The effect of early ambulation on patient comfort and delayed bleeding after cardiac angiogram: a pilot study.

OBJECTIVE

To examine the effects of ambulation at 3 versus 6 hours on delayed bleeding, pain, and anxiety in patients after cardiac angiogram.

DESIGN

Experimental, pretest posttest, random assignment.

SETTING

Western Canadian University-affiliated tertiary care hospital.

PATIENTS

Thirty-nine patients who underwent cardiac angiograms.

OUTCOME MEASURES

Delayed bleeding, pain, and anxiety.

INTERVENTION

The experimental group ambulated at 3 hours after cardiac angiogram; the control group ambulated at 6 hours. Delayed bleeding was evaluated by sanguinous drainage through a standard gauze pressure dressing and/or the presence of a palpable hematoma greater than 5 cm in width. Melzack's Present Pain Intensity Scale and Spielberger's State Anxiety Inventory were used to evaluate patient comfort at 2, 4, and 7 hours after angiogram and the next day.

RESULTS

None of the patients experienced any delayed bleeding. Student's t test was used to compare pain levels and anxiety scores. In addition, repeated measures analysis of variance was applied to pain scores taken at 4 hours, 7 hours, and the next day. The 2-hour observation data were used as a covariate and a basis for comparison of pain at the next three observations. Patients ambulating early had significantly less pain overall (p < 0.005) and less back pain at 4 and 7 hours after angiogram (p < 0.05). There was no significant difference in the mean anxiety scores.

CONCLUSION

The significant decrease in back pain of patients who ambulated earlier demonstrates the need to consider patient comfort as well as the potential risks and sequelae of delayed bleeding.