Trent Williams1, Jeremy Condon2, Allan Davies3, Jennifer Brown4, Lucinda Matheson5, Thomas Warner, Lindsay Savage6, Andrew Boyle7, Nicholas Collins8, Kerry Inder9. 1. Clinical Nurse Consultant, Department of Cardiology, John Hunter Hospital, Australia. 2. Registered Nurse, Department of Cardiology, John Hunter Hospital, Australia. 3. Interventional Fellow, Cardiology, John Hunter Hospital, Australia. 4. Registered Nurse, Cardiology, John Hunter Hospital, Australia. 5. Clinical Nurse Educator, John Hunter Hospital, Australia. 6. Clinical Nurse Consultant, Cardiology, John Hunter Hospital, Australia. 7. Professor of Cardiovascular Medicine, Director of Priority Clinical Centre for Cardiovascular health, Department of Cardiology, John Hunter Hospital, Australia. 8. Associate Professor, Director, Cardiac Catheterisation Lab, John Hunter Hospital, Australia. 9. Associate Professor of Nursing: Deputy Head of School-Research, School of Nursing and Midwifery, University of Newcastle, Australia.
Abstract
BACKGROUND: Trans-radial access is increasingly common for cardiac catheterisation. Benefits include reduced bleeding complications, length of hospital stay and costs. AIMS: To determine the feasibility of implementing a nurse-led ultrasound programme to measure radial artery diameter before and after cardiac catheterisation; to determine radial artery occlusion (RAO) rates, risk factors for RAO and predictors of radial artery (RA) diameter. METHOD: A prospective observational cohort study design for 100 consecutive patients undergoing cardiac catheterisation, using RA access. Pre- and post-procedural RA diameter were measured using ultrasound, by specialist nurses trained to do so. Logistic regression analyses were performed to determine risk factors for RAO and predictors of RA diameter with results reported as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: There were no adverse events, supporting the feasibility of nurse led ultrasound programmes. A 4% (n = 4) rate of occlusion was observed. Haemostasis device application time of greater than 190 min was a predictor of RAO (OR 3.12, 95% CI 0.31-31). Male gender and height were predictors for a RA diameter of >2.2 mm. CONCLUSIONS: Nurses can lead the assessment of RA occlusion using ultrasound to enhance planning and care, including monitoring compression times to reduce RAO.
BACKGROUND: Trans-radial access is increasingly common for cardiac catheterisation. Benefits include reduced bleeding complications, length of hospital stay and costs. AIMS: To determine the feasibility of implementing a nurse-led ultrasound programme to measure radial artery diameter before and after cardiac catheterisation; to determine radial artery occlusion (RAO) rates, risk factors for RAO and predictors of radial artery (RA) diameter. METHOD: A prospective observational cohort study design for 100 consecutive patients undergoing cardiac catheterisation, using RA access. Pre- and post-procedural RA diameter were measured using ultrasound, by specialist nurses trained to do so. Logistic regression analyses were performed to determine risk factors for RAO and predictors of RA diameter with results reported as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: There were no adverse events, supporting the feasibility of nurse led ultrasound programmes. A 4% (n = 4) rate of occlusion was observed. Haemostasis device application time of greater than 190 min was a predictor of RAO (OR 3.12, 95% CI 0.31-31). Male gender and height were predictors for a RA diameter of >2.2 mm. CONCLUSIONS: Nurses can lead the assessment of RA occlusion using ultrasound to enhance planning and care, including monitoring compression times to reduce RAO.
Authors: Amit P Amin; Mark Patterson; John A House; Helmut Giersiefen; John A Spertus; Dmitri V Baklanov; Adnan K Chhatriwalla; David M Safley; David J Cohen; Sunil V Rao; Steven P Marso Journal: JACC Cardiovasc Interv Date: 2017-02-27 Impact factor: 11.195
Authors: Arnold H Seto; Mazen S Abu-Fadel; Jeffrey M Sparling; Soni J Zacharias; Timothy S Daly; Alexander T Harrison; William M Suh; Jesus A Vera; Christopher E Aston; Rex J Winters; Pranav M Patel; Thomas A Hennebry; Morton J Kern Journal: JACC Cardiovasc Interv Date: 2010-07 Impact factor: 11.195
Authors: Sanjit S Jolly; Salim Yusuf; John Cairns; Kari Niemelä; Denis Xavier; Petr Widimsky; Andrzej Budaj; Matti Niemelä; Vicent Valentin; Basil S Lewis; Alvaro Avezum; Philippe Gabriel Steg; Sunil V Rao; Peggy Gao; Rizwan Afzal; Campbell D Joyner; Susan Chrolavicius; Shamir R Mehta Journal: Lancet Date: 2011-04-04 Impact factor: 79.321
Authors: Brigitte M Baumann; Kathryn McCans; Sarah A Stahmer; Mary B Leonard; Justine Shults; William C Holmes Journal: Am J Emerg Med Date: 2008-01 Impact factor: 2.469
Authors: Anna T Beyer; Ramford Ng; Amardeep Singh; Jeffrey Zimmet; Kendrick Shunk; Yerem Yeghiazarians; Thomas A Ports; Andrew J Boyle Journal: Int J Cardiol Date: 2013-04-10 Impact factor: 4.164