Intra-aortic balloon counterpulsation therapy

I would like to bring to your attention what I would consider to be a wrong recommendation in the article, “Nursing Care of Patients on Receiving Intra-aortic Balloon Counterpulsation” (October 2005:40–49). In Table 2, on page 43, it is stated that during intra-aortic balloon counterpulsation (IABC) therapy, the distal pulses need only be assessed every 4 hours. It has been my experience that signs of limb ischemia and distal pulses should be checked every hour along with vital signs. The 5th edition of the AACN Procedure Manual for Critical Care states (on page 376) that “peripheral vascular assessment should be every 15–60 minutes as patient status requires.” Most of us consider Susan Quaal to be the nursing expert for IABC therapy and her textbook Comprehensive Intra-Aortic Balloon Counterpulsation published in 1993 to be the gold standard. On page 158 in this book, she states that lower limb circulatory assessment should...