Pre‐procedure

ActionRationale

1. 1.Show
   Explain and discuss the procedure with the patient.
   To ensure that the patient understands the procedure and gives their valid consent (NMC [202], C).
2. 2.Show
   The patient should be seated. Extend their arm out; rest on a flat surface if required.
   To support the arm. E

Procedure

1. 3.Show
   Apply a liner or apply the patient's compression garment if the adjustable wrap compression system is being used as adjunct to a compression garment.
   To protect the skin. E
2. 4.Show
   Unfasten all the straps of the adjustable wrap compression system and fold back each strap securing the Velcro pads.
   To ensure the wrap is open and flat and to ensure Velcro pads do not stick and tangle, making application difficult. E
3. 5.Show
   Position the arm wrap on the arm with the base of the wrap above the wrist and the top below the axilla.
   To prevent rubbing at the axilla. E
4. 6.Show
   Secure the top strap near the axilla.
   To hold the arm wrap in the correct position. E
5. 7.Show
   Beginning at the wrist, secure the straps, following the manufacturer's instructions. Straps are usually pulled at 75% stretch (not full stretch on arm).
   To ensure equal consistent compression is applied. E
6. 8.Show
   Apply elbow straps before surrounding straps.
   To ensure wrinkle‐free application and allow movement of the elbow joint. E
7. 9.Show
   Continue to the axilla then undo the original strap and secure again.
   To ensure consistent application of compression. E
8. 10.Show
   Visually inspect the arm wrap.
   To ensure all straps are secure. E

Post‐procedure

1. 11.Show
   Check that the patient finds the adjustable wrap compression system comfortable and that they are not experiencing any feelings of pain, tingling or numbness.
   Pain, tingling or numbness indicates that the sleeve has been inappropriately applied or fitted. E
2. 12.Show
   To remove the adjustable wrap compression system, unfasten each Velcro strap, folding it back and fastening it on itself.
   To prevent Velcro sticking to itself and make reapplication easier. E
3. 13.Show
   Inspect the skin. A mild indent where the straps have been is normal.
   To check for areas of redness and ensure straps have not been applied with too much stretch. E
4. 14.Show
   Document the manufacturer and style and size of the arm wrap that the patient has been provided with.
   To maintain accurate records (NMC [202], C).