Effects of three groin compression methods on patient discomfort, distress, and vascular complications following a percutaneous coronary intervention procedure.
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 = -3.1, p = .0019), hematoma (z = -9.4, p < .0001), and ecchymosis(z = -10.1, p < .0001). C-clamp contributes to less oozing when hemostasis time is < 30 min (z = -2.2, p = .03), and Femostop is superior when time to hemostasis is >30 min (z = -2.3, p = .02). Not receiving eptifibatide (Integrilin) contributes to less ecchymosis (z = -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.
Chlan
Linda L
LL
School of Nursing, University of Minnesota, 5-160 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA. chlan001@umn.edu
Sabo
Julie
J
Savik
Kay
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000451:nursing*; D001458:Bandages; D001510:Bed Rest / Q000523:psychology; D015400:Clinical Nursing Research; D005260:Female; D005263:Femoral Artery; D006119:Groin; D006488:Hemostasis, Surgical / Q000379:methods* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013527:Perioperative Nursing / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000451:nursing* / Q000517:prevention & control; D013315:Stress, Psychological