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External pneumatic compression (EPC) devices are increasing in popularity for deep vein thrombosis (DVT) prophylaxis. Patients who have these devices applied postoperatively are assumed to have effective prophylaxis, although a number of extensive postoperative DVT complications have been observed. This study evaluates the proper application of EPC devices in patients in intensive care units and regular nursing floor units and assesses whether dedicated in-service instruction can improve proper use.
In a prospective study of 138 patients with 2 or more risk factors for postoperative DVT, it was found that patients on routine nursing units had properly functioning EPC devices during 48% (306 of 636) of the visits compared with 78% (312 of 398) of the visits in the intensive care unit (ICU) (p<0.0001). Follow-up of patients transferred from an ICU to a regular nursing unit showed that functional application decreased from 82% (129 of 157) to 33% (40 of 122) (p<0.005). The compression sleeves weee not applied in 84% of the nonfunctional devices and were properly in place but the pump nonfunctional in 16%. Unfortunately, dedicated in-service instruction did not improve the proper use of EPC.
Although proper application of EPC is better inthe ICU compared with regular nursing units, improper use is frequent and failure of DVT prophylaxis with EPC devices may be due to improper use, rather than failure of the method itself.
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*This work was supported in part by Grant 2 M01 RR00349 fromthe US Public Health Service, National Institutes of Health, General Clinical Research Centers Branch.
**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
© 1992 Reed Publishing USA. Published by Elsevier Inc.