Download Compression

Compression II
Dr. Hira Jabeen
BSPT,PPDPT
Contraindications
For the Use of intermittent or Sequential
Compression Pumps:
1. Acute pulmonary edema
2. Congestive Heart failure
3. Recent or acute DVT, thrombophlebitis, or
pulmonary embolism
4. Obstructed lymphatic or venous return
5. Severe peripheral arterial disease or ulcers
due to arterial insufficiency
6. Acute local skin infection
7. Significant hypoproteinemia-protein levels
less than 2 g/dl
8. Acute fracture or other trauma
9. Uncontrolled hypertension
1. Patients with heart failure
• The shift of fluid from the peripheral to the
central circulation may increase the stress on
the failing organ
• Decrease efficiency of cardiac muscle
contraction  decreased cardiac output
increase in venous pressure  sodium and
water retention which all act to cause edema
• CHF requires decreasing the load on the heart,
whereas compression increases cardiac load
by increasing the fluid load of the veins
2. Pulmonary edema
• Pulmonary edema is a major side effect of
CHF
• Result of elevated lung capillary pressure
causing fluid to leave the circulation and
accumulate in the alveolar air spaces in the
lungs
• Increases the fluid load of the vascular system
and the pressure in the lung capillaries,
potentially aggravating this serious medical
condition
3. Recent or acute DVT, thrombophlebitis,
or pulmonary embolism
• Thrombus may become dislodged or the
embolus may travel by means of:
– Mechanical agitation of the clot by the
compression
– Increased circulation produced by compression
• If a thrombus or embolus becomes dislodged
through circulation lodge at another site
organ damage, severe morbidity, or even
death.
• Not to be used when it is thought that
thrombus may already be present.
4. Obstructed lymphatic or venous return
• Lymphatic or venous return may be
obstructed by a thrombus, radiation damage
to the lymph nodes, an inguinal or abdominal
tumor, or other masses
• Partial obstruction of the vessels or
complete occlusion of only a few of the
vessels, treatment with compression may
enhance functioning of the intact collateral
vessels
5. Severe peripheral disease or ulcers
due to arterial insufficiency
• Aggravate these conditions by closing
down the diseased arteries and further
impairing circulation into the area.
6. Acute local skin infection
• The sleeves and coverings used increase the
moisture and temperature of the area,
encouraging the growth of microorganisms.
• If a chronic skin infection is present, singleuse sleeves that avoid cross-contamination
from one patient to another, or re-infection of the
same patient, may be used for the application of
intermittent compression.
7. Significant hypoproteinemia
(serum protein less than 2 g/dl)
• Returning the fluid to the vessels will further lower
the serum protein concentration , resulting in
severe consequences
– Cardiac and immunological dysfunction.
• Severe hypoproteinemia can occur due to:
– Inadequate food intake
– Increased nutrient losses
– Increased nutrient requirements due to an
underlying disease
8.Acute trauma or fracture
• Excessive motion at the site of trauma,
increasing bleeding, impair healing
• Aggravating the acute inflammation, or
destabilizing an acute fracture
• Intermittent compression should be used for
treating post traumatic edema only after the
– Initial acute inflammatory phase has passed,
– Bleeding has stopped,
– Area is mechanically stable
• Static compression, as provided by stockings
or wraps, may be used immediately after an
acute trauma to prevent edema and reduce
bleeding.
• Directly after an injury static compression is
frequently applied in conjunction with rest, ice,
and elevation in order to optimize the control of
pain edema, and inflammation
PRECAUTIONS
•Impaired sensation or mentation
•Uncontrolled hypertension
•Cancer
•Stroke or significant vascular
insufficiency
•Superficial peripheral nerves
1. Impaired sensation or mentation
• Patients may be unable to recognize or
communicate when pressure is excessive
or painful.
2. Uncontrolled hypertension
• Compression can further elevate blood pressure
by increasing the vascular fluid load
• Pharmacologically controlled hypertension can
be given compression therapy with precautions
• Blood pressure should be monitored frequently
during treatment of these patients, and treatment
should be stopped if their blood pressure
increases above the safe level
3.Patients with cancer
• Compression can increase circulation
which may disturb or dislodge metastatic
tissue, promoting metastasis,
• Improve tissue nutrition, promoting tumor
growth
4. Patients with stroke or significant
Cerebrovascular insufficiency
• History of transient ischemic attacks.
• Caution is required because the
hemodynamic changes caused by
compression may alter circulation to the
brain
5. Area of a superficial peripheral nerve
• Peroneal nerve palsy is documented
application of intermittent sequential
compression
• Significant weight loss, resulting in loss of
fat and muscle mass around Peroneal
nerves
THE
END