CNA Skill: Application of Anti-Embolism Stockings

Anti-embolism stockings are used for patients who are recovering from surgery or who are non-ambulatory for any reason.  The stockings encourage normal function of the venous and lymphatic systems of the leg and prevent complications related to pooling blood from arising.  Before you apply a stocking, begin by gathering your supplies and washing your hands.  Then, follow these steps for proper and safe application of the elastic stocking:

1. Greet your patient, and explain what you are going to do.  This gives the patient an opportunity to assist you with the procedure, and reduces anxiety around medical procedures.
2. Check the size of the stockings to ensure they are the correct size for your patient.  You will also want to ensure the patient does not have a latex allergy, as elastic may contain latex.
3. Assist the patient in lying down on his or her back, also known as the supine position.
4. Make sure the patients feet are dry. You can apply talcum powder if they are not dry.
5. Gather the fabric of the stocking into your hand, and place it onto the patient’s foot.
6. Continue to roll the stocking upwards until the upper edge of the stocking reaches just above the patient’s knee.
7. Examine the stocking to ensure there are no wrinkles in the fabric, as this may be uncomfortable for the patient.  Check the fit at the toes and heel, to verify correct placement of the foot.
8. Assist the patient into a comfortable position if he or she wishes to move.  Remove your gloves and dispose of them safely.  Repeat the hand washing procedure to avoid the spread of disease.

While your patient is wearing the elastic stockings, you will need to regularly monitor them to ensure that all extremities are receiving adequate circulation.  Check the patient’s toes for signs of decreased circulation such as coldness, slow refill, or discomfort. If the patient complains of numbness, tingling, or loss of feeling in any extremity, report it to the nurse immediately.   Remove stockings every eight hours to allow for adequate circulation.  Removal of the stockings should be done by the doctor’s order.  Proper application of anti-embolism stockings is an important part of patient care, and can prevent life-threatening complications from occurring.

Expert Tip:

Putting on anti-embolism stockings can be a nerve wracking experience, especially for new CNA’s! Some people have a “thing” about feet and this makes it difficult to properly work with the stockings. Others are afraid of putting too much pressure or pulling on the patients legs too hard when putting on or taking the hose off. These are common fears; and you would be right in thinking that you have to use gentle force when doing this skill. They can be very difficult to get onto your patient if you are fearful of jumping in there and actually exerting any force to get the job done! If you are having trouble mastering this skill, don’t feel bad. Even I have issues with it after 12 years. In fact, putting any type of socks on even my children is hard for me because it is simply awkward!

To ease your troubled mind and help you do well on your skills test, go to Wal-mart and buy yourself a pair of TED hose. Begin by putting them on your own feet and legs, then move onto other people’s feet and legs! Grab onto your spouse, your kids, your parents and your friends – anyone who will allow you to play with their tootsies! The more you do it, the more comfortable you will be with it. Work on whatever your main issues are. For many of us it is getting the hose on without leaving wrinkles behind. Trust me when I say that this is something we have all struggled with and overcome. You will overcome it too- just practice! Also remember that they instructor giving the skills test is not against you. If you make a mistake or two, simply stop, tell what your mistake was and continue on from that point. Take a deep breath and pretend you are alone.