Repetative injury question

JustMe · Jun 26, 2007

Does anyone out there pull arterial sheaths s/p heart caths? Our Recovery room nurses do this and in a 4 month period...D/C'd 400 sheaths. Some ofour nurses now have wrist , fore arm and back problems and just last week, our top pullers were complaining of hand numbness/ thumb and joint pain.
Our institution rarely uses closure devices and sheath pulling has been identified as a nursing duty. We are a unit of 14...6 of whom cannot pull sheaths anymore. I am afraid that we will cause permanent injury to the remining nurses. Thoughts?

I was just browsing the critical care threads and saw your posting. We pull sheaths in our CICU (it is one of our competencies). We have a device called a Compressar that holds pressure on the groin but the nurse must remain at the bedside at all times. Personally I don't like the device so I went back to using my hands. Yes, it is hard on the wrists, arms, etc. I've had bilateral carpal tunnel release but I don't think it was pulling sheaths that caused it, although it certainly didn't help. If you have that many nurses with problems perhaps your safety officer needs to look into this. There are other devices on the market that relieve the nurse from holding manual pressure. You also might want to look at what level of bleeding time is being used. We use an ACT of less than 150 to pull sheaths. Less pressure time is required if the ACT is less than 150 in my experience. The literature on carpal tunnel injury in nurses and the levels of ACT is VERY sparce--a good choice for any nurse willing to do the research.