From the Guidelines
Patients should be instructed to continue wearing the intermittent pneumatic compression (IPC) devices as prescribed, and follow-up appointments should be scheduled to assess treatment effectiveness and skin integrity, typically within 2-4 weeks after initiation or when the patient becomes independently mobile, at discharge from hospital, if the patient develops any adverse effects, or by 30 days (whichever comes first) 1. When guiding the patient to follow up after pneumatic compression of the lower extremities, it is essential to emphasize the importance of monitoring for signs of skin irritation, bruising, or discomfort at the compression sites and reporting these to their healthcare provider.
- Patients should be advised to maintain proper skin hygiene by washing the areas under compression daily and applying moisturizer to prevent dryness.
- They should also stay adequately hydrated and perform gentle range-of-motion exercises when not using the devices to promote circulation.
- If the compression therapy is for deep vein thrombosis prevention, patients may need to continue anticoagulant medication as prescribed, such as low-molecular-weight heparin (e.g., enoxaparin) for patients with acute ischemic stroke at high risk of venous thromboembolism 1. The effectiveness of pneumatic compression relies on consistent use and proper technique, as it works by improving venous and lymphatic flow, reducing edema, and decreasing the risk of blood clot formation in the lower extremities.
- Regular assessment of skin integrity is crucial, and consultation with a wound care specialist is recommended if skin breakdown begins during IPC therapy 1.
- Early mobilization and adequate hydration should be encouraged for all acute stroke patients to help prevent venous thromboembolism 1.
From the Research
Follow-up Care for Pneumatic Compression of Lower Extremities
To ensure proper follow-up care for a patient after pneumatic compression of the lower extremities, consider the following:
- Schedule regular follow-up appointments to monitor the patient's condition and adjust treatment as needed 2, 3.
- Educate the patient on how to properly use the pneumatic compression device and encourage them to adhere to the recommended treatment schedule 2, 4.
- Monitor for signs of infection, such as increased redness, swelling, or warmth, and advise the patient to seek medical attention if they experience any of these symptoms 2, 3.
- Encourage the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to help manage their condition 3, 5.
- Consider referring the patient to a physical therapist or other healthcare professional for additional guidance and support 2, 3.
Additional Considerations
- The patient's treatment plan may need to be adjusted based on their individual response to pneumatic compression therapy 6, 4.
- It is essential to screen for venous insufficiency and other underlying conditions that may be contributing to the patient's lymphedema 3.
- The patient should be advised to report any changes in their symptoms or condition to their healthcare provider promptly 2, 3.
- Pneumatic compression therapy can be an effective adjunct to standard lymphedema treatment, but it is crucial to monitor the patient's progress and adjust the treatment plan as needed 2, 3.