Research-Based Practice: Effectiveness of Pneumatic and Clamp Hemostasis Devices in the Prevention of Vascular Complications

2.50
Hdl Handle:
http://hdl.handle.net/10755/150755
Type:
Presentation
Title:
Research-Based Practice: Effectiveness of Pneumatic and Clamp Hemostasis Devices in the Prevention of Vascular Complications
Abstract:
Research-Based Practice: Effectiveness of Pneumatic and Clamp Hemostasis Devices in the Prevention of Vascular Complications
Conference Sponsor:Sigma Theta Tau International
Conference Year:2004
Conference Date:July 22-24, 2004
Author:Bert, Quana D., ARNP, MSN, RN-C
P.I. Institution Name:Swedish Medical Center
Title:Cardiac Clinical Outcomes Manager
Co-Authors:Joya D. Pickett, RN, MSN, CCRN
Background: The optimal vascular access site management remains controversial. Clinical practice varies and little agreement exists on which hemostasis strategy is most effective. Purpose: 1) To analyze empirical evidence appraising femoral artery hemostasis devices; 2) To assist in making informed decisions and planning evidence-based practice interventions. Method: A rigorous two-tiered literature search was conducted utilizing predetermined inclusion criteria. Three studies were selected for analysis of methodologies, strengths, limitations, findings, and conclusions. Results: When comparing hemostasis methods bleeding (hematoma, ecchymosis) and vascular (thrombosis, echogenic hematoma, AV fistula, or pseudoaneurysm) complications were clamp vs. manual (n.s., p=0.041), pneumatic vs. manual (n.s., not analyzed), and pneumatic vs. clamp (p<0.05, p=0.09). Initial bleeding was controlled when substituting pneumatic for clamp compression (p<0.01). In percutaneous coronary interventions the pneumatic device is as effective as manual pressure. Manual compression was found to be effective with a blood pressure >170, compared to pneumatic. Age (>63), weight (<78kg), and height (<171 cm) were predictive of complications. Combined factors of advanced age and reduced weight contributed to complications. Clamp over manual hemostasis prevented ultrasound defined pathologies. Physical exam alone failed to detect serious vascular complications. Clinical Implications/Conclusions: The results indicate mechanical compressive devices are as effective as manual compression. Factors that predict bleeding complications were identified. Research supports interchanging compressive techniques to achieve arteriotomy hemostasis. Controlling blood pressure and limiting dose of acetylsalicylic acid may reduce the risk of bleeding. Patient comfort levels were comparable utilizing pneumatic or manual pressure. Considerations for future research include standard research definitions for bleeding and vascular complications, optimal blood pressure for sheath removal, and identification of the patient population requiring routine ultrasonography.
Repository Posting Date:
26-Oct-2011
Date of Publication:
22-Jul-2004
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleResearch-Based Practice: Effectiveness of Pneumatic and Clamp Hemostasis Devices in the Prevention of Vascular Complicationsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150755-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Research-Based Practice: Effectiveness of Pneumatic and Clamp Hemostasis Devices in the Prevention of Vascular Complications</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 22-24, 2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bert, Quana D., ARNP, MSN, RN-C</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Swedish Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Cardiac Clinical Outcomes Manager</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">joya.pickett@swedish.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joya D. Pickett, RN, MSN, CCRN</td></tr><tr><td colspan="2" class="item-abstract">Background: The optimal vascular access site management remains controversial. Clinical practice varies and little agreement exists on which hemostasis strategy is most effective. Purpose: 1) To analyze empirical evidence appraising femoral artery hemostasis devices; 2) To assist in making informed decisions and planning evidence-based practice interventions. Method: A rigorous two-tiered literature search was conducted utilizing predetermined inclusion criteria. Three studies were selected for analysis of methodologies, strengths, limitations, findings, and conclusions. Results: When comparing hemostasis methods bleeding (hematoma, ecchymosis) and vascular (thrombosis, echogenic hematoma, AV fistula, or pseudoaneurysm) complications were clamp vs. manual (n.s., p=0.041), pneumatic vs. manual (n.s., not analyzed), and pneumatic vs. clamp (p&lt;0.05, p=0.09). Initial bleeding was controlled when substituting pneumatic for clamp compression (p&lt;0.01). In percutaneous coronary interventions the pneumatic device is as effective as manual pressure. Manual compression was found to be effective with a blood pressure &gt;170, compared to pneumatic. Age (&gt;63), weight (&lt;78kg), and height (&lt;171 cm) were predictive of complications. Combined factors of advanced age and reduced weight contributed to complications. Clamp over manual hemostasis prevented ultrasound defined pathologies. Physical exam alone failed to detect serious vascular complications. Clinical Implications/Conclusions: The results indicate mechanical compressive devices are as effective as manual compression. Factors that predict bleeding complications were identified. Research supports interchanging compressive techniques to achieve arteriotomy hemostasis. Controlling blood pressure and limiting dose of acetylsalicylic acid may reduce the risk of bleeding. Patient comfort levels were comparable utilizing pneumatic or manual pressure. Considerations for future research include standard research definitions for bleeding and vascular complications, optimal blood pressure for sheath removal, and identification of the patient population requiring routine ultrasonography.</td></tr></table>en_GB
dc.date.available2011-10-26T10:41:59Z-
dc.date.issued2004-07-22en_GB
dc.date.accessioned2011-10-26T10:41:59Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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