IPCP Application Technique PDF

APPLICATION TECHNIQUE of IPCP Equipment Required Intermittent pneumatic compression unit Inflatable sleeves for upper and lower extremities Stockinette Blood pressure monitor St...

APPLICATION TECHNIQUE of IPCP Equipment Required Intermittent pneumatic compression unit Inflatable sleeves for upper and lower extremities Stockinette Blood pressure monitor Stethoscope Tape measure Procedure 1. Determine that compression is not contraindicated for the patient or the condition. Be certain to check for signs of DVT, including calf pain or tenderness associated with swelling. Take the patient’s history or check the chart for CHF, pulmonary edema, or other contraindications that may be the cause of the edema. 2. Remove jewelry and clothing from the treatment area, and inspect the skin. Cover any open areas with gauze or an appropriate dressing. 3. Place the patient in a comfortable position, with the affected limb elevated. Limb elevation reduces both the pain and the edema caused by venous insuffiency, if applied soon after the development of these symptoms, because elevation allows gravity to accelerate the flow of blood in the veins toward the heart. With chronic venous insuffiency or lymphatic dysfunction, elevation of the limbs is generally less effective in reducing edema because the fluid is trapped within fibrotic tissue and cannot return as readily to the venous or lymphatic capillaries, from where it can flow back to the central circulation. 4. Measure and record the patient’s blood pressure. 5. Measure and record the limb circumference at a number of places with reference to bony landmarks, or take volumetric measurements by displacement of water from a graduated cylinder. 6. Place a stocking or stockinette over the area to be treated and smooth out all the wrinkles. 7. Apply the sleeve from the unit. Reusable sleeves made of washable Neoprene and nylon are generally used, although vinyl sleeves intended for single use are also available for application when concern about cross- contamination arises. The Neoprene and nylon sleeves can be machine washed in warm water and air dried or dried at low heat in a drier. The sleeves provide intermittent or sequential compression, depending on their design. Single-chamber sleeves provide intermittent compression only, and sleeves composed of a series of overlapping chambers can inflate sequentially, starting distally and progressing proximally, to produce a milking effect on the extremity. Sequential compression has been shown to result in more complete emptying of the deep veins and a greater increase in fibrinolytic activity than single-chamber, intermittent compression and therefore is preferred for most applications. Both single-chamber and multichambered sleeves are available in a variety of lengths and widths for treatment of upper or lower extremities of various sizes. When a compression pump is used for the treatment of edema, it is recommended that the sleeve be long enough to cover the entire involved limb, so that fluid does not accumulate in areas of the limb proximal to the end of the sleeve. 8. Attach the hose from the pneumatic compression pump to the sleeve. Pumps vary in size and complexity from small home units intended for the treatment of one extremity to larger clinical units that can be used to treat four extremities at different settings all at one time. 9. Set the appropriate compression parameters, including inflation and deflation times, inflation pressure, and total treatment time. 10. Provide the patient with a means to call you during the treatment. Measure and record the patient’s blood pressure during treatment, and discontinue treatment if the systolic or diastolic pressure exceeds the limits set for the patient by the physician. 11. When the treatment is complete, turn off the unit, disconnect the tubing, and remove the sleeve and the stockinette. 12. Remeasure and record limb volume in the same manner as in step 5. 13. Reinspect the patient’s skin. 14. Remeasure and document the patient’s blood pressure. 15. Apply a compression garment or bandage to maintain the reduction in edema between treatments and after discontinuing the use of a compression pump. Maximum reduction of edema is usually achieved with use of the pump for 3 to 4 weeks.