Sizing - Covidien

A-V Impulse Foot Compression System
Nursing Procedure Guide

A-V Impulse Foot Compression System
The A-V Impulse foot compression system has been developed to mimic the natural
hemodynamic effects of walking and weight bearing. Upon every step, the plantar
arch is flattened, causing an immediate evacuation of blood from the plexus of
veins in the bottom of the foot. This action sends a column of blood up the leg
and back to the heart. The ImPad rigid sole foot covers are designed with a hard
sole, which contains and directs the impulse to the bottom of the foot. This action
mimics the natural hemodynamic effect of ambulation and has been clinically
proven to reduce this incidence of VTE as well as post operative swelling and pain.

Getting Started
You will need:
• ImPad rigid sole foot cover
• A-V Impulse foot
compression system
• Tubing set
• T.E.D. anti-embolism
stockings or stockinette
(optional)
Sizing
ImPad rigid sole foot covers are available according to patient’s shoe size and foot circumference.
Consult the sizing chart below before selecting an ImPad rigid sole foot cover for your patient.
ImPad Rigid Sole Foot Cover Latex Free
Women’s
Shoe Size
Men’s
Shoe Size Size Item Code
Foot
Circumference
5½ - 9 4½ - 8 Medium 5065 up to 12"
9½ - 11½ 8½ - 12½ Large 5075 up to 13"
9½ - 12½ 8½ - 13½ Extra Large 5107 13-18"
Sterile ImPad Rigid Sole Foot Cover
Style Size Item Code
Sterile Right Foot One Size Fits All 6066
Sterile Left Foot One Size Fits All 6067

Application
1. Apply T.E.D. anti-embolism stocking
or stockinette over foot and ankle.
Avoid wrinkles. (optional)
2. Select appropriate ImPad foot cover.
Note: ImPad foot covers are available in color
distinction. Red: Left Foot, Blue: Right Foot.
3. Place foot centrally on the ImPad foot cover so that
the plantar arch is directly above the hard rigid
sole as shown by the graphics on the inflation pad.
4. Wrap the medial side over the top of the
foot and then overlap the lateral side of
the ImPad foot cover. Pull to fit “sneaker
tight” and secure in place with the tab.
5. Next, loosely position the rear strap around
the back of the heel and secure medially.

System Operation
1. Connect tubing to the controller by pushing
the black connector firmly into the output
socket on the rear panel of the controller. To
disconnect, pull the connector from the socket.
2. Power on the controller by pressing the black
power switch located on the front lower right
of the controller.
Note: The controller will initiate a brief
self-test followed by a 5 second countdown
shown on the LCD display.
3. Press the run/stop buttons on the
top panel to activate each channel
being used. (left, right, or both)
4. Check that the impulse is felt directly
under the arch of the foot. If not, adjust
the ImPad foot cover accordingly.
5. Check regularly for patient comfort, tenderness
and skin integrity per hospital protocol.
6. For optimum results, make sure patient is seated
head up, feet down (reverse trendelenberg position).

Sterile ImPad Rigid Sole Foot Cover
1. Apply non-sterile foot cover to
non-operative limb as described previously
in application instructions on page 4.
2. After sterilizing field, apply the sterile foot cover
to the foot of the operative limb. When applying
the ImPad foot cover, be careful to ensure
that the tubing remains in the sterile field.
3. Place foot centrally on top of the ImPad foot
cover as shown by the graphic on inflation
bladder. The bladder must be located
directly under the arch of the foot.
4. Wrap the medial side over the top of the
foot and then overlap the lateral side of
the ImPad foot cover. Pull to fit “sneaker
tight” and secure in place with the tab.
5. Next, loosely position the rear strap around
the back of the heel and secure medially.
6. Check to ensure the ImPad foot cover
fits securely on patient foot.
7. Lift patient’s leg to estimate the
tubing length required to perform the
intraoperative limb manipulation.
8. Secure the tubing by twisting the sterile drape
around the tubing and clip. This will prevent the
portion of tubing required for the limb manipulation
from dropping below the operating table.
9. Connect tubing to the controller by pushing the
black connector firmly into the output socket on the
rear panel of the controller.
NOTE: Unlike the non-sterile ImPad foot cover,
the sterile ImPad foot cover’s clear tubing is
ATTACHED - please do not attempt to use blue
tubing set with sterile ImPad foot cover.

Alarm Codes
Ault Code 1:
tubing disconnect
Check the tubing connection at the back of the
controller and at the ImPad rigid sole foot cover.
Ensure no leaks are present in the tubing set.
FAult Code 2:
tubing Kink
Check the tubing set for a kink or blockage.
FAult Code 3:
low Pressure Alarm
Check the fit of ImPad foot covers to
ensure they are not too loose.
FAult Code 4:
High Pressure Alarm*
Check the fit of ImPad foot covers to
ensure they are not too tight.
* For patient safety, excess pressure is immediately
vented and controller operation is suspended.

Tips and Tricks
Swelling Reduction
The A-V Impulse foot compression
system is indicated to reduce swelling
in the lower limb. Over time, swelling
reduction could affect the fit of the ImPad
foot cover, causing an alarm. This alarm
can easily be addressed by readjusting
the ImPad foot cover for a proper fit.
duplicate Alarms
To avoid duplicate alarms when adjusting
one ImPad foot cover (e.g., left) to correct
an alarm, it is often a good idea to adjust
the other (e.g., right) at the same time.
Patient Comfort
Should a patient have difficulty adapting
to the foot compression therapy, consider
using one of the Preset Operating
Parameters by pressing the button*.
(Preset 3 is designed to allow the patient
to become accustomed to the therapy)
* Always consult the physician prior to
adjusting the default pressure parameters.
See the Operators Manual for more
detailed information on Presets.
For additional information, log on to
www.covidien.com/dvtcompression
15 Hampshire Street
Mansfield, MA
02048
Patient education
Empower your patient to take an active
role in their recovery. Your local Covidien
Representative can supply you with A-V
Impulse foot compression system Patient
Education Pads and DVT Awareness Literature
to help educate your patients on the risks of
VTE and the importance of prophylaxis.
Continuing education
Contact your local Covidien Representative
to schedule CEU programs on VTE
Prophylaxis for your nursing staff.
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registered trademarks of Covidien AG. Other brands are trademarks of a Covidien company © 2011 Covidien.
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