Intermittent Mechanical Compression

Question 1

Intermittent Mechanical Compression:

Answer 1

• Pneumatic Applies pressure to limb via inflatable sleeve
• Single compartment=uniform circumferential pressure
• Multiple compartements=Applies pressure sequentially (greater pressure in distal compartments)
• Cold can be applied simultaneously - coolant pumped through sleeve

Question 2

Intermittent Mechanical Compression: Physiological Effects

Answer 2

• Increased interstitial fluid pressure
  
  • fluids forced into lymphatic and venous return systems
  • = reduced fluid volume in limb

Question 3

Intermittent Mechanical Compression: Indications

Answer 3

• Decrease or prevent formation of edema
• Chronic edema Lymphedema
• Stasis ulcer Traumatic edema
• Venous insufficiency
• Amputation

Question 4

Intermittent Mechanical Compression: Contraindications

Answer 4

• Acute inflammation or infection of tx area
• Acute DVT or pulm edema
• Aterial insufficiency
• Cancer
• Diminished skin sensation
• Kidney or cardiac insufficiency
• HTN
• Cognitive dysfunction
• Obstructed lymph
• Very long, frail elderly

Question 5

Intermittent Mechanical Compression: Precautions

Answer 5

• Patients blood pressure determines compressive force ratio
• Never exceed patients DBP or between DBP and SBP depending on brand

Question 6

Intermittent Mechanical Compression: Application

Answer 6

• 2 hours per day (24 hours)
• Inflation to deflation ratio:
  
  • 3:1 edema reduction (45 sec: 15)
  • 4:1 reshape limb
• Treatment Time
  
  • 2-3 hrs = lymphedema
  • 2 hrs = traumatic edema
  • 2.5 hrs/wk to 2hrs/d = venous ulcers
  • 1 hr to 1-3x/d = residual limb

Question 7

Intermittent Mechanical Compression: Pressure Forces

Answer 7

Pt’s BP determines setting Some manufacturers redommend the pressure never exceed diastolic Others advise pressure should fall between diastolic and systolic. Numbness, tingling, pain, pulse should not be felt by pt during treatment

Question 8

Intermittent Mechanical Compression: Treatment Time

Answer 8

• Depends on tolerance
• Minimum daily treatment:
  
  • Lymphedema - 2 hrs to two 3 hr sessions
  • Traumatic edema - 2 hrs
  • Venous ulcers - 2.5 hrs/3x/week to two 1 hr periods
  • Stump reduction - 1 hr to 3 hr sessions totalling 4 hrs