Application of anti-embolism (TED) stockings
Author: Elizz editors and experts Date Posted:26 March 2018
When a person is going to be immobile for a long period of time such as after an operation, the doctor may prescribe anti-embolism (TED) stockings to help reduce the risk of developing a blood clot in the legs.
If you are caring for someone who needs to wear TED compression stockings you may find the following information and advice helpful.
Reasons for using anti-embolism stockings
- When a person lies or sits in the same place for a long time, the blood in their legs flows slower than normal. This increases the risk of a blood clot.
- Coagulation (the blood clotting process) can also be affected by a lack of activity or different medications.
- Blood clots can be painful and cause swelling at the site but, more importantly, the real danger is that blood clots can break off and move throughout the body.
- A blood clot can enter the lungs, heart, or brain which can cause an embolism that can be harmful or even fatal.
- The TED compression stockings put pressure on the legs and help improve circulation to reduce thechances of blood clots.
- Those who have had recent surgery on their legs or who require large amounts of bed rest are often given a pair of anti-embolism stockings to encourage good circulation and prevent blood clotting.
- Studies have shown that the risk of developing blood clots can continue up to six weeks after a person leaves the hospital.
The risk of getting a blood clot may also be increased by smoking, heart failure, bed rest, or as a result of breaking one’s leg or pelvic bone, or recent surgery.
Situations where TED stockings should not be used
If the person you are caring for has any of these conditions, it is best to check with the doctor about whether TED stockings are still appropriate.
NOTE: Anti-embolism stockings are primarily designed for those who are lying down. Do not use anti-embolism stockings for people who are very physically active. TED compression stockings are not thesame as the type of compression stockings used for venous disease or fluid in the legs (edema).
TED Stocking Do’s and Don’ts
Do make sure that the person has been measured and fitted for the correct compression stocking size.
Do remove anti embolic stockings at least daily, inspect skin, provide skin care and reapply stockings as needed.
Don’t apply lotion immediately before putting on anti embolism stockings.
Do check for any signs of patient discomfort.
Don’t pull or tug the compression stocking into place. This can increase friction and shear (movement of the stocking against the skin, which can damage the tissues).
Do have more than one pair of compression stockings to allow for washing.
Don’t position the heel of the anti embolism stocking above or below the heel. This could affect the pressure gradient (changes in pressure obtained by the stocking from the ankle up the leg; this is needed to keep the blood moving).
Do check heels daily. Heels can develop pressure sores if a person is in bed and not able to move well.
Don’t take TED compression stockings off for long periods of time to let the skin “breathe.” This could affect their function.
Do use a small amount of talcum powder to help the compression stockings slide on more easily.
Caring for anti-embolism stockings
- Wash the stockings every two to three days to remove any bodily secretions, soiling, dry skin, etc.
- Stockings may be washed by hand or in the washing machine with cold water using the delicate cycle
- Hang or lay the stockings flat to air dry
- Do not use ointments when applying the stockings- use starch-free talcum powder
- Avoid contact with chlorine bleach
- With correct care, TED compression stockings can last around 10 washes
How would I know if the person I am caring for develops a blood clot?
In some cases, there are no blood clot symptoms at all but some of the symptoms may include:
- Pain, swelling, and tenderness in one of the legs (usually the calf)
- The pain may become worse by bending your foot upward towards your knee
- A heavy, aching feeling in the affected area
- Warm, red skin in the area of the clot - particularly at the back of the leg below the knee in the calf area
If a blood clot is not treated it can move to the lungs causing a pulmonary embolism. Signs of a pulmonary embolism (PE) may include:
- TED compression stockings are not recommended for anyone suffering from conditions such as:
- Massive leg edema (swelling) or pulmonary edema (fluid in the lungs) caused by congestive heart failure
- An extremely deformed leg
- Severe vascular disease
- Or any condition of the leg where compression stockings might interfere such as immediate post-operative vein ligation, dermatitis, gangrene, or recent skin graft