A-V Impulse Foot Compression System Nursing Procedure Guide July 2011

A-V Impulse Foot Compression System

The A-V Impulse foot compression system has been developed to mimic the natural hemodynamic effects of walking and weight bearing. Upon every step, the plantar arch is flattened, causing an immediate evacuation of blood from the plexus of veins in the bottom of the foot. This action sends a column of blood up the leg and back to the heart. The ImPad™ rigid sole foot covers are designed with a hard sole, which contains and directs the impulse to the bottom of the foot. This action mimics the natural hemodynamic effect of ambulation and has been clinically proven to reduce this incidence of VTE as well as post operative swelling and pain.

Getting Started You will need: • ImPad™ rigid sole foot cover • A-V Impulse™ foot

compression system

Sizing ImPad rigid sole foot covers are available according to patient’s shoe size and foot circumference. Consult the sizing chart below before selecting an ImPad rigid sole foot cover for your patient.

ImPad Rigid Sole Foot Cover Latex Free Women’s Shoe Size

Men’s Shoe Size

Size

Item Code

Foot Circumference

5½ - 9

4½ - 8

Medium

5065

up to 12"

• T.E.D.™ anti-embolism

9½ - 11½

8½ - 12½

Large

5075

up to 13"

stockings or stockinette (optional)

9½ - 12½

8½ - 13½

Extra Large

5107

13-18"

• Tubing set

Sterile ImPad Rigid Sole Foot Cover Style

Size

Item Code

Sterile Right Foot

One Size Fits All

6066

Sterile Left Foot

One Size Fits All

6067

Application

1. Apply T.E.D.™ anti-embolism stocking

4. Wrap the medial side over the top of the

or stockinette over foot and ankle.

foot and then overlap the lateral side of

Avoid wrinkles. (optional)

the ImPad foot cover. Pull to fit “sneaker

2. Select appropriate ImPad foot cover.

tight” and secure in place with the tab.

Note: ImPad foot covers are available in color

5. Next, loosely position the rear strap around

distinction. Red: Left Foot, Blue: Right Foot.

the back of the heel and secure medially.

3. Place foot centrally on the ImPad foot cover so that the plantar arch is directly above the hard rigid sole as shown by the graphics on the inflation pad.

System Operation

1. Connect tubing to the controller by pushing

3.  Press the run/stop buttons on the

the black connector firmly into the output

top panel to activate each channel

socket on the rear panel of the controller. To

being used. (left, right, or both)

disconnect, pull the connector from the socket.

2. Power on the controller by pressing the black power switch located on the front lower right of the controller. Note: The controller will initiate a brief self-test followed by a 5 second countdown shown on the LCD display.

4. Check that the impulse is felt directly under the arch of the foot. If not, adjust the ImPad foot cover accordingly.

5. Check regularly for patient comfort, tenderness and skin integrity per hospital protocol.

6. For optimum results, make sure patient is seated head up, feet down (reverse trendelenberg position).

Sterile ImPad Rigid Sole Foot Cover

1. Apply non-sterile foot cover to non-operative limb as described previously in application instructions on page 4.

2. After sterilizing field, apply the sterile foot cover to the foot of the operative limb. When applying the ImPad foot cover, be careful to ensure that the tubing remains in the sterile field.

3. Place foot centrally on top of the ImPad foot cover as shown by the graphic on inflation bladder. The bladder must be located directly under the arch of the foot.

4. Wrap the medial side over the top of the

6. Check to ensure the ImPad foot cover fits securely on patient foot.

7. Lift patient’s leg to estimate the tubing length required to perform the intraoperative limb manipulation.

8. Secure the tubing by twisting the sterile drape around the tubing and clip. This will prevent the portion of tubing required for the limb manipulation from dropping below the operating table.

9. Connect tubing to the controller by pushing the black connector firmly into the output socket on the rear panel of the controller.

foot and then overlap the lateral side of

NOTE: Unlike the non-sterile ImPad foot cover,

the ImPad foot cover. Pull to fit “sneaker

the sterile ImPad foot cover’s clear tubing is

tight” and secure in place with the tab.

ATTACHED - please do not attempt to use blue

5. Next, loosely position the rear strap around the back of the heel and secure medially.

tubing set with sterile ImPad foot cover.

Alarm Codes

ault Code 1:

Fault Code 3:

Tubing Disconnect

Low Pressure Alarm

Check the tubing connection at the back of the controller and at the ImPad rigid sole foot cover. Ensure no leaks are present in the tubing set.

Check the fit of ImPad foot covers to ensure they are not too loose.

Fault Code 2:

Fault Code 4:

Tubing Kink

High Pressure Alarm*

Check the tubing set for a kink or blockage.

Check the fit of ImPad foot covers to ensure they are not too tight. *F  or patient safety, excess pressure is immediately vented and controller operation is suspended.

Tips and Tricks Swelling Reduction

Patient Education

The A-V Impulse foot compression system is indicated to reduce swelling in the lower limb. Over time, swelling reduction could affect the fit of the ImPad foot cover, causing an alarm. This alarm can easily be addressed by readjusting the ImPad foot cover for a proper fit.

Empower your patient to take an active role in their recovery. Your local Covidien Representative can supply you with A-V Impulse foot compression system Patient Education Pads and DVT Awareness Literature to help educate your patients on the risks of VTE and the importance of prophylaxis.

Duplicate Alarms

Continuing Education

To avoid duplicate alarms when adjusting one ImPad foot cover (e.g., left) to correct an alarm, it is often a good idea to adjust the other (e.g., right) at the same time.

Contact your local Covidien Representative to schedule CEU programs on VTE Prophylaxis for your nursing staff.

Patient Comfort Should a patient have difficulty adapting to the foot compression therapy, consider using one of the Preset Operating Parameters by pressing the button*. (Preset 3 is designed to allow the patient to become accustomed to the therapy) * Always consult the physician prior to adjusting the default pressure parameters. See the Operators Manual for more detailed information on Presets.

For additional information, log on to

www.covidien.com/dvtcompression

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