The patient with acute cardiovascular problems
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
The National Institute for Health and Care Excellence (2018b) have issued guidance for management of specific risk groups that can be found at https://www.nice.org.uk/guidance/ng89. This includes a combination of two approaches to prevention, through the use of mechanical devices and pharmacological intervention. Mechanical devices that have been assessed as appropriate for the individual, include any one of: Anti-embolic stockings, thigh- or knee-length.Intermittent pneumatic compression devices.Foot impulse devices.
Venous anatomy and pathophysiology
Helane S Fronek in The Fundamentals of Phlebology: Venous Disease for Clinicians, 2007
Examples of short-stretch bandages are Unna's paste bandage and Comprilan® (BSN-JOBST, Inc., Rutherford College, NC). ACE® bandages are inadequate as a treatment of venous ulceration. Prescription compression stockings can be used in the maintenance phase of treatment. Generally, calf length stockings are used with 30-40 or 40-50 mmHg. It is easier for some patients to apply a zippered stocking over a nylon liner (Jobst® UlcerCARE; BSN-JOBST, Inc., Rutherford College, NC) or to superimpose two 20-30 mrnHg stockings (yielding 40 mmHg). Consider intermittent pneumatic compression in patients who do not respond to standard compression measures and in patients who are not ambulatory.
Inside the Operating Theatre
Manoj Ramachandran, Tom Nunn in Basic Orthopaedic Sciences, 2018
Patients assessed as being at increased risk of venous thromboembolism should be offered thromboprophylaxis. Mechanical devices can reduce thrombosis risk without increasing the risk of bleeding and include: Graduated compression stockings.Intermittent pneumatic compression devices – foot, calf or thigh pumps.Electrical muscle stimulation devices.
Surgical and non-surgical approaches in the management of lower limb post-thrombotic syndrome
Published in Expert Review of Cardiovascular Therapy, 2021
M Machin, S Salim, M Tan, S Onida, AH Davies, J Shalhoub
Newer technologies have been developed in order to aid venous return and ease symptoms of PTS. Venous assist devices and pneumatic compression are therapies that lack a significant body of evidence. Intermittent pneumatic compression devices consist of a pneumatic pump and an inflatable sleeve worn on the limb. The segments of the inflatable sleeve are inflated to apply a desired pressure to the limb compartments and the deep venous system within. Ginsberg et al. undertook a small randomized crossover trial, published in 1996, that assigned 15 participants to either a therapeutic intervention pressure (50 mm Hg) or a placebo pressure (15 mm Hg) for 4 weeks, with subsequent crossover [47]. It was reported that symptom scores were significantly better in the intervention arm in comparison to the control arm (16.5 vs. 14.4, p = 0.007). This symptom score pre-dates validation of the Villalta scale.
The importance of the rehabilitation program following an internal hemipelvectomy and reconstruction with limb salvage – gait analysis and outcomes: a case study
Published in Disability and Rehabilitation, 2019
The patient was admitted to the Defense Medical Rehabilitation Centre (DMRC), Headley Court for intensive in-patient rehabilitation, which is a Ministry of Defense in-patient based rehabilitation facility. The Complex Trauma department is a multidisciplinary team involving Physiotherapists, Exercise Rehabilitation Instructors, Occupational Therapists, Nurses, Social Workers, Medical Team, Podiatrists, Psychologists and a Rehabilitation Assistant. Patients have varying lengths of admission depending on their individual needs and typically go back home for a period of recovery leave in between each admission. This patient had 13 separate admissions between 3 and 6 weeks in duration over a two-year period. Goals were set at the start of every admission and reviewed throughout. An individual weekly timetable of sessions were provided at the start of each week and included hydrotherapy, yoga, circuit training, swimming and time to complete his individual exercise program. Due to the clearance of lymph nodes, lymphoedema management became a vital part of rehabilitation and included the use of compression hosiery, a Pulse Press Intermittent Pneumatic Compression Machine with a whole leg boot plus lower limb elevation. He received approximately an hour of individual Physiotherapy treatment per day as well as scheduled time with other healthcare professionals. The patient’s long-term goal was to mobilize independently and return to cycling.
Unilateral pleural effusion as the sole clinical presentation of severe ovarian hyperstimulation syndrome: a systematic review
Published in Gynecological Endocrinology, 2018
Mohamad Irani, Alex Robles, Vinay Gunnala, Pak Chung, Zev Rosenwaks
Patients with severe OHSS are at a higher risk of developing a potentially life-threatening thromboembolic event. Hemoconcentration, low plasma volume, and elevated estrogen levels are likely to be the etiology of the increased incidence of thromboembolic disease [53]. Thrombosis has been described in uncommon locations of patients with OHSS, such as upper limbs and cardiac and cerebral vessels [6]. Therefore, it is recommended that all patients with severe OHSS wear full-length venous support stockings. In addition, prophylactic anticoagulation (i.e. subcutaneous injection of heparin 5000 units every 12 h; subcutaneous injection of enoxaparin sodium 40 mg every 24 h) should be strongly advised [50]. Ambulation should be emphasized and intermittent pneumatic compression device should be applied in patients who are unable to ambulate.
Related Knowledge Centers
- Deep Vein Thrombosis
- Edema
- Heparin
- Laparoscopy
- Pulmonary Embolism
- Low-Molecular-Weight Heparin
- Pneumoperitoneum