Research problem
Sequential Compression Device is well known among the nursing practitioners as a necessary device applicable in intensive care unit, courtesy of its role in the reduction of deep vain thrombosis (DVT) risk in the legs of seriously ill people. Perhaps it is commonly known for its beneficial qualities. That is why little attention has been accorded to the possibility of this device to cause some health complications to the patients. There is documented evidence that when improperly placed or used, sequential compression devices can, in a period of ten to thirteen hours of application, this device causes a patient to develop a foot drop. Therefore, the improper use of this device may have a big role to play in the etiology and development of peroneal nerve palsy. The possible explanation of this is that this device may, in short statured patients; cover the fibular neck in such a way that it compresses the peroneal nerve found at this point during the application process. In addition, there is a possibility that because of the use of postoperative analgesia, the pain response of the patients to potential over-compression may become blunted (Kozier, 2004).
Background of the problem
A woman who was sixty seven years old, 122-lb, and 5-ft 3-in, was given a right primary total knee replacement under general anesthesia. She had no significant medical history. When the surgeon documented that the patient, who was still in the recovery room had an intact peroneal nerve function, bilateral sequential compression devices having loop and hook fastener straps had to be applied to the patient’s lower extremities. Unfortunately, the patient, in about ten hours following the application of sequential compression devices, developed a foot drop.
Another woman, seventy three years old, 135-lb and 5-ft 1-in, was given a left primary total knee replacement under general anesthesia. She had a medical history of asthma and hypertension. When she was examined in the recovery room after the uncomplicated surgery, her both lower extremities had grossly intact peroneal nerve function. Bilateral sequential compression devices having loop and hook fastener straps had to be applied to the patient’s lower extremities without using abduction pillow. Unfortunately, the patient, in about thirteen hours following the application of sequential compression devices, developed a left foot drop.
Occurrences of the problem in their clinical or work area
Though the cases of foot drop have not been widely documented, the above two cases suggest that there is a closer link between foot drop and the sequential compression device. In our clinic joint replacement surgery has often led to peroneal nerve palsy, though in both the surgeries conducted with or without the use of sequential compression device. Therefore, the peroneal nerve palsy occurs mostly around 10-13 hours following the application of sequential compression device (Kozier, 2004).
Variables within the problem
For this research, the dependent and independent variables are the development of the peroneal nerve palsy (falling of patients) and the use of sequential compression device. Investigation will therefore be conducted by using/not using the device and observing the development of the foot drop (falling) (Spry, 2009).
The significance of the problem
This research is significant since it will recommend the alternative device to sequential compression device or the alternative way of using the device.
Impact of solving
When the solution to this problem is obtained, it will bring relief to doctors and patients. For the doctors, they will not have to worry about the consequences of using SCD on patients in the recovery room. For the patients, they will rest assured that no further complication arises while in the recovery room (Spry, 2009).
References:
Kozier, B. (2004). Fundamentals of nursing: concepts, process, and practice, Volume 1. New
York: Prentice Hall Health.
Spry, C. (2009). Essentials of Perioperative Nursing. New York: Jones & Bartlett Learning.
