title: The effectiveness of superficial subcutaneous lidocaine administration prior to femoral artery sheath removal.
abstract: The dynamic world of healthcare requires continuous review of practice to ensure that patient care aligns with current evidence and best practice. Superficial subcutaneous lidocaine injection has been an order option at London Health Sciences Centre-University Hospital (LHSC-UH) for use in post-percutaneous coronary intervention (PCI) prior to femoral artery sheath removal (FASR). The purpose of administering lidocaine is to reduce pain during FASR, subsequently enhancing the patient's experience. A critical appraisal was performed by the Continuous Quality Improvement-Cardiac Care Council (CQI-CCC) at LHSC-UH, evaluating the effectiveness of superficial subcutaneous lidocaine for use in patients undergoing FASR. This paper details the process followed to evaluate this practice and reports on the subsequent findings and recommendations. A literature review, a retrospective chart audit, a blinded online survey and peer hospital polling were compiled, and a summary of findings was shared with the cardiac interventionists, with subsequent polling. No significant evidence for pain reduction was identified when lidocaine injections were administered prior to FASR. As such, a unanimous decision was reached to remove lidocaine from the LHSC Coronary Angioplasty Clinical Pathway order form.
authors.affiliation: Laura Davison, RN, BScN, Acute Care Nurse, Cardiac Care Program & Chair, CQI Council, 2012-2014.
authors.forename: Laura
authors.initials: L
authors.lastname: Davison
authors.affiliation: Anne McVety, RN, BHSN, CCN(C), Professional Scholarly Practice Clinical Educators, Cardiac Care Program, London Health Sciences Centre - University Hospital.
authors.forename: Anne
authors.initials: A
authors.lastname: McVety
authors.affiliation: Tara Oke, RN, CCN(C), Professional Scholarly Practice Clinical Educators, Cardiac Care Program, London Health Sciences Centre - University Hospital.
authors.forename: Tara
authors.initials: T
authors.lastname: Oke
mesh_terms: D000772:Anesthesia, Local / Q000451:nursing*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000451:nursing*; D020878:Device Removal / Q000451:nursing*; D005263:Femoral Artery; D006801:Humans; D008012:Lidocaine; D010147:Pain Measurement / Q000451:nursing; D017410:Practice Guidelines as Topic
chemical_list: D008012:Lidocaine