Università degli Studi di Modena e Reggio Emilia
Corso di laurea in infermieristica - Sede di Modena
| Thesis Title | Patent hemostasi radial access management after percutaneous diagnostics and interventistic coronary procedure for RAO prevention |
|---|---|
| Name | Corina Luca |
| Supervisor(s) | Malagoli Maurizia, Miccoli Rosa |
| Academic Year | 2017/18 |
| Thesis type | Research thesis |
Abstract
Radial artery represent the most used vascular access to perform percutaneus coronary intervention (PCI) for diagnostic and interventional purposes in the management of the person suffering from coronary heart disease because it’ s associated with minor complications, especially hemorrhagic, low mortality and it’s preferred by the assisted. Nursing care in the post coronary procedure is mainly focused on the management of the arterial access, using compressive bandages to achieve hemostasis of the puncture site. Among these the Tr Band, a pneumatic compressive system, represents the most used device. Radial access is not exempt from the incidence of complications. The most common complication is the radial artery occlusion (RAO). An endothelial lesion, as well as decreasing blood flow after insertion of the introducer and of the higher caliber catheter than that of the artery, contribute to the formation of intravasal thrombus and therefore to RAO. The prevention that is done by maintaining the artery’s patency in all phases of PCI, using catheters with a smaller diameter than the artery and the Patent Hemostasis technique in the post procedure, is very important. This technique allows the achievement of hemostasis, exerting pressure on the puncture site sufficient to stop bleeding while maintaining the arterial patency, which is considering with the inverse Barbeau Test. The main purpose of the pre - post study, included in the context of an formative intervention, was to consider if nursing staff of the Cardiology departments of the AOU Modena’s Policlinico and Baggiovara’s OCSAE had sufficient knowledge of the Patent Hemostasi technique, already used in other reality for about a decade, which allows a drastically decreasing of the incidence of RAO. The formative intervention led to the creation of an improvement project that will change in time the procedures currently used in the participating departments.