Issues in Cardiovascular CareCoronary angiography observations: Evidence-based or ritualistic practice?*,**
Section snippets
Methods
This article reports the findings of a study conducted in conjunction with a multicenter randomized trial to detect the effect of compression bandaging on complications and comfort in patients undergoing coronary angiography.10 The study reported here examined specific incidents of femoral artery complications in terms of vital signs immediately before and during femoral hemorrhage, time since previous assessment, and how the complication was detected.
Patient randomization and characteristics
During a 6-month period, 1075 patients undergoing coronary angiography were enrolled in the randomization study; 519 patients were randomized to the pressure-bandage group and 556 to the no-bandage group. This number represents 53.7% of all patients admitted for coronary angiography during this time.
Complications
The characteristics, incidence, time, and extent of local complications in relation to the 2 treatment groups are described in detail in the article by Botti et al.10 The results to be discussed in
Discussion
The general aim of this study was to gain a better understanding of vascular complications after coronary angiography and to determine the efficacy of current assessment protocols in the early detection of these complications. Conducting a randomization study that tested a therapeutic intervention not only met the general aim of the project but also provided a unique opportunity to evaluate the effect of this intervention on the patient outcomes of interest. The use of compression bandaging
Acknowledgements
We are grateful to all of the nurses who participated in the data collection, without whom it would not have been possible. Thank you, also, to Jo McTaggart, Elizabeth Reid, and Heather MacFarlane for their substantial contribution in coordinating this project in their centers.
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Cited by (13)
Randomized Controlled Trial Comparing Simple Light Dressing (Transparent Film Dressing) Versus Pressure Dressing (Elastoplast) After Femoral Arterial Sheath Removal
2016, Journal of Radiology NursingCitation Excerpt :The study found that 5.1% of 1,075 patients (N = 55) experienced a recurrent bleed despite controlling for other variables, such as sheath size, length of pressure, and puncture site (Botti et al., 2001). The bleedings had occurred with a median of 2.02 hr after angiography (Botti et al., 2001). Therefore, it has been a long tradition to use pressure dressing to prevent local vascular complications among patients who have undergone femoral artery puncture (Botti, Williamson, Steen, McTaggart, & Reid, 1998).
Nursing clinical practice guidelines to improve care for people undergoing percutaneous coronary interventions
2011, Australian Critical CareCitation Excerpt :Even though the outcomes of arterial access closure devices are improving, a 2.5% failure rate has been reported.67 A comprehensive approach to observations (local puncture site assessment, limb and systemic observations, and patient-reported data, i.e. pain, sensation, and orientation) is recommended as vital signs alone have not been shown to provide diagnostic clues to localised vascular complications such as haematoma, ecchymosis or bleeding.63 Bleeding during PCI has been found to have a greater impact on mortality than was previously thought.27
Observations and vital signs: ritual or vital for the monitoring of postoperative patients?
2006, Applied Nursing ResearchRoutine blood pressure measurements do not predict adverse events in hospitalized patients
2006, American Journal of MedicineCitation Excerpt :Even when blood pressure differences of at least 20 mm Hg were considered, the findings were identical. The results of the present study agree with previous studies in selected patients.9-11 However, these studies assessed the value of blood pressure measurement for the management of specific admission diagnoses.
Efficacy of frequent blood pressure and heart rate monitoring for early identification of bleeding following percutaneous coronary intervention
2012, International Journal of Nursing Practice
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Supported by a grant from La Trobe University, Melbourne, Australia.
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Reprint requests: Mari Botti, BA, RN, MRCNA, School of Nursing, Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125, Australia.