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Biomedical subjects

D Almond

Publications and source records attributed to D Almond.

6 recordsLinked to original sources
PubMed2001

Reducing bedrest following arterial puncture for coronary interventional procedures--impact on vascular complications: the BAC Trial.

BACKGROUND: The optimal time for ambulating patients following femoral arterial puncture for percutaneous coronary intervention is unknown. This study was designed to test the hypothesis that reducing time to ambulation from 6 hours to 2 hours would not increase vascular complications. METHODS: In this randomized, controlled, single-center trial, patients were randomly assigned to receive either 2, 4 or 6 hours (control group) of bedrest after hemostasis was achieved at the femoral arterial puncture site. A total of 354 patients, enrolled from March 1997 to October 1998, participated in the study with 299 completing the full protocol. The primary endpoint was the incidence of vascular complications and any resulting interventions or outcomes including surgery, blood transfusion, prolonged length of stay or ultrasound compression. RESULTS: The 2 hour and 4 hour experimental groups were comprised of 99 patients each, while the 6 hour control group was comprised of 101 patients. There were no differences in vascular complications between the groups. A subgroup analysis of patients who received abciximab (n = 43) did not reveal any differences between groups. Only one patient developed a pseudoaneurysm (p = 0.36), requiring surgical repair and a prolonged length of stay. CONCLUSIONS: Patients undergoing femoral arterial puncture for coronary interventional procedures can safely ambulate 2 hours after hemostasis of the puncture site. Patients receiving abciximab as part of their coronary procedure may be able to ambulate as early as 2 hours following hemostasis.

Adult↗
PubMed1999

Research-based practice: reducing bedrest following cardiac catheterization.

Patient discomfort with prolonged bedrest following femoral arterial puncture for cardiac catheterization is a significant nursing problem. Safely reducing the time required for supine bedrest could improve patient comfort and reduce nursing care needs. Reducing bedrest also has the potential to improve organizational resource utilization. A review of the literature was conducted and a decision was made to implement 2 hours of bedrest, a significant decrease from the previous practice of 6 hours. Vascular complications were closely monitored in the first 50 patients, as a means of implementing the research-based change in practice. No significant vascular complications occurred and the practice change has expanded to all inpatient and outpatient areas caring for patients undergoing cardiac catheterization. This experience with utilizing research to change practice has created a positive environment for future research-based initiatives.

Back Pain↗
PubMed1998

The patients perspective of extracorporeal shock wave lithotripsy.

We studied the effect of a single analgesic regime for outpatient lithotripsy on the patient's perception of pain and the disruption of their normal activities by sending a postal questionnaire to 200 patients. Results showed that 15% of patients received insufficient analgesia during ESWL, 25% considered treatment painful, 6.8% had side effects from analgesia, 18% had delayed return to their normal activities and 33% contacted their doctor within a week of lithotripsy with problems related to it. This study shows that analgesic requirements of patients treated with modern lithotriptors are underestimated. This can be avoided by tailoring analgesia to individual needs and better patient communication.

Adolescent↗