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Hemostasis after IIb/IIIa infusions

How are you managing hemostasis after interventions when patients are receiving IIb/IIIa infusions? Is this an automatic indication to use the Femostop device?

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Current Postings on This Page (18):

• Hemcon bandages are the best and not expensive. Decreases hematomas and turn around time.
RPS, New York, USA, April 26, 2008

• Syvek Excel Hemostasis System is Excellent for hemostasis management post IIb/IIIa's as well has Plavix, Aspirin and all the other multi-modal drugs that patients are now on, results have been great.
DeAnna Rewis-McDuffie, Marine Polymer Technologies, Jacksonville, Florida USA, February 7, 2008

• The syvek patch was invented by a biologist. The money was from South America. The South American family The Finkelstines of polish decent started the company.
Charles D., Massachusetts. USA, November 6, 2007

• HemCon is a bandage that's being used on the battlefield in Iraq and Afghanistan. Some research has been done in porcine models to test its usefulness for femoral artery puncture hemostasis, but to our knowledge it is not currently an appproved product for this use. You can read more about it on HemCon's company web site.

We would also point readers to our new section on "Radial Access" and specifically to our interview with Dr. R. Lee Jobe in which he discusses the fact that his center uses the radial approach, if possible, specifically when they receive emergency patients who have been aggressively anticoagulated with heparin and a IIb/IIIa inhibitor.
Forum Editor, Angioplasty.Org, August 24, 2007

• Has anyone heard of the new product called HemCon for hemostasis?
Judy L., California, USA, August 24, 2007

• Simpler is better. For those using finger pressure please consider the FAVC-HandHeld to improve your comfort. It has the best of both worlds, hand held and able to adjust local pressure as needed when needed. Additionally, it's 2.2 pounds so it takes the strain off your hold and because it uses a disposable disc it helps with blood born pathogen control. interventionalhp.com
Hal Oien, DMD, MAGD, IHP, Inc., Tualatin, Oregon, USA, December 14, 2006

• A great cost saver that works just as efficiently is TZ Medicals Neptune Pad. Its a topical hemostasis pad that is used in cardiac cath labs, radiology and dialysis departments for radial, brachial and hemodialysis procedