Venous Thromboembolism (VTE) - Anti-Embolic Stockings and Intermittent Pneumatic Compression Device

Anti-Embolism Stockings (AES)

Anti-Embolic Stockings are tight fitting stockings which usually fit up to the knee. The tightness of the stockings is tightest at the ankle and decreases further up the leg, this helps encourage blood flow in the leg.

The stockings provided to you will be fitted according to your leg measurements. These should be removed each day for 30 minutes to fully wash and inspect the leg, at other times the stockings should be worn day and night. If the stockings become soiled, please ask for a clean pair.

How do I put the stockings on?

• Put your hand into the stockings as far as the heel
• Pinch the heel and turn the stocking inside out as far as possible
• Put the stocking over your foot and heel. The centre of your heel should be over the heel pocket of the stocking
• Pull the stocking up and fit around your ankle and up the calf. Ensure that the top of the stocking lies just below the knee
• Smooth out any excess material, making sure the heel is in the heel pocket and your toes are enclosed within the stocking.

Staff are always available to assist you if necessary.

The following picture will help guide you in putting your stockings on

Are there any pitfalls to avoid or problems to look out for?

• Do not leave the stockings rolled down as they can form a tight band around your legs which cancels the benefit of wearing them
• The stockings should be taken off once a day for hygiene purposes and to check for any possible skin changes
• Avoid using ointments, oils or lanolin on your skin as these can damage the stocking’s elastic fibres
• If a rash develops remove the stockings and inform the nursing team
• Be alert to pain and numbness, pins and needles and discolouration of the toes. This could be a sign that the stockings are too tight. Inform staff immediately if this is the case and they will remove the stockings
• When moving around, please make sure you are wearing slippers or shoes as the stockings can be very slippery on hard floors
• Stockings should be smooth and free from wrinkles whilst being worn
• Stockings worn below the knee should fit below the crease at the back of the knee
• Toes should always be covered by the stockings

Stop wearing your stockings and discuss with the ward staff or GP if you develop any of the following:

• Ulcers to your leg or foot
• Peripheral arterial disease (narrowing of vessels carrying blood)
• Peripheral neuropathy (damage to nerves)
• Cellulitis (infection in the skin)
• Oedema due to heart failure (build-up of fluid due to flow being reduced out of the heart)
• Pulmonary Oedema (fluid in the lungs)
• Peripheral vascular disease (narrowing of vessels carrying blood)

How do I look after my stockings at home?

If your doctor has advised you to continue wearing your stockings after discharge from hospital, please remember to:

• Remove them once a day for a maximum of 30 minutes to clean and check the skin underneath the stocking
• Put on clean stockings at least every three days, or earlier if they have become soiled
• Wash stockings by hand or in a machine at 40°C or above
• Do not use bleach or fabric conditioner
• Hang to dry. Do not tumble dry or leave to dry on the radiator

Intermittent Pneumatic Compression Devices

What are they?

These garments are made from soft material, which is wrapped around the leg or, if worn on the foot, worn as an open toe slipper.

The garments are connected by a tube to a pump which inflates and deflates the garments at regular intervals. The squeezing moves the blood in the foot or leg to reduce the development of DVT’s.

How long will I need to wear them?

These will only be worn whilst you are in hospital.

Some patients may wear these as they are unable to have tablets or injections to thin their blood. Some patients may wear these in addition to having tablets or injections. The garments should be worn day and night when in use and should not be left off for long periods of time. A single pair can be worn for up to 30 days unless they become soiled and should then be replaced.

How to put them on

These are wrapped around the legs and fastened by Velcro. Trained staff will apply and remove these as necessary.

Always request for these to be removed before getting out of bed and walking around.

If removed, request them to be reapplied as soon as possible by trained staff.

Are there any pitfalls to avoid or problems to look out for?

There will be occasions when these garments will be unsuitable to use.

Some of these reasons include:

• Peripheral arterial disease (narrowing of vessels carrying blood)
• Peripheral neuropathy (damage to nerves)
• Cellulitis (infection in the skin)
• Oedema due to heart failure (build-up of fluid due to flow being reduced out of the heart)
• Pulmonary Oedema (fluid in the lungs)
• Peripheral vascular disease (narrowing of vessels carrying blood)
• DVT or PE

If you develop any discomfort or pain, inform your nurse or doctor.