The effect of the application of cold on hematoma, ecchymosis, and pain at the catheter site in patients undergoing percutaneous coronary intervention.
Yeter Kurt, Mağfiret Kaşıkçı
PMID 31728389WHAT IT FOUND
After a groin catheter used for PCI was removed and bleeding was stopped, a 15-minute cold pack under the sandbag was associated with less bruising, smaller hematoma and less groin pain than sandbag alone.
Nurses may consider this simple comfort and monitoring measure.
Key findings
01A 15-minute cold pack covered with sterile gauze under the sandbag after femoral catheter withdrawal and hemostasis was associated with less bruising, hematoma and pain than sandbag alone.
02At 48 hours, ecchymosis occurred in 21 of 100 cold-pack patients and 55 of 100 controls; hematoma occurred in 19 of 100 and 44 of 100.
03At 72 hours, ecchymosis occurred in 43 of 100 cold-pack patients and 73 of 100 controls; hematoma occurred in 20 of 100 and 49 of 100.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Patients were not randomised: the first 100 patients became the control group and the last 100 became the experimental group, so time-related changes in care or patient mix could affect the comparison. The study was done in one coronary intensive care unit, so it may not apply to other hospitals or to radial or brachial access. Patients with thrombolytic drugs, glycoprotein 2b/3a, coagulation disorder, plegia, or pre-existing oozing hemorrhage, hematoma or ecchymosis were excluded, so results do not apply to higher bleeding-risk patients. The paper does not report blinding of patients or outcome assessors, and pain was reported by patients. The cold pack was tested only as an add-on to a 5 kg sandbag and routine hemostasis, so its effect without those measures is not known.
Declared interests
The authors declared no potential conflicts of interest. The study was supported by the Scientific Research Projects Commission of the Ataturk University Scientific Research Projects unit (Project No. 2011/55).
The easy way to misread this
Do not conclude that a cold pack alone prevents post-PCI vascular complications. Both groups received routine hemostasis and a 5 kg sandbag, and the groups were assigned by recruitment order rather than random allocation.