Coronary angiography observations: evidence-based or ritualistic practice?

Botti, Mari, Williamson, Betty and Steen, Kate 2001, Coronary angiography observations: evidence-based or ritualistic practice?, Heart and lung : the journal of acute and critical care, vol. 30, no. 2, pp. 138-145, doi: 10.1067/mhl.2001.114192.

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Title Coronary angiography observations: evidence-based or ritualistic practice?
Author(s) Botti, MariORCID iD for Botti, Mari
Williamson, Betty
Steen, Kate
Journal name Heart and lung : the journal of acute and critical care
Volume number 30
Issue number 2
Start page 138
End page 145
Publisher Mosby, Inc.
Place of publication St.Louis, Mo.
Publication date 2001-03
ISSN 0147-9563
Summary Objective: The purposes of this study were to describe the incidence and occurrence of femoral artery bleeding during the first 6 hours after coronary angiography and to determine whether there is a relationship between  current postangiogram observation protocols and the detection of  complications.

Design: This was a prospective descriptive study.

Setting: The study was conducted in 3 university hospitals in Melbourne, Australia.

Patients: Subjects included 55 patients representing the complication rate of 1075 patients, mean age 61 years (SD, 12), 69% male.

Results: About 5.1% of patients had 1 or more incidents of bleeding  requiring manual compression. In 4.2% of patients, bleeding occurred within 6 hours of angiography. Bleeding occurred a median of 2.02 hours (Q1 = 45 minutes, Q3 = 4.31 hours) after angiography. Patients without pressure bandaging bled a median of 1.32 hours (Q1 = 36.50 minutes, Q3 = 2.59 hours) after angiography. Patients with pressure bandaging bled a median of 4.75 hours (Q1 = 2.25 hours, Q3 = 7.28 hours) after angiography. In 40.6% of cases, bleeding was detected through the patient’s call for assistance, and in 59.4% of cases nurses noted bleeding while checking the puncture site. Postcatheter observations were recorded 23.70 (SD, 14.60) minutes before the bleeding incident. There were no significant changes in vital signs, systolic blood pressure (P > .05), diastolic blood pressure (P > .05), or pulse (P > .05) before or during a bleeding episode. All were within normal parameters. No neurovascular assessment anomalies were detected.

Conclusion: The use of pressure bandaging has a significant effect on the incidence and pattern of bleeding. Routine vital sign measurement has no relevance in detecting local complications after angiography. The most significant complication is bleeding that requires manual compression. Detection is through frequent puncture site observation and patient recognition and communication.
Notes Available online 9 May 2002.
Language eng
DOI 10.1067/mhl.2001.114192
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2001, Mosby, Inc.
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