Sequential Compression

Does a Sequential Compression Device Increase Risk of Falls? Recent Research on SCDS

A sequential compression device (or intermittent pneumatic compression device) is designed to improve blood and fluid flow in people with vein disorders or lymphedema. In many cases, doctors recommend these medical devices for use in post-surgical patients at increased risk of blood clots.

But are they safe, and do they increase the risk of falls? A 2008 editorial in the American Journal of Nursing suggested that patients who wear these devices and try to walk may trip over the bulky sleeves used to help circulate the body’s fluid.

To examine the issue of whether these devices pose a safety risk, researchers from the Department of Surgery at the Hospital of the University of Pennsylvania examined almost 5 years of patient safety data from a large, urban hospital. Their study noted how many SCDS falls occurred, compared to the number of days pneumatic compression users spent in the hospital. Overall, they looked at 3.562 falls that occurred at their hospital during the 5-year period.

The results? Using these devices failed to increase the risk of falls. Out of the 3,562 falls that took place, only 16 were related to using SCDS. Most of the falls occurred in a surgical ward and while patients were trying to get to the toilet. All but two of the falls were minor and required no medical intervention.

If you need to use a sequential compression device for lymphedema or other vein disorder, rest assured that the devices won’t contribute to an increased risk of falls and won’t increase the risk of a dangerous spill. However, it still pays to be careful, so here are a few tips to prevent injuries if you use these devices at home:

• Choose a clear area to use SCDS. Move items on the floor and around the chair or couch so you have a clear area in case you need to get up quickly. Remove rugs that could become bunched or otherwise impede your movement.
• Take the time to use the toilet before beginning to use a sequential device.
• Have a friend or family member nearby in case you need help getting up after using the device.
• Give yourself plenty of time to use the device. Don’t schedule appointments or activities right after a session with your SCDS; clear your schedule so you are free to move slowly and at your own pace.
• Keep a cane, walker, or scooter chair nearby if you need one, so you can access it immediately after using the device.
• Ask your doctor about tips for using these medical devices safely and for other tips on avoiding falls.

Intermittent Pneumatic Compression Basics

If you have deep vein thrombosis, or DVT, chronic vein disease, or need surgery that will keep you in bed for lengthy periods of time, your doctor may recommend you use intermittent pneumatic compression.

That’s a mouthful! What’s intermittent pneumatic compression? Let’s break it down:

• Intermittent – in intervals
• Pneumatic – using air
• Compression – with a squeezing motion

This intermittent therapy helps prevent blood clots from forming in the extremities, especially useful for people with vein problems, lymphedema, or after surgery. Your legs or arms are inserted into a plastic or cloth sleeve and an air pump inflates the sleeve with air at regular intervals. This squeezing action provides pressure that helps circulate blood from your veins and back to your heart and reduces the chance that you’ll develop dangerous clots.

Doctors may also refer to the machine that pumps the air as a sequential compression device.

Using these devices can cut the risk of deep vein thrombosis by up to 60%, some research studies show. In addition to using intermittent pneumatic compression, your doctor may recommend that you take medications to thin your blood and use compression stockings to support your veins and improve blood flow.

Sequential Compression Pump for Restless Legs

Are you one of the estimated 5 million people with moderate to severe restless legs syndrome (RLS)? This neurological disorder causes tugging, pulling, tingling, and other uncomfortable sensations in the legs, especially when you go to sleep at night. For some people, RLS is bothersome and uncomfortable; for others, the condition causes severe chronic pain. According to the National Institute of Neurological Disorders and Stroke, up to 10 percent of people in the United States have this disorder. Using a sequential compression pump or device for restless legs may help treat your uncomfortable symptoms.

Researchers from Walter Reed Army Medical Center in Washington, DC, had people with restless legs use a sequential compression pump for an hour before bed or when they usually developed restless legs symptoms. A sequential device is often prescribed for people with a circulation problem called lymphedema. A puffy sleeve is placed around your arm or leg and hooked to a machine. When turned on, the machine inflates the sleeve and squeezes your arm or leg, which helps blood and fluid flow more effectively throughout your body. Extra fluid that collects in your limbs is eliminated through urine. It’s a time-consuming but painless type of treatment that helps restless legs syndrome, too.

