André ML, Argibay V, Guillem P, Vázquez A, Gómez M. Deambulación precoz con dispositivo angio-seal tras angioplastia coronaria. Comparación frente a compresión mecánica. Enferm Cardiol 2001; 24:16-23.

Precocious deambulation with an angio-seal device after a coronary angioplasty. Comparison with mechanical compression.

The hemostasy of the femoral artery after the intervencionist procedures is still an important problem which has to be solved. The main complications range from the patient’s discomfort, peripheric vascular complications 1,2, an increase in the average stay in hospital and, consequently, an increase in hospital expenditure. The traditional methods used to reach hemostasy require a long time of compression and a constant surveillance on the part of the infirmery personnel. Moreover, they do not admit an immediate withdrawal of the arterial introductor but they require the normalisation of the activate clotting time (ACT), followed by a later time of resting and the placing of a compressive bandage between 12-24h 3,4,5,6.   All this contributes to the patient’s discomfort and it occasionally generates idle vessel reactions associated with the pain produced during the withdrawal of the introductor and femoral artery compression 7,8,9.  Different devices have lately been marketed which reach the hemostasy of the femoral artery faster through: a) collagen tampon with a positioning lever 4,5, 10-17, b) collagen tampon, 3, 12, 18-20c, c) emulsion, a mixture of trombine and collagen microfibres, 21, d) non-surgical sutures, 14, 16, 22.   The potential benefits of these devices are centred on three aspects: the patient’s well-being, the immediate withdrawal of the arterial introductor and the obtaining of an earlier hemostasy and movilization time. The aim of this research was to evaluate the efficiency, security and confort of a closing artery device through a collagen tampon (angio-seal device of 6 Fr, S. Jude Medical) in a consecutive series of patients and to counteract the obtained results and the analised ones in a reference control group (C-clamp), in which mechanical compression was used to reach hemostasy. In both groups a predefined protocol of performance was followed which was particularly designed for each group.

García Niebla J.  Identificación de una arritmia maligna.  Enferm Cardiol 2001; 24:24-26.

A patient affectec by pre-exitatation of the kind Wolff-Parkinson-White seems to present one or several accesory pathways that conect the atrial to ventricular muscular tissue so that the stimulus propagates faster to the ventricles than through node AV. It is very important the electrocardiography identification of this kind of pre-exitation due to:
• The posible confusion with different kins of necrosis and block or ventricular hypertrophy.
• Its frequency association to cardiac arrhythmias.

Alconero AR, Resano AC, Mendoza O, Barreiro R, Méndez V, Fernández R, Ortego MC, Labrador P.  Cardioversión eléctrica ambulatoria. Enferm Cardiol 2001; 24:27-30.

Alconero AR, Resano AC, Mendoza O, Barreiro R, Méndez V, Fernández R, Ortego MC, Labrador P.

The eletrical elective cardioversion (EEC) is a relatively frequent procedure, but it doesn’t mean that it lacks risks and complications. Therefore, it must be protocolised and both the medical and nursing bodies must reach a consensus on it. The ultimate goal of our research was to evaluate the procedure and revise any possible complications.  A retrospective research has been carried out on 31 cases that were hospitalised in the Coronary Unit during 1999-2000 through the revision of their medical histories and phone calls after leaving hospital.   The following were the variables in the research: demography, diagnosis, venal access, energy selection, electrocardiographic alterations, hemodynamic, patient’s origin and time of stay in hospital, among others. Statistical method used: SPSS: We have highlighted the following data: male 84%; females 16,3%; with an average age of 58,6 years old; auricular fibrillation diagnosis 61%; propofol anesthetic 71%; peripheric venal tract 71%; Selection of most highly used energy: 200 jules in 64%; conversion of arrythmia: 71%; electrocardiographic and hemodynamic alterations in 9,68%; ambulatory origin 71%; average stay: three hours and 44 minutes, among other results.  The conclusions reached were that 71% of patients were ambulatory; EEC had an average stay of three hours and forty-four minutes in most cases, little complications (9,68%) and optimum results.

Poza C, Torre C de la, Resano C, Alconero AR.  Cardioversión eléctrica electiva. Enferm Cardiol 2001; 24:31-32.

Poza C, Torre C de la, Resano C, Alconero AR.

Nursing guide to elective cardioversion. Elective cardioversion is usually scheduled ahead of time. After arriving at the hospital, an intravenous (IV) catheter will be placed in the arm and oxygen will be given through a face mask. A short-acting general anesthetic will be administered through the vein. During the two or three minutes of anesthesia, the doctor will apply two paddles to the exterior of the chest and administer the electric shock. It may be necessary to give the shock two or three times to obtain normal rhythm.

Ariza Olarte C.  Atención de enfermería al paciente con infarto agudo del miocardio en la fase aguda.  Enferm Cardiol 2001; 24:33-40.

Ariza Olarte C.

According to date published by Statistical National Administration Department (DANE), the second cause of death in Colombia is the coronary artery disease; this fact makes possible that a nurse must give assistance to a patient with acute myocardid infarction (AMI). In the acute phase, the patient is taken to an intensive care unit (ICU) or to a coronary care unit (CCU), staying under constant monitorization during a variable time in order to determine his evolution and prevent possible complications.  To accomplish all of these, the intervention nurse is very important. That is why the nurse must have all the knowledge and skills to lead in an opportune way all her/his efforts not only to offer a specific treatment to the patient with AMI but also to the prevention and early detection of complications.  To establish a medical diagnostic, there are clinical, electrocardiographic and laboratory date, some of the tools a nurse needs to begin her/his intervention. This intervention is given to the patient and his family through several interactive elements of the nurse process: observation, diagnosis, planning, intervention and evaluation.  Observation and physical examination made by the nurse begin with pain assistance; she must determine the pain pattern, localization, duration and causes. The meaning of pain to the patient and the result of the emotional response are essencial factors for the nurse assistance.   Fear and anxiety, product of pain, may increase the cardiac work and frequency by sympathetic stimulation.  A physical exam supplies information about the present situation of the patient. The obtained date are correlated with clinical and laboratory data and then it is possible to determine the plan of nursing care.  It is important that the nurse determines thoroughly arterial pressure, cardiac and respiratory frequencies and temperature, because a patient with AMI in acute phase presents very specific changes related with it, so the nurse must be able to analyze and interpret them.   To confirm the presence of infarct there are several diagnosis methods as cardiacal enzymes and electrocardiogram. The control and analysis are a responsibility of the nurse. Other method is the control of arterial gases to allow the evaluation of oxygenation and the acid-basic balance which guides the treatment and fixes an optimal oxygenation.   On the basis of findings and statements, the nurse identifies and defines the present and/or potential problems a patient with AMI in acute phase may have. For each one, she plans activities which favor their solution and, this way, foresees the quality of given assistance.

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