Venous thromboembolism (VTE) — encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE) — is responsible for approximately 100,000 deaths annually in the United States and remains one of the most common preventable causes of in-hospital mortality. Compression stockings, anti-embolism hosiery, and sequential compression devices (SCDs) are foundational components of every VTE prophylaxis protocol.
Understanding Compression Levels (mmHg)
Compression garments are graded by the pressure they exert at the ankle, measured in millimeters of mercury (mmHg):
- 8–15 mmHg: Mild compression. Travel socks, general wellness. Not for clinical VTE prevention.
- 15–20 mmHg: Mild-moderate. Minor varicosities, leg fatigue, pregnancy. OTC available.
- 20–30 mmHg (Class I): Moderate compression. First-line clinical treatment for varicose veins, mild edema, post-sclerotherapy. Most common prescription strength.
- 30–40 mmHg (Class II): Firm compression. Severe varicosities, DVT treatment, lymphedema management, post-thrombotic syndrome.
- 40–50 mmHg (Class III): Extra firm. Severe lymphedema, chronic venous insufficiency. Requires fitting by a trained specialist.
Anti-Embolism Stockings (TED Hose)
Anti-embolism stockings — commonly called TED hose (from Thrombo-Embolic Deterrent) — are 18 mmHg graduated compression garments specifically designed for non-ambulatory patients at VTE risk. They are indicated for surgical patients, immobilized medical patients, and anyone with limited mobility during hospitalization. TED hose are not therapeutic compression garments — they are prophylactic, intended to maintain venous flow in patients who are not walking.
Key brands: Covidien (Kendall TED), Jobst (BSN Medical), Medline, and Sigvaris. Available in knee-length and thigh-length configurations with open or closed toe.
Sequential Compression Devices (SCDs)
SCDs take mechanical prophylaxis further by intermittently inflating leg sleeves to actively propel venous blood proximally. They are indicated for high-risk surgical patients (orthopedic, neurosurgical, bariatric) and ICU patients where pharmacologic anticoagulation is contraindicated. SCD systems from Covidien (Kendall), Medi, and Zimmer Biomet require compatible single-use sleeves — a high-velocity consumable for active surgical and ICU units.
Therapeutic Compression for Outpatient and Home Care
Post-discharge, patients with DVT, CVI, or lymphedema transition to therapeutic compression stockings (20–40 mmHg). Compliance is the biggest challenge — proper fitting and patient education dramatically improve outcomes. For home health agencies and DME suppliers, stocking a range of sizes and compression levels is essential. Medicare covers compression for lymphedema when criteria are met (benefit clarified under the SUPPORT Act).
Procurement and Stocking Strategy
Hospitals and SNFs should maintain par levels of TED hose in the most common sizes (S, M, L in both knee and thigh length) to avoid last-minute procurement. For SCD sleeves, standardize on a single manufacturer compatible with your pump inventory. Healix stocks anti-embolism stockings, therapeutic compression garments, and SCD sleeves from leading brands — browse our orthopedic and rehab catalog or call (888) 585-6510 for bulk pricing.