Wednesday 21 December 2016

Effect Of Low Fowler's Position On Back Pain And Vascular Complications Following Trans-Femoral Cardiac Catheterization: A Randomized Controlled Trial

Vol. 6  Issue 1
Year:2016
Issue:Feb-Apr 
Title:Effect Of Low Fowler's Position On Back Pain And Vascular Complications Following Trans-Femoral Cardiac Catheterization: A Randomized Controlled Trial
Author Name:Jogindra Vati, Tintu K. Mathew and Yash Paul Sharma
Synopsis:
Cardiac catheterization remains the gold standard diagnostic test and evaluation for coronary heart diseases. The aim ° of this study was to investigate the effect of low fowler's position (30 ) on the severity of back pain and local vascular complications following transfemoral cardiac catheterization. A Randomized Controlled Trial (RCT) is the design principle used here. The study was conducted in the Advanced Cardiac Centre of Post Graduate Institute of Medical Education and Research, Chandigarh, India. A total 60 patients scheduled for elective transfemoral diagnostic cardiac catheterization were included in the study. Patients were randomly assigned to the control group (n=30) and the experimental group (n=30). Data were collected through the self developed 'Interview schedule, 'Numerical pain intensity scale', and 'Vascular complications assessment' tools after checking its validity and reliability. Low fowler's position protocol and the protocol for assessing vascular complications were also developed. Both groups were restricted to bed rest for first 2 hours following the procedure in supine position with the affected leg straight and immobilized. After 2 hours, patients in the control group (n=30) were receiving conventional care in supine position and patients of the experimental group (n=30) were restricted to bed rest in low fowler's position with the head of the bed elevated to 30 degree. Severity of back pain was assessed at regular time intervals of 2, 4, 6 hours of post cardiac catheterization. Local vascular complications (hematoma, ecchymosis, and bleeding) were assessed at the time of removal of dressing at 12 hours after catheterization. The experimental group patients significantly had less back pain than the control group (p<0.01) at 4 hours and 6 hours after cardiac catheterization. The control group patients (on supine position) significantly developed ecchymosis as compared to the experimental group (on low fowler position) (p<0.02) at the time of removal of dressing from the puncture site. None of the patient developed hematoma in both groups. There was no major bleeding in any of the groups. Nursing patients in low fowler's position at 30 degree during the early hours after cardiac catheterization can minimize the severity of back pain and ecchymosis.

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