Ted Hose and Its Use
By Tim Wall MS ATC
What is a TED Hose?
Patients often complain about having to wear those uncomfortable, stark white compression stockings that clinicians call TED hose. Although inconvenient, they serve a very important role in preventing deep venous thrombosis, also known as DVT. The compression mechanism of the stocking gently squeezes the calf muscles, narrowing the veins, allowing the blood to flow more normally.
Why Would You Need a TED Hose?
When normal circulation of blood is slowed following an orthopaedic surgery, for example, blood can pool and eventually lead to a DVT. A DVT is a potential risk following a trauma, fracture, joint replacement, or other orthopaedic surgery. This is partially due to immobility and lack of the normal contract/relax action in the leg muscles essential for normal blood flow. However, there are several other factors that should also be considered. Individuals who have sustained an injury to the blood vessels, as in a blow to the leg, sports related injury, or radiation treatment for cancer are more susceptible due to a narrowing of the vein and/or tendency for trauma to initiate clotting. Others at higher risk include women who are pregnant or taking oral contraceptives, patients who smoke or are significantly overweight, people over 60, and those participating in long distance travel where prolonged sitting can slow circulation.
What is a DVT?
DVT is the formation of a blood clot in the deep veins, usually of the lower extremities. These clots can partially or completely block the blood flow in the vein resulting in dangerous consequences. The deep veins are located in the muscles and play a role in propelling blood upward toward the heart. Calf muscles, especially, function to squeeze and compress these veins as we walk and go about our daily activities to force blood back to the heart.
Symptoms of a DVT
DVTs can occur without significant signs or symptoms. In fact 50% of DVTs display minimal to no symptoms at all.
Signs to watch for include:
- Redness in the calf or thigh
- Warmth and tenderness to touch
More serious signs that should immediately be brought to the attention of a doctor or clinician are:
- Chest pain
- Shortness of breath
- Increased heart rate
- Unexplained coughing
- Coughing up blood
Diagnosis of a DVT
A clinician may also perform a Homan’s test to determine the presence of a DVT. This is a squeeze of the calf with forced dorsiflexion of the ankle. However, this test to is only about 50% accurate. More conclusive tests include the use of Doppler Ultrasound, venography, or MRI.
There are a variety of ways to prevent and treat a DVT. A clinician may ask a patient to perform ankle pumps, a flexing of the ankle which is extended in order to contract and relax the calf muscles. Also, the use of anticoagulant medications, which are designed to decrease the clotting action of blood, may be effective in high-risk individuals. Thirdly, YES, you guessed it, TED hose. These or other similar compression garments given to the patient by a clinician can help to treat or prevent a DVT when worn properly.
In conclusion, DVTs are a potential hazard for individuals undergoing orthopedic surgery, such as THR or TKA, ORIF of a fracture, and/or other invasive procedure of the lower extremity. Therefore, a patient should know the clinical signs and symptoms (keeping in mind a DVT may have minimal to no obvious symptoms), if he or she is in a high-risk group, and the ways to prevent a DVT. These methods include medication, ankle pump exercises, resuming ambulation as soon as appropriate, and YES, wearing TED hose as instructed by your MD.
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By: Tim Wall MS ATC
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