Application of anti embolism (TED) stockings

Application of anti embolism (TED) stockings

When a person is going to be immobile for a long period of time such as after an operation, the doctor may prescribe anti-embolism stockings (TED stockings) to help reduce the risk of developing a blood clot in the legs.

TED Stockings help reduce the risk of developing a blood clot in the legs.

If you are a caregiver caring for someone who needs to wear TED compression stockings you may find the following information and advice helpful.

Reasons for using anti embolic stockings

  • When a person lies or sits in the same place for a long while, the blood in their legs will flow slower than normal. If blood flows slower, it increases the risk that the blood may clot.
  • The way coagulation (the blood clotting process) occurs may also change, which can also be affected by a lack of activity or different medications.
  • Blood clots can be painful and cause swelling at the site, but more importantly, the real danger is that blood clots can break off and move throughout the body.
  • A blood clot can enter the lungs, heart, or brain, which can cause an embolism that can be harmful, or even fatal.
  • The TED compression stocking puts pressure on the legs, and helps improve circulation and reduce the chances of blood clots.
  • Those who have had recent surgery on their legs or who require large amounts of bed rest are often given a pair of anti embolic stockings to encourage good circulation and prevent blood clotting.
  • Studies have shown that the risk of developing blood clots can continue up to six weeks after a person leaves the hospital.

The risk of getting a blood clot may also be increased by smoking, heart failure, bed rest, or as a result of breaking one’s leg or pelvic bone, or recent surgery.

Situations where TED stockings should not be used

TED compression stockings are not recommended for anyone suffering from conditions such as:

  • Massive leg edema (swelling) or lung edema (pulmonary) caused by congestive heart failure
  • An extremely deformed leg
  • Severe vascular disease
  • Or any condition of the leg where compression stockings might interfere, such as immediate post-operative vein ligation, dermatitis, gangrene, or recent skin graft

If you are concerned that the person you are caring for has any of these conditions, then check with the doctor about whether TED stockings are still appropriate.

NOTE: Embolism prevention stockings are primarily designed for those who are lying down. Do not use anti embolism stockings for people who are very physically active. TED compression stockings are not the same as the type of compression stockings used for venous disease or fluid in the legs (edema).

TED Stocking Do’s and Don’ts

Do's

Don'ts

Do remove anti embolic stockings at least daily, inspect skin, provide skin care and reapply stockings as needed.(See our article on Elderly Skin Care.) Don’t apply lotion immediately before putting on anti embolism stockings.
Do check for any signs of patient discomfort. Don’t pull or tug the compression stocking into place. This can increase friction and shear (movement of the stocking against the skin, which can damage the tissues).
Do have more than one pair of compression stockings to allow for washing. Don’t position the heel of the anti embolism stocking above or below the heel. This could affect the pressure gradient (changes in pressure obtained by the stocking from the ankle up the leg; this is needed to keep the blood moving).
Do check heels daily. Heels can develop pressure sores if a person is in bed and not able to move well. Don’t take TED compression stockings off for long periods of time to let the skin “breathe.” This could affect their function.
Do use a small amount of talcum powder to help the compression stockings slide on more easily. Don’t pass your compression stockings to another friend or family member, as everybody has different leg sizes. Fitting the wrong size of TED stocking may cause pain and a worsening of any condition.
Do make sure that the person has been measured and fitted for the correct compression stocking size.  

The following link provides detailed instructions and a visual step-by-step on how to ensure correct fit of compression stocking application and other tips

Caring for anti embolism stockings

  • Wash compression stockings every two to three days to remove any bodily secretions, soiling, dry skin etc.
  • Stockings may be washed by hand or machine washed with cold water using a delicate cycle
  • Hang or lay the compression stockings flat to air dry
  • Do not use ointments. Use starch-free talcum powder
  • Avoid contact with chlorine bleach
  • With correct care, TED compression stockings can last around 10 washes

How would I know if the person I am caring for develops a blood clot?

In some cases there may be no blog clot symptoms at all, but some of the symptoms may include:

  • Pain, swelling, and tenderness in one of the legs (usually the calf)
  • The pain may be made worse by bending your foot upward towards your knee
  • A heavy aching feeling in the affected area
  • Warm, red skin in the area of the clot, particularly at the back of the leg below the knee/calf area

If a blood clot is not treated it can move to the lungs causing a pulmonary embolism. Signs of a pulmonary embolism (PE) may include:

  • Sudden breathlessness, or difficulty in brea2pxg that is getting worse over a short period of time
  • Chest pain that may be worse when the person breathes in
  • Sudden collapse

As a caregiver, if, at any time, you 2pxk that the person you are caring for may have a blood clot or PE, you should call 911 and arrange for them to be seen immediately at the emergency department.

You might also like our Elizz blog article on Medication Safety for Caregivers.

 

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