The Big Picture
Some clients need special stockings or elastic bandages to help reduce swelling and support blood flow back toward the heart. These items need careful application because poor fit, bunching, twisting, or too much pressure may interfere with circulation or harm the skin.
For safe care, follow the client’s care plan, employer policy, and the directions for the product being used. Pay close attention to skin colour, temperature, swelling, discomfort, and other signs that circulation or skin condition has changed.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Anti-embolic stockings help prevent swelling and blood clots by increasing blood flow through the veins back toward the heart.
- Apply anti-embolic stockings before the client gets out of bed.
- Stockings and elastic bandages should fit snugly without being tight, twisted, bunched, or wrinkled.
- Elastic bandages are applied upward from the lower part of the extremity toward the upper part.
- Check circulation carefully. Watch skin colour and temperature and ask about pain, numbness, tingling, and other discomfort.
- Report and record required actions and observations according to employer policy.
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Course Notes: Key Ideas You Need to Know
What Anti-Embolic Stockings Do
Anti-embolic stockings are close-fitting, circular-knitted elastic stockings designed to help prevent swelling in the lower extremities and blood clots. They increase venous blood flow back toward the heart.
They are also called:
- compression stockings
- thromboembolic devices (TED)
A physician orders anti-embolic stockings or elastic bandages when the client needs them. When anti-embolic stockings are prescribed, they must be applied as part of the client’s daily dressing routine.
Clients with circulatory disorders, heart disease, or prolonged bed rest are at risk for blood clots. A blood clot, also called a thrombus, may form in a deep vein of the leg. The clot may break loose and travel through the bloodstream. If it reaches a vessel in the lungs, severe breathing problems or death may result.
Stay Inside the Care Plan and Workplace Directions
Incorrectly applied stockings may harm the client.
You may be asked to apply anti-embolic stockings only to clients who are in stable condition. Follow:
- employer policy
- the manufacturer’s instructions
- the client’s care plan
The care plan identifies the correct stocking size.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition tells you to follow the care plan, employer policy, and product directions. In Nova Scotia, the current Continuing Care Assistant Occupational Standards of Practice specifically list applying compression/anti-embolism garments as a Personal Care occupational indicator.
Each employer sets the CCA’s scope of employment, meaning the duties the CCA is permitted to perform in that workplace. A CCA must also stay within the provincial occupational standards and employer policies and procedures. If an intervention is beyond the CCA’s training or capabilities, the CCA must contact the relevant healthcare provider. The current standards do not specifically list elastic bandage application under the Personal Care indicator, so the anti-embolism garment competency should not be treated as automatic permission for every bandaging task.
Why this matters in Nova Scotia: Current provincial standards identify applying compression or anti-embolism garments as part of CCA personal care, while the CCA still has to follow workplace scope, training requirements, policies, and the established care plan.
Official source: Continuing Care Assistant Occupational Standards of Practice (novascotiacca.ca)
Last checked: September 12, 2026
Stocking Sizes and Lengths
Anti-embolic stockings come in different sizes and lengths, including:
- knee-high
- thigh-high
Correct sizing matters.
A stocking that is too tight restricts blood circulation. A stocking that is too large does not provide the intended support for venous blood flow back toward the heart.
When to Apply and Remove the Stockings
Apply the stockings in the morning before the client gets out of bed.
Sitting or standing allows swelling to develop in the legs. Swelling makes the stockings harder to apply.
Number to remember: Remove the stockings every 8 hours for 30 minutes, or follow the care plan.
The client lies in bed while the stockings are off to help prevent leg swelling.
Openings in Anti-Embolic Stockings
Many stockings have an opening near the toes. Other designs place the opening at the top or bottom of the foot.
The opening allows checks of:
- circulation
- skin colour
- skin temperature
Caring for the Stockings
The client usually has two pairs of stockings. One pair is worn while the other pair is washed.
Wash the stockings by hand with mild soap. Hang them to dry.
Keep the Stockings Smooth
After application, the stockings should remain smooth and snug.
Avoid:
- bunching
- binding
- twisting
- creases
- wrinkles
Bunching, binding, and twisting may interfere with circulation. Creases and wrinkles may contribute to skin breakdown.
Applying Anti-Embolic Stockings in the Correct Order
Before the Procedure
- Identify the client according to employer policy. Correct identification prevents confusing one client with another.
- Explain the procedure to the client.
- Practise proper hand hygiene.
- Collect the anti-embolic stockings in the correct size and length.
- Provide privacy.
- Practise proper hand hygiene again.
- Raise the bed to a comfortable working height and lower the head of the bed. Raising the bed reduces back strain. Lowering the head helps with positioning the client.
Applying the Stockings
- Lower the bed rail near you if it is raised.
- While the client remains in bed, place the client in the supine position. Apply the stockings before the client gets out of bed and before blood collects in the feet.
- Fan-fold the top linen toward the client’s thighs so only the legs are exposed.
- Prepare the first stocking:
- Face the client’s feet.
- Stand on the same side of the bed as the stocking you are applying.
- Turn the stocking inside out down to the heel. This helps prevent bunching, tearing, and twisting.
- Slip the foot of the stocking over the toes, foot, and heel.
- Grasp the top of the stocking. Slip it over the foot and heel, then pull it up the leg. The stocking turns right side out as it moves upward. Make sure it is even and snug.
- Remove all twists, creases, bunching, and wrinkles.
- Repeat the same application steps for the other leg.
After the Procedure
- Cover the client.
- Provide for safety and comfort.
- Place the call bell within reach so the client has a safe way to contact staff when needed.
- Return the bed to its lowest position. Follow the care plan for bed rail use.
- Remove the privacy measures.
- Practise proper hand hygiene.
