Programs

Applying Elastic Support Hose

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure for Applying an Elastic Support Hose

Equipment needed: elastic stockings.

  1. Perform hand hygiene.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. If the bed is adjustable, raise the bed to a comfortable working height.
  4. Assist the patient into a supine position.
  5. Expose the patient’s bare leg by removing any socks, shoes, or slippers.
  6. Turn the stocking inside out, down to the heel. To do this, slip the stocking onto your arm and grasp inside the heel pocket. With your other hand, turn the stocking inside out by pulling the stocking down your arm.
  7. Slip the foot into the stocking. Align the heel into the heel pocket and ensure the stocking is on straight. Smooth out any bumps before proceeding.
  8. Now, grab the inside-out portion of the stocking and begin pulling it over the foot, heel, and leg. The stocking will turn right side out as you pull it up the leg.
  9. Remove any wrinkles by smoothing out the stocking.
  10. Verify that the hose is on correctly and is not too tight or cutting off circulation.
  11. Repeat procedure on the other leg if necessary.
  12. Assist the patient back into a comfortable position.
  13. Perform hand hygiene.
  14. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels [1]. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.

First off, stockings should be the right size and shape for the person. Stockings that are too loose provide no benefit, whereas stockings that are too tight can cut off blood circulation, causing ischemia and increasing the risk for developing a DVT [1]. Second, stockings must be completely smooth, without folds or wrinkles. Folds and wrinkles may create a compressive band that can impede blood flow and result in patient injury [1].

Last, it is important to closely monitor patients wearing elastic stockings. Stocking should be worn for no longer than eight hours at a time, unless ordered otherwise. The stockings should be completely removed, and a nurse should assess the patient’s circulation. Nursing assistants should promptly notify the nurse if a patient complains of any numbness or tingling in the extremities.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356208/

More Resources

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

Performing the Heimlich Maneuver

The Heimlich Maneuver, also known as abdominal thrusts, is used to remove an object that is blocking a resident’s airway and preventing air from reaching the lungs. It only takes four to six minutes for brain damage to occur from lack of oxygen, so prompt action is vital.

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).

Assisting the Resident to Sit on the Side of the Bed

Having the resident sit on the side of the bed is otherwise referred to as dangling. When a resident quickly changes position, especially from lying to sitting or standing, there can be a rapid drop in the resident’s blood pressure. This drop in blood pressure may cause dizziness or lightheadedness.

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