Effects of three methods of femoral site immobilization on bleeding and comfort after coronary angiogram

BACKGROUND: Postangiogram femoral site care varies by institution and practitioner. The literature is unclear about which intervention provides the best hemostasis and patient comfort. OBJECTIVE: To investigate which method of femoral site immobilization results in less bleeding and more comfort after coronary angiography. METHODS: Three hundred inpatients and outpatients undergoing coronary angiography in a large, metropolitan, tertiary care facility were assigned randomly to three types of femoral site immobilization. A three-group experimental design was used in this intervention study. Patients were on bedrest and received one of the following interventions to the affected (site of puncture) leg for 6 hours: group 1 had a sandbag applied to the femoral site, group 2 had a sheet over the affected leg and tucked under the mattress, and group 3 had verbal instruction to keep the leg straight and still. An ordinal level hemostasis scale was developed, with descriptors based on the extent of intervention necessary, ranging from 1 = none to 5 = surgical. A 17-item, Likert-type scale was used. RESULTS: The verbal instruction group experienced significantly more bleeding than the sandbag group. There was no difference in bleeding or comfort between the sandbag and sheet-tuck groups. CONCLUSIONS: Our results indicated that sheet-tuck immobilization of the affected leg provides the same degree of hemostasis to the femoral site after coronary angiography as the sandbag.