Raising or lowering the bed, placing the call bell within reach, and bed-rail steps may not apply in community settings.
What to Report and Record After Stocking Application
After applying elastic stockings, report and record:
- skin colour and skin temperature
- swelling of the legs and feet
- signs of skin breakdown
- complaints of pain, tingling, or numbness
Report and record actions and observations according to employer policy. Actions, observations, and basic assessments are recorded and reported for legal reasons and to keep the rest of the health care team informed.
What Elastic Bandages Do
Elastic bandages have purposes similar to anti-embolic stockings. They are applied to upper or lower extremities and may also hold dressings in place.
Apply an elastic bandage from the lower, or distal, part of the extremity toward the upper, or proximal, part.
Your supervisor and the care plan identify:
- the area to bandage
- the proper bandage width
If one roll is not long enough to cover the area, another roll may be added.
Removing and Cleaning Elastic Bandages
Number to remember: Remove elastic bandages every 8 hours for 30 minutes.
If the care plan specifies washing, clean the bandage with mild soap and water. Rinse it well, pat it dry, and hang it overnight to finish drying.
Cleaning is especially important when the client has perspired on the bandage or the bandage becomes soiled.
General Safety Rules for Elastic Bandages
When applying an elastic bandage:
- use the correct length and width
- place the body part in good alignment
- face the client
- leave fingers or toes exposed when possible for circulation checks
- apply firm, even pressure
- keep the bandage snug, not tight
- check the colour and temperature of the extremity every hour
- reapply a bandage that becomes loose, wrinkled, moist, or soiled
A bandage that is too tight interferes with circulation.
Applying an Elastic Bandage in the Correct Order
Before the Procedure
- Identify the client according to employer policy.
- Explain the procedure.
- Practise proper hand hygiene.
- Collect the supplies:
- the elastic bandage directed by the care plan
- tape or metal clips, unless the bandage has Velcro
Gathering the needed equipment before starting helps you remain with the client and avoids unnecessary interruptions.
- Provide privacy.
- Practise proper hand hygiene again.
- Raise the bed to a comfortable working height.
Applying the Bandage
- Lower the bed rail near you if it is raised.
- Help the client into a comfortable position. Expose the body part that needs bandaging.
- Make sure the area is clean and dry. Moisture in the covered area supports the growth of pathogens and may lead to skin infection.
- Hold the bandage with the roll facing upward and the loose end on the bottom.
- Begin at the smallest part of the wrist, foot, ankle, or knee.
- Make two turns around the body part. These first turns hold the bandage in place.
- Continue upward using overlapping spiral turns. Each new turn should overlap about two thirds of the previous turn.
This upward application supports blood flow back toward the heart. Incorrect application may cause swelling of the hand or foot.
- Apply the bandage smoothly with firm, even pressure. Keep it snug without making it tight.
- Secure it with Velcro, tape, or a clip. Make sure the bandaged area does not press against a clip because pressure from the clip may injure underlying tissue.
- Check the fingers or toes for:
- coldness
- cyanosis, or bluish colour
Ask the client about:
- pain
- itching
- numbness
- tingling
Report: Report and record abnormal observations.
Safety: Remove the bandage when these abnormal signs or complaints occur, then report the observations to your supervisor.
These findings indicate decreased circulation to the extremity because the bandage is too tight. The area needs immediate attention because leaving the bandage in place may lead to serious health problems.
After the Procedure
- Complete the same post-procedure actions used after applying anti-embolic stockings:
- cover the client
- provide for safety and comfort
- place the call bell within reach when applicable
- return the bed to its lowest position and follow the care plan for bed rail use when applicable
- remove privacy measures
- practise proper hand hygiene
Report and record your actions and observations according to employer policy.
What to Report and Record After Bandage Application
Report and record:
- skin colour and temperature
- swelling in the leg and foot
- signs of skin breakdown
- complaints of pain, tingling, or numbness
During the procedure, also report and record abnormal findings such as coldness, cyanosis, itching, pain, numbness, or tingling as directed in the procedure.
Protect the Client’s Quality of Life
During both procedures, support:
- dignity
- independence
- individualized care
- preferences
- privacy
- safety
These principles remain part of the procedure from preparation through follow-up care.
Exam Clue Words
- Before: Apply anti-embolic stockings before the client gets out of bed.
- Must not: An elastic bandage must not be tight. It should remain firm and snug.
- Follow the care plan: Use the care plan for stocking size, bandaging directions, bed rail use, and other specified care.
- Report: Report abnormal circulation findings, skin problems, swelling, and client complaints identified in the procedures.
- Document: Record required actions and observations according to employer policy.
Fast Review
Focus on the safety rules, numbers, and correct order of application.
- Anti-embolic stockings help prevent swelling and blood clots by increasing venous blood flow back toward the heart.
- Apply stockings before the client gets out of bed.
- Stockings are removed every 8 hours for 30 minutes, or according to the care plan.
- Keep stockings smooth, even, and snug without twists, bunching, creases, or wrinkles.
- Elastic bandages are applied upward from the lower part of the extremity toward the upper part.
- Each spiral bandage turn overlaps about two thirds of the previous turn.
- Elastic bandages are removed every 8 hours for 30 minutes.
- Check the colour and temperature of a bandaged extremity every hour.
- A bandage should feel snug, not tight.
- Coldness, cyanosis, pain, itching, numbness, or tingling after bandaging require the bandage to be removed and the observations reported to the supervisor.
- Report and record skin colour, temperature, swelling, skin breakdown, and the listed client complaints.
- Follow the care plan, employer policy, and supported product directions throughout the procedure.
Final Pep Talk
There are several steps here, so focus first on the order, the 8-hour and 30-minute timing, and the signs of poor circulation. Review the sequence in smaller sections until each part feels familiar.