Intermittent Pneumatic Compression
What is a Compression device?
• Mechanical pressure applied
*Encourages venous & lymphatic
system return from the extremities
• Nylon appliance is applied to a body part & is connected with hoses to a unit • Air flow through the appliance
• Sequential or Circumferential
Sequential vs. Circumferential Compression
o The appliance is divided into various compartments.
o Compartments are filled distal to proximal.
o The appliance is filled simultaneously.
o Equal amounts of pressure are applied to all parts of the extremity. o Pressure rises with ON cycle & drops with OFF cycle.
Cold & Compression
• Devices can utilizes cold and compression therapy together to treat an injury • Can use intermittent circumferential or sequential
Circumferential can be used to prevent the formation of edema • Can use continuous cold therapy units
Useful in preventing edema
Injury Response Process - Effects
• Movement of fluids is caused by various pressure gradients • Two pressure gradients are being utilized
External compression causes the gradient between the tissue hydrostatic pressure and the capillary filtration pressure and reduces the pressure • Encourages reabsorption of interstitial fluids
A gradient is also formed between the distal portion of the extremity (high pressure) & proximal portion (low pressure) because the tissues are being compressed • Forces fluids to move from high-pressure to low pressure area Mechanical and biochemical effects of IPC on a vein
Injury Response Process – Effects
If the extremity is elevated, both gradient pressures are enhanced by gravity, encouraging a speedier venous drainage Low pressure (35-55 mmHg) have shown to increase venous velocity 175% Because debris is removed from area, fresh blood flow is increased significantly to the area following treatment During ON time - the blood flow to the area is decreased because of the external pressure During OFF time – the blood flow is restored allowing venous & lymph vessels to absorb fluids Effects
Increase venous return
• Pressure is not to exceed diastolic blood pressure.
• Normal ranges 40-60 mm Hg upper extremity; 60-100
• mm Hg lower extremity
• Normal duty cycle: 3:1 On:Off ratio
• Temperature for cold fluid devices: 50-55 °F
• Inform patients of sensations
Contact clinician if unusual sensations are experienced
• Can perform gentle ROM exercises during off cycle (wiggle toes, etc.) • Can be applied twice a day for 20-30 minutes
Acute & subacute injuries
Reduce pain due to swelling
Prevention of DVT
• Acute conditions if FRACTURE has not been eliminated
• Should not be used if compartment syndrome is suspected or known • Congestive heart failure
• Peripheral vascular disease
• Gangrene, Dermatitis
• Deep vein thrombosis
• Unhealed fractures, unresolved joint dislocations
• Check distal extremity for circulation.
• Check throughout treatment for circulation of extremity. • Make sure that any fabric, electrode, etc. within the appliance is not folded. It may cause further damage.
• Involves placing the patient on a table with a foot-support. • Required to accommodate to upright position.
• The table is tilted upward and the blood pressure and pulse are measured and symptoms are recorded with the patient in diverse positions. • The tilt-table test is designed to detect postural hypotension (orthostatic hypotension), a condition that results from changing body position from a prone, supine or sitting position to a more vertical position. • Conditions Requiring Tilt Table
Prolonged recumbence (SCI, Halo)
Disturbance in balance, proprioception, kinesthesia, LE circulation Generalized weakness...
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