Nursing-led ultrasound to aid in trans-radial access in cardiac catheterisation: a feasibility study

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.

Nurse-led intervention in the management of patients with cardiovascular diseases: a brief literature review

“…Nursing staff teaching is simple, and this could significantly be effective in interventional cardiology to minimize complications after coronary interventions. In addition, the implication of nurse specialists in the assessment of radial artery prior to and after coronary catheterization using ultrasound in order to enhance planning and care has also shown positive response in Interventional Cardiology [ 20 ].…”