Effectiveness of using sand bag and ice pack on hematoma and pain in post-percutaneous coronary intervention patients with femoral sheath

The procedure used in this study was that enumerators introduced themselves to prospective respondents, explained the purpose of the study, and obtained informed consent from them. After providing an explanation, enumerators asked prospective respondents to read the informed consent form. If they agreed to participate, they were asked to sign the informed consent form. After the signation the informed consent form, the enumerator began to fill demographic data including; age, gender, education, occupation, marital status, percutaneous coronary intervention experience, body mass index, and hemodynamic measurements. After that, the enumerator looked at the data in the medical records related to sheath size and coagulant therapy. In group 1, before performing the intervention, the enumerator measured the hematoma and pain. The first measurement was taken 0 minutes after the removal of the femoral sheath or before the puncture area was covered with gauze. Then, the enumerator took an ice pack from the medical refrigerator. The ice pack was placed in the medical refrigerator at a temperature of 18-20°C at least 2 hours before the procedure. The average temperature of the ice pack was 18.1°C at 0 minutes, 19.2°C at 10 minutes, and 19.5°C at 20 minutes. The ice pack is placed on top of the dressing and two gauze bandages after removal of the femoral sheath. After that, the enumerator prepared a 2.1 kg sandbag that had been prepared in each Intensive Cardiovascular Care Unit, cardiovascular ward, High Care Unit for Surgical, and High Care Unit for Medical room and placed it on top of the ice pack. The sandbag and ice pack were used simultaneously for 20 minutes. After 20 minutes, the dressing is removed to measure the hematoma and pain for the second time. After the measurement is complete, the puncture area is closed again using gauze and the ice pack is removed. Next, the puncture area is pressed using a sandbag for 1 hour and 40 minutes, or a total of 2 hours. The ice pack that is no longer in use is cleaned with disinfectant and returned to the refrigerator for storage. After 2 hours, the third measurement of hematoma and pain is taken. After the measurement is complete, the puncture area is not covered again with gauze. After use, the sandbag is also cleaned with disinfectant before being stored in the equipment cabinet. The same steps are taken for groups 2 and 3. The difference is that group 2 only uses the sand bag for 2 hours and group 3 only uses the ice pack for 20 minutes. To ensure that all respondents followed the procedures in accordance with the standards operating procedure in this research, direct observation was conducted and reported on the observation sheet. After collecting the data, the researcher or enumerator checks the completeness and accuracy of the questionnaire. The researcher or enumerator concludes the interview by expressing gratitude for the willingness to participate in the research, providing a towel, and provides a reward in the form of education about coronary heart disease and the prevention of bleeding using a leaflet has been designed specifically for this study. Leaflet reference from Ministry of Health the Republic of Indonesia. The intervention is conducted face-to-face and individually and this study is conducted in a hospital. Each intervention is performed once, with the following details: Group 1 receives an ice pack for 20 minutes and a sandbag for 2 hours. Group 2 receives a sandbag for 2 hours, and Group 3 receives an ice pack for 20 minutes.