SLEEVES SQUEEZE A few precautions can prevent mechanical circulation aids from harming patients' skin.

UNDER PRESSURE
3 Tips to Use Compression Devices Safely

The intraoperative use of mechanical compression can help prevent deep vein thrombosis and other circulatory hazards, but if it's not used properly, it can end up damaging patients' skin. Take the following precautions to prevent the possibility of pressure injuries.

• Size matters. Make sure the sequential compression device sleeves you're applying fit properly by sizing up your patients' lower extremities with a tape measure. There should be 2 finger-widths of space at the top and bottom of the sleeve. Keeping in mind the potential for intraoperative edema, post-op nurses should consider re-measuring the legs after surgery.
• Apply while they're awake. SCD sleeves should be on the patient and the pump should be operational before the induction of anesthesia, so the patient will be able to warn you of any pain or discomfort it may cause.
• Don't force friction. When a patient is subject to mechanical compression, repositioning and pulling causes shear friction between their skin and the SCD sleeve. This harsh rub, combined with the fact that the skin is usually moist from perspiration, can result in blistering, tearing or other skin integrity issues and the infection risks that follow. If you have to move a patient, first turn off the pump and remove the compression sleeves. After they're repositioned, dry and inspect their skin before reapplying the device.

Lynn Razzano, RN, MSN, ONCC
Physician-Patient Alliance for Health and Safety
Westborough, Mass.
[email protected]