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IRCT201604138650N8 IRCT 2016-06-05 Baqiyatallah University of Medical Sciences Outcomes of removal of arterial sheath in patients with angioplasty The effect of evidence based practice on outcomes after removal of arterial sheath in patients with angioplasty 2014-07-01 anticipated 200 Complete https://irct.ir/trial/9142 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Other design features: The objectives of the study were explained to the patients and informed consent was obtained. Then according to the inclusion criteria, patients were randomly assigned based on random-number table to intervention (n =100) and control group (n=100). Then, in control group according to the conventional methods and in intervention group based on the new designed guideline, removal of the arterial sheath and then outcomes (vasovagal, bleeding, hematoma, urine retention and back pain ) are recorded. 3 Coronary Artery disease. Intervention 1: In the intervention group, removal of the arterial sheath and clinical care were based on the following protocol. 1. Control of ACT in the third hour after angioplasty 2. If ACT was less than or equal to 175, the arterial sheath would be removed by manual compression. 3. Put direct pressure on the arterial sheath insertion site for two to three minutes so that the dorsalis pedis pulse disappears. Then lower the pressure to feel the dorsalis pedis pulse. Continue pressuring until hemostasis (10 to 20 minutes). 4. Put pressure dressing on arterial sheath area by a trained doctor or nurse. 5. Put two sandbags (4 kg weight per bag) on the dressing by nurse 6. Remove the first and the second sandbags two and three hours after removing the arterial sheath, respectively. 7. Patients were out of bed three hours after removal of the arterial sheath in case of no complication. 8. Record outcomes of removal of the arterial sheath in the data record form (all outcomes during the removal and up to one day after that were recorded). Intervention 2: In control patients, the arterial sheath was removed 4 to 6 hours after angioplasty, and then the manual compression was used for hemostasis. Two 8 kg sandbags compressed the dressing position. The first and second sandbags were removed two hours and 4-6 hours after removing the arterial sheath, respectively. Patients were out of bed 6 hours after removing the arterial sheath. Finally, outcomes of removing the arterial sheath, during this procedure and up to one day after that, were logged in the data record form.
public Ali reza paraj
Baqiyatallah Hospital,mollasadra Ave,Vanak Sq,Tehran,Iran
Tehran Iran (Islamic Republic of) 1435915371 +98 21 8126 3596 rezaparaj300@gmail.com School of nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran scientific Dr. Abbas Ebadi
School of nursing, Baqiyatallah University of Medical Sciences
Tehran Iran (Islamic Republic of) 19575174 +98 88040060 ebadi1347@yahoo.com Baqiyatallah University of Medical Sciences Iran (Islamic Republic of) inclusion criteria: 1- patient does not have hemodialysis 2-patients who do not require emergency percutaneous Transluminal coronary Angioplasty(PTCA) exclusion criteria: 1- patients who for any reason had a sudden increase in serum creatine that were leading to hemodialysis 2- patients who developed severe hemorrhage in the arterial sheath place and returned to cath lab. 42 years 89 years Both I25 ischemic heart disease Prevention Prevention In the intervention group, removal of the arterial sheath and clinical care were based on the following protocol. 1. Control of ACT in the third hour after angioplasty 2. If ACT was less than or equal to 175, the arterial sheath would be removed by manual compression. 3. Put direct pressure on the arterial sheath insertion site for two to three minutes so that the dorsalis pedis pulse disappears. Then lower the pressure to feel the dorsalis pedis pulse. Continue pressuring until hemostasis (10 to 20 minutes). 4. Put pressure dressing on arterial sheath area by a trained doctor or nurse. 5. Put two sandbags (4 kg weight per bag) on the dressing by nurse 6. Remove the first and the second sandbags two and three hours after removing the arterial sheath, respectively. 7. Patients were out of bed three hours after removal of the arterial sheath in case of no complication. 8. Record outcomes of removal of the arterial sheath in the data record form (all outcomes during the removal and up to one day after that were recorded). In control patients, the arterial sheath was removed 4 to 6 hours after angioplasty, and then the manual compression was used for hemostasis. Two 8 kg sandbags compressed the dressing position. The first and second sandbags were removed two hours and 4-6 hours after removing the arterial sheath, respectively. Patients were out of bed 6 hours after removing the arterial sheath. Finally, outcomes of removing the arterial sheath, during this procedure and up to one day after that, were logged in the data record form. Vasovagal. Timepoint: During and after removal the arterial sheath. Method of measurement: check list. Bleeding. Timepoint: ِDuring and after removal the arterial sheath. Method of measurement: check list. Hematoma. Timepoint: After removal the arterial sheath. Method of measurement: Check list. Urine retention. Timepoint: After removal the arterial sheath. Method of measurement: Check list. Back pain. Timepoint: After removal the arterial sheath. Method of measurement: Check list. Baqiyatallah University of Medical Sciences Approved 2014-04-30 ٍEthics commitee of Baqiyatallah University of Medical sciences 6th Floor, Nursing Faculty, Baqiyatallah University of Medical Sciences, P.O.Box: 19575174 Tehran Iran (Islamic Republic of)