A radial artery pseudoaneurysm represents a rare, potentially catastrophic complication of arterial cannulation that has been reported after cardiac catheterization. Treatment options are limited to chemical, mechanical, and combined approaches to obliterate the radial artery pseudoaneurysm and tract. Manual compression protocols using the TR Band (Terumo Medical Corporation, Somerset, NJ) have been variable and anecdotal, without objective measurements of adequate compression, making this technique prone to failure. In this report, we present an efficient, safe, and noninvasive management protocol using a pulse oximeter and the TR Band for treatment of radial artery pseudoaneurysms that is cost-effective and efficient and ensures correction without occlusion of the radial artery.

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The objective of this study is to develop a reliable Tablet-PC based observational tool for identifying work systems factors that impact cardiac surgical care. Using the tool we observed 26 open heart surgeries over a five-month period. In thirteen of the 26 observations, both observers stood in the same location and in the other thirteen cases the observers stood in different locations within the operation room (OR). The surgical cases typically last five hours and were conducted in multiple operating rooms within the hospital and with mixed surgical teams. There was an average of 8.49 flow disruptions per hour related to work system factors with an average of 42.45 disruptions per case. Results revealed that inter-rater reliability in identifying work system factors that disrupted surgical flow was roughly 87% when observers were standing in the same location. However, when standing in different locations, the reliability decreased to an average of 75%.

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