Effects of three groin compression methods on patient discomfort, distress, and vascular complications following a percutaneous coronary intervention procedure

Linda L. Chlan, Julie Sabo, Kay Savik

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

Background: Incidence of vascular complications (VCs) after sheath removal following a percutaneous coronary intervention procedure (PCIP) vary widely by the compression method used to achieve femoral artery hemostasis. Objective: To determine if one groin compression method causes the least discomfort and distress for patients and results in fewer VCs. Methods: Patients (n ≤ 306, mean age ≤ 62.3 years, 77% male, 96.4% Caucasian) undergoing PCIPs at a tertiary care center in the urban Midwest participated in this three-group experimental design study. They were randomly assigned to Femostop®, C-clamp, or manual compression and rated level of groin discomfort and distress on a 0-10 Numeric Rating Scale (NRS) prior to, during, and after arterial compression was released. The groin area was assessed for any VCs (oozing, ecchymosis, hematoma) prior to sheath removal, after compression released, and 12 and 24 hr after sheath removal. Results: No significant differences were found by compression method for discomfort, distress, or VCs. Regardless of method, not having a VC prior to femoral sheath removal contributes to less oozing (z ≤ ĝ̂'3.1, p ≤ .0019), hematoma (z ≤ ĝ̂'9.4, p < .0001), and ecchymosis(z ≤ ĝ̂'10.1, p < .0001). C-clamp contributes to less oozing when hemostasis time is <30 min (z ≤ ĝ̂'2.2, p ≤ .03), and Femostop® is superior when time to hemostasis is >30 min (z ≤ ĝ̂'2.3, p ≤ .02). Not receiving eptifibatide (Integrilin) contributes to less ecchymosis (z ≤ ĝ̂'2.9, p ≤ .004). Conclusions: Nurses need to be vigilant when caring for patients who have a VC prior to femoral sheath removal and have received antiplatelet medications. Further research is needed to identify patient characteristics that may contribute to VCs.

Original languageEnglish (US)
Pages (from-to)391-398
Number of pages8
JournalNursing research
Volume54
Issue number6
DOIs
StatePublished - Nov 1 2005

Keywords

  • Complications
  • Coronary angioplasty

ASJC Scopus subject areas

  • Nursing(all)

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