the prescribed maximum pressure (usually 35–55 mm Hg). Make sure the tubing is free from kinks. Check that the patient can move about without interrupting the airflow. Turn on the pump. Initiate cooling setting, if available.
10. Observe the patient and the device during the first cycle. Check the audible alarms. Check the sleeves and pump at least once per shift or per facility policy.
11. Place the bed in the lowest position. Make sure the call bell and other necessary items are within easy reach.
12. Perform hand hygiene.
13. Assess the extremities for peripheral pulses, edema, changes in sensation, and movement. Remove the sleeves and assess and document skin integrity every 8 hours.