Thromboembolic prophylaxis with intermittent pneumatic compression devices in trauma patients: a false sense of security?
OBJECTIVE
Intermittent pneumatic compression devices provide a safe and attractive means of venous thromboembolism prophylaxis. We hypothesized that intermittent pneumatic compression devices were inadequate prophylaxis secondary to noncompliance.


METHODS
This was a prospective double-blind study evaluating compliance with intermittent pneumatic compression devices in nonambulatory adult trauma patients. Compliance was evaluated for the first 3 days of admission. The study consisted of two 3-month stages (before and after hospital personnel education on the importance of venous thromboembolism prophylaxis).


RESULTS
During the first stage, device compliance was 85%, 59%, and 74% in the intensive care unit, surgical ward, and overall, respectively. Following hospital personnel education, device compliance was 82%, 65%, and 77% in the intensive care unit, surgical ward, and overall, respectively. There was no significant difference in compliance between the 2 stages.


CONCLUSIONS
With inadequate compliance and the cost attributed with intermittent pneumatic compression devices, other means of venous thromboembolism prophylaxis should be considered first, specifically low-molecular-weight heparin if not contraindicated.
Macatangay
Chona
C
Thomason Hospital Trauma Department, El Paso, TX, USA.
Todd
S Rob
SR
Tyroch
Alan H
AH
D000328:Adult; D015400:Clinical Nursing Research; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D004509:Education, Nursing, Continuing; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D015601:Injury Severity Score; D007318:Inservice Training; D048228:Intermittent Pneumatic Compression Devices / Q000009:adverse effects / Q000191:economics; D008297:Male; D009104:Multiple Trauma / Q000150:complications*; D015402:Nursing Education Research; D009741:Nursing Staff, Hospital / Q000193:education*; D018579:Patient Selection; D011446:Prospective Studies; D012307:Risk Factors; D013781:Texas; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D014193:Trauma Centers; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data*