Indications of JOBST
Contraindications of JOBST
Thrombophlebitis (could dislodge clot)
Cellulitis (could spread infection)
Severe congestive Heart Failure (could overwhelm heart with fluid volume)
10 mins to 4 hrs 1-2 X a day
45sec on /15 sec off 3 min on / 1 min off.
Set to comfort of patient and prevent numbness
Should never exceed 90 - 120 mmHg (systolic Pressure)
Arm : approx 50 mm Hg
Leg : approx 60-70 mmHg
Types of Swelling
Joint swelling - Caused by presence of blood and joint fluid in a joint at a result of tearing of tissues and blood vessels or synovial irritation. Has appearance and feel of a water balloon.
Interstitial Tissue Swelling - Caused by increase of osmotic pressure in tissues which attracts water and creates swelling. Has the appearance of "silly putty" when involved tissue is pressed.
Cell Swelling - Cells near death and unable to control the cell membrane can attract water and swell
Factors which can cause Edema
High capillary pressure (high blood pressure or blood clots)
Low blood plasma (starvation, alcoholism, hypothyroidism)
Lymphatic blockage (post mastectomy, elephantitis)
Increased capillary porosity relweases electrolytes and protiens (burns, allergic reaction)
Increased tissue osmotic pressure (cell destruction with protein release secondary to injury)
Edema caused by obstruction of lymph channels.
Primary - A congenital blockage of lymph channels.
Inflammation - swelling
Trauma - swelling cuts off flow
Neoplasm - takes up space to reduce flow
Irradiation - radiation causes sweeling and cuts off flow.
Treatment of Edema
Compression (not only moves fluids out of the area, but also distributes it to a wider area of lymph channels for their absorbtion and drainage.)