T.E.D. HOSE

Embolism – blood clot Common in patient’s with limited mobility (elderly, surgery patients)

Most hospitals use T.E.D. stockings which are a brand of anti-embolism stockings. Pressure pattern clinically proven to apply enough pressure in the correct part of the leg to prevent formation of an embolus. 18 mm Hg at the ankle 14 mm Hg at the calf 8 mm Hg at the popliteal (knee) 10 mm Hg at the lower thigh 8 mm Hg at the upper thigh

It is the nursing assistants job to measure and apply anti-embolism stockings. Proper sizing and application must be assured for a patient to receive the optimal benefit of stockings.

Thigh Length Stocking: 1. measure upper thigh circumference at gluteal furrow 2. measure calf circumference at greatest dimension 3. measure leg length from gluteal furrow to bas of the heel. 4. refer to chart or package for sizing A. If right and left legs measure differently, use two different stocking sizes B. If the thigh circumference is greater than 36 inches, use a knee length stocking C. If calf circumference is outside the specified range, select a knee length stocking.

Knee Length Stocking: 1. measure calf circumference at greatest dimension 2. measure length from bend of knee to base of heel. 3. consult the sizing guide to determine appropriate size A. If fight and left legs measure differently, order two different stocking sizes

ORDER TWO PAIRS OF STOCKINGS TO ENSURE THAT PROPHYLAXIS IS UNINTERRUPTED DURING LAUNDERING CARE.

1. Insert hand into stocking as far as the heel pocket. 2. Grasp center of heel pocket and turn stocking inside out to heal area. 3. Position stockings over foot and heel. Be sure patient’s heel is centered in heel pocket. 4. Pull a few inches of the stocking up around the ankle and calf. 5. Continue pulling the stocking up the leg. 6. As thigh portion of the stocking is applied, start rotating stocking inward so panel is centered over femoral artery. When using thigh length, the top band rests at the gluteal furrow.

7. Smooth out wrinkles 8. Align inspection toe to fall under the toes. Toes should not stick out of the stocking. 9. Instruct patient as to proper positioning of stockings.

1. Any leg condition in which stockings would interfere (dermatitis, skin graft etc.) 2. Severe arteriosclerosis or other ischemic (decreased blood flow) vascular disease 3. Massive edema of legs or pulmonary edema from congestive heart failure 4. Deformity

Record style and size of stocking and date applied Record removal of stockings Note appearance of skin Report absence or tenderness in calves, thighs or toes Record inspection of stockings during each shift Be aware of size changes due to weight loss

CALF CIRCUMFERENCELENGTHSIZE < 12 “< 16 “ > 16” Small Regular Small Long 12”-15”< 17 “ > 17 “ Medium Regular Medium Long 15”-17.5”< 18 “ > 18 “ Large Regular Large Long 17.5”-20”< 18 “ > 18” X-Large Regular X-Large Long 20” – 23”< 18” > 18 “ XX-Large Regular XX-Large Long 23”-26 “< 18 “ > 18 “ XXX-Large Regular XXX-Large Long