Presenter Information

Kimberly LoewenFollow

Academic Level at Time of Presentation

Senior

Major

Nursing

List all Project Mentors & Advisor(s)

Dr. Jessica Naber; Mrs. Michelle Qualls, RN

Presentation Format

Poster Presentation

Abstract/Description

Optimal TR-Band Time to Wean – A Study About Nursing Care of TR band Post Cardiac Catheterization

Abstract

The aim of this study was to compare the results of different research completed to find the optimal TR-band weaning strategy in order to implement best practice when caring for patients who underwent cardiac catheterization via the radial artery. Radial artery access for cardiac catheterization has become increasingly used because of the decreased risk for bleeding complications when compared with the femoral approach. It is reported that premature weaning of the compression device may increase the risk of hematoma while prolonged placement may increase the risk of radial artery occlusion. Although the TR band is widely used, there is no standardized protocol available for safe deflation. Different institutions use different locally generated procedures despite the importance to use evidence-based protocols for safe deflation of the TR band. Therefore, research is being conducted to potentially decrease the incidence of hematoma and radial artery occlusion. Current research for optimal weaning strategy shows that the TR band should be left in place for 30 minutes if diagnostic procedure was done with no blood thinners. While optimal time to wean varies when blood thinners are used. These variations include: if PCI with Heparin or Bivalirudin received, leave TR band for 60 minutes, remove 3 mL of air every 15 minutes until there is no air remaining in the balloon; if PCI with GPIIB/IIA in addition to Heparin or Bivalirudin received, leave TR band for 60 minutes, remove 3 mL of air every 15 minutes until there is no air remaining in the balloon; if bleeding occurs, immediately re-inflate TR band with 2-3 mL of air and restart weaning in 30 minutes.

Keywords: hematoma, radial artery, occlusion, pressure, weaning, cardiac catheterization, blood thinner, TR band

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Evidence Based Best Practices in Clinical Healthcare (Posters)

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Optimal TR-Band Weaning Strategy

Optimal TR-Band Time to Wean – A Study About Nursing Care of TR band Post Cardiac Catheterization

Abstract

The aim of this study was to compare the results of different research completed to find the optimal TR-band weaning strategy in order to implement best practice when caring for patients who underwent cardiac catheterization via the radial artery. Radial artery access for cardiac catheterization has become increasingly used because of the decreased risk for bleeding complications when compared with the femoral approach. It is reported that premature weaning of the compression device may increase the risk of hematoma while prolonged placement may increase the risk of radial artery occlusion. Although the TR band is widely used, there is no standardized protocol available for safe deflation. Different institutions use different locally generated procedures despite the importance to use evidence-based protocols for safe deflation of the TR band. Therefore, research is being conducted to potentially decrease the incidence of hematoma and radial artery occlusion. Current research for optimal weaning strategy shows that the TR band should be left in place for 30 minutes if diagnostic procedure was done with no blood thinners. While optimal time to wean varies when blood thinners are used. These variations include: if PCI with Heparin or Bivalirudin received, leave TR band for 60 minutes, remove 3 mL of air every 15 minutes until there is no air remaining in the balloon; if PCI with GPIIB/IIA in addition to Heparin or Bivalirudin received, leave TR band for 60 minutes, remove 3 mL of air every 15 minutes until there is no air remaining in the balloon; if bleeding occurs, immediately re-inflate TR band with 2-3 mL of air and restart weaning in 30 minutes.

Keywords: hematoma, radial artery, occlusion, pressure, weaning, cardiac catheterization, blood thinner, TR band