Preventing thrombosis in bedridden patients
In the case of immobile persons, special attention must be paid to preventing thromboses due to the lack of movement. This concerns, among other things, patients who are immobilised in the hospital after surgery, or people in nursing homes or care homes. In most cases, thrombosis prophylaxis in immobile patients is carried out with medicinal and physical measures and medical thrombosis prophylaxis stockings (MTPS) – also known as antithrombosis stockings.
Antithrombotic stockings: Mechanical pressure promotes return blood flow
Everyone who has had surgery before and spent time in hospital is familiar with these: white hospital stockings. They are used to prevent thromboses and pulmonary embolisms. And this is how they work: The stockings reduce the vascular cross-section of the veins with mechanical pressure and increase the flow rate of the blood. This counteracts the formation of blood clots. An exactly defined and correct pressure curve is the decisive factor – decreasing from the ankle to the thigh.
Medications – antithrombotic injections
A classic medication in thrombosis prophylaxis is low-molecular heparin – a blood thinner that reduces the ability of blood to clot.
More information on thrombosis prophylaxis
Further measures for the prevention of blood clots in immobile patients
- Elevating the legs: If the patient is lying on his back, the blood must overcome the “femoral hump" when flowing back from the lower extremities to the heart. Elevating both legs by about 20 degrees can be suitable for this purpose. The legs should be slightly bent so that the knees do not poke through and cause discomfort. The femoral vessels in the groin area must not be kinked – so there must not be a right angle between the thigh and the pelvis. Likewise, drainage in the vessels of the hollows of the knees must not be impeded, for example by placing a knee roller which is too firm underneath.
- Use breathing techniques: If the patient breathes deeply, this produces caval negative pressure – a blood reflux-increasing effect. This can be brought about by breathing exercises or movement. Diaphragmatic breathing has an effect on the body: It promotes blood flow, accelerates the pulse rate and lowers blood pressure.
Thrombosis prophylaxis exercises in bed: Immediate and early mobilisation
"Immediate mobilisation" means walking around on the day of the operation. Early mobilisation begins the day after the procedure. If the patient runs a few steps or walks in place, the calf muscle pump is activated. This promotes the return of blood to the heart.
In addition, there are suitable circulatory exercises against thrombosis for bedridden people: These special movement exercises can be done under the guidance of a qualified nurse or a physiotherapist:
The "bed bike" - cycling in bed
Cycling can be done with the "bed bike" as well as with an "imaginary bike": The patient is in the supine position and turns imaginary pedals in the air. For easier execution, the exercise can be performed with one leg. If an appropriate device is available, the patient makes pedalling movements on the crank device with the pedals.
Rocking your feet
Allow your toes to point towards your body – hold this pose for a few seconds and then stretch them out far forward, towards the end of the bed.
Clawing
Alternate clawing each of the toes inwards, hold for a few seconds and then spread them apart. This exercise is particularly well suited for patients who still have a little strength and ability to move.
Products by medi: Thrombosis prophylaxis stockings
Various mediven compression stockings and a special donning aid can be used for prevention, therapy and aftertreatment:
What’s more: The mediven thrombexin 18 thrombosis prophylaxis stocking from medi performed best in a comparison test1 with stockings from other manufacturers. It achieved the best results in terms of compression pressure and the pressure curve.
Mode of operation and use of medical thrombosis prophylaxis stockings (MTPS) – Measuring method: Hohenstein System (HOSY) – globally recognised system for measuring the pressure profiles of compression stockings
Diagnosis & treatment
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Diagnosis & treatment
Sources
1 U. Wegener, M. Kraft, Kröger u.a. Biomechanische Charakterisierung von medizinischen Thromboseprophylaxestrümpfen. Gefässchirurgie 2013;18:278-286.
Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.
Your medical retailer will fit them individually for you.
