title: Effects of modified positioning and mobilization of back pain and delayed bleeding in patients who had received heparin and undergone angiography: a pilot study.
abstract: OBJECTIVE
  To examine the effects that a modified positioning and mobilization routine had no back pain and delayed bleeding in patients who had received heparin and undergone cardiac angiography.
  
  
  METHODS
  An experimental research design was used. Each patient was assigned randomly to either the control group, which required 6 hours of bed rest after cardiac angiography, or the experimental group. The experimental group had modified positioning, in which the head of the bed was elevated to a maximum of 45 degrees, and modified mobilization, in which they were ambulated briefly at the bedside 4 hours after angiography.
  
  
  METHODS
  Two cardiology units of a 700-bed urban teaching hospital in western Canada.
  
  
  METHODS
  All patients admitted for nonemergent cardiac angiography were approached for consent, to attain a sample of 29 patients, and were randomly assigned to the experimental or the control group.
  
  
  METHODS
  Each patient was randomly assigned before cardiac angiography. The assignment was confidential until the patient was admitted to the cardiac unit after angiography. A demographic tool and the McGill Present Pain Intensity Scale were used to collect data. Perception of pain was evaluated over four observation periods. A research assistant monitored sanguineous drainage on the dressing and hematoma to evaluate the presence of delayed bleeding.
  
  
  METHODS
  Demographic information was analyzed primarily through descriptive statistics. Results were analyzed to compare back pain and delayed bleeding between the two groups. Wilcoxon scores and t tests both were used for analysis and correlated well with each other.
  
  
  RESULTS
  The group with the modified positioning and mobilization routine experienced significantly less pain overall (p = 0.02), less pain at each interval, and significantly less pain intensity (p < 0.05). There was no difference in bleeding. One person in each group had an estimated blood loss of more than 100 ml through the pressure dressing.
  
  
  CONCLUSIONS
  This pilot study supports our hypothesis that modifying the immobilization of patients after cardiac angiography is associated with a reduction in back pain and with no increase of delayed bleeding at the femoral access site. The results support the need for further investigation of ambulation interventions after cardiac angiography.
authors.affiliation: Foothills Hospital, Calgary, Alberta, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Pooler-Lunse
authors.forename: A
authors.initials: A
authors.lastname: Barkman
authors.forename: B F
authors.initials: BF
authors.lastname: Bock
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001416:Back Pain / Q000209:etiology* / Q000628:therapy*; D001510:Bed Rest; D017023:Coronary Angiography; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011187:Posture; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin