Implementation
Performance
1. Prior to performing the procedure, introduce self and verify the client’s identity using the
agency protocol. Explain to the client what you are going to do, why it is necessary, and
the procedure for applying the sequential compression device.
Rationale: The client’s participation and comfort will be increased by
understanding the rationale for applying the SCD.
2. Perform Hand hygiene and observe other appropriate infection prevention procedures.
Rationale: Observing infection prevention procedures would help avoid or prevent
contamination.
3. Provide for client privacy and drape the client appropriately.
Rationale: Privacy gives secure environment to patient and gives respect for
patient autonomy.
4. Prepare the client:
Place the patient in a dorsal recumbent or semi-Fowler’s position.
Measure the client’s legs as recommended by the manufacturer if a thigh-length
sleeve is required.
Rationale: Foot-and knee-length sleeves come in just one size; the thigh
circumference determines the size needed for a thigh-length sleeve.
5. Apply the sequential compression sleeves.
Place a sleeve under each leg with the opening at the knee.
Wrap the sleeve securely around the leg, securing the Velcro tabs. Allow two
fingers to fit between the leg and the sleeve.
Rationale: This amount of space ensures that the sleeve does not impair
circulation when inflated.
6. Connect the sleeves to the control unit and adjust the pressure as needed.
Connect the tubing to the sleeves and control unit, ensuring that arrows on the
plug and the connector are in alignment and that the tubing is not kinked or
twisted.
Rationale: Improper alignment or obstruction of the tubing by kinks or
twists will interfere with operation of the SCD.
Turn on the control unit and adjust the alarms and pressures as needed. The
sleeve cooling control and alarm should be on; ankle pressure is usually set at 35
to 55 mmHg.
Rationale: It is important to have the sleeve cooling control on for comfort
and to reduce the risk of skin irritation from moisture under the sleeve.
Proper pressure settings prevent injury to the client. Alarms warn of
possible control unit malfunctions.
7. Document the procedure.
Rationale:
Record baseline assessment data and application of the SCD. Note control unit
settings.
Assess and document skin integrity and neurovascular and peripheral vascular
status per agency policy while the SCD is in place. Remove the unit and notify
the primary care provider if the client complains of numbness and tingling or leg
pain. These may be symptoms of nerve compression.