In the study, published in the journal Medicine, one patient out of 10 dropped out because of noncompliance. But three of the patients, who’d experienced RLS for an average of 5 years before the study, found their restless legs symptoms went away entirely after 1 to 3 months of using the sequential compression device. The other 6 patients said their symptoms significantly improved. They reported having a better quality of life, less daytime sleepiness, better sleep quality and emotional well-being, and an easier time competing daily tasks.

Restless legs can be caused by a variety of symptoms, including chronic diseases like nerve disorders, kidney failure, and diabetes. Some medications cause RLS, such as antipsychotic drugs, antinausea drugs, antidepressants, and allergy medications. Pregnancy is another common cause. Though some types of medicine can treat RLS, they do carry a risk of side effects. Sequential pumps, though expensive, may help relieve restless legs without significant side effects.

The cost of sequential compression devices often depends on how many chambers they have. More chambers are more expensive, but also generally more effective.

Portable Sequential Compression

Maybe you travel a lot for business. Maybe you care for a parent in their home, or maybe you prefer not to be tied to one area of the house. If you have lymphedema and need sequential compression, a portable device may make it easier to complete your lymphedema therapy.

A 2005 study in 30 people with lymphedema published in the Journal of Vascular Surgery found that a portable sequential compression unit called the SCD Express was just as effective at removing lymphedema fluid as a larger, stationery unit.

Compression units are pricey, and even portable versions cost upward of $1000 or more. If portability is important to you, talk to your doctor about choosing sequential compression that can go with you wherever you go. People who use this type of medical therapy may need to complete three to four 2-hour sessions a day. Having the flexibility to carry the unit with you may help you comply with your doctor’s compression instructions more easily.

And if you’re traveling, don’t forget your lymphedema sleeves, compression sleeves, and compression stockings, as well as compression stocking aids.

For sequential compression devices, your doctor may recommend a brand like PresSion, Flexitouch, BioCompression, Wright Therapy, or Kendall. Both compression garments and compression pumps are medical devices, can be somewhat complicated to operate if you’re new to using them and may require assistance to learn how to use properly. It’s tempting to go with an off-name brand to save a few bucks, but your doctor made a recommendation for a tested product for your situation, so it’s advisable to follow the advice of someone familiar with your specific health situation.

Compression Pump Guide

People who have lymphedema, a health disorder caused by the lymph node’s inability to drain fluid in the tissues, sometimes need a compression pump.

Part of treating lymphedema, especially lymphedema of the leg, may involve therapy with a pump. One brand is called the Lympha Press. The person with lymphedema puts a sleeve on the leg and hooks the sleeve to a plastic tube, which connects to the pump. Then the pump squeezes and releases the sleeve – kind of like a blood pressure cuff. This process encourages the flow of fluid in the leg so it can be removed from the body through urine.

If you use a pump in the hospital, you may need a catheter to collect your urine because you won’t be able to move easily while wearing the sleeve and because the process creates lots of urine. Your nurse may check how much urine you’re producing to see how well the compression pump treatments are working.

You may also need to buy compression stockings to wear when you’re not using your pump.

A physical therapist or nurse can help you learn how to use a pump at home.

Each compression session lasts 2 hours. You may do up to 3 or 4 sessions daily. You may need to do one leg first, then the other. Your nurse, doctor or physical therapist will tell you which pressure setting to use.

To use the pump, put it on a flat surface. Put on the protective stockinette, with the sleeve over top of it. Attach the hoses to the leg sleeve – hose #1 should attach at the foot, followed by #2, etc., until you get to #12 at the top of your leg. Prop your feet on a pillow or blanket so your toes are above your knees. Now connect the hoses to the pump and tighten them. Turn the pump on, and ensure the pressure is at the correct level.

If you have to do both legs, repeat the steps once your treatment time is up.

If you develop problems like chest pain, a fever, chills, drainage from your wound or you feel short of breath, give your doctor a call.