Acceptable use of pressure for cath removal

[emdmac]

I was wondering what med surg nurses are allowed in your areas to use for applying pressure after the removal of a heart cath in a femoral artery.

Someone told me they used 2 IV bags in a pillow case. I had never heard of that before and don't see how that could work.

I thought the belt, the clamp, sandbags or manual hand pressure was allowed.

Just curious.

[KaroSnowQueen, RN]

IF someone just has some minor oozing at the site, I have seen IV bags used for weight. BUT for a really big bleed, the clamp comes back out. The IV bags work well as a reminder to someone who just doesn't seem to remember NOT to move that leg too.:)

[emdmac]

So is it an acceptable practice to use IV bags? I would think that they would roll and not stay in place, and that they are not heavy enough to maintain adequate pressure above the incision area.

My director told us it was unreliable and could lead to encouraging the developement of pseudo-aneurysms. I just wondered how often IV bags are used, and if they are reliable and authorized as acceptable.

[bellehill, RN]

I have used IV bags when sandbags were not available...non-cardiac floor, inappropriate pt, different thread. Worked okay until a sandbag could be located.

[Dinith88]

"

Originally posted by emdmac [/i

"My director told us it was unreliable and could lead to encouraging the developement of pseudo-aneurysms."

You should ask your director what she means by that. It doesn't make any sense that a pseudo-aneurysm could be caused by laying anything on-top of an a-line/sheath.

Pseudo-aneuryisms are 99.99% of the time caused by an accidental rupture of the vessel (other than the initial puncture) during insertion of the catheter (MD-induced!),. The resulting bleed becomes 'walled off' by the body and resembles an anyeurism...thus the term 'pseudo'...

Perhaps she meant 'hematoma'?

Either way, if the sheath has been pulled without incident and the patient understands post-sheath pull restrictions (bed-rest, leg immobility, HOB down, etc.) then a sandbag (or iv-bag!) isnt even neccesary. We rarely use them anymore. Some nurses like them as 'reminders' to the patient to keep still...but in my experience it hasn't increased or decreased the development of post-pull hematomas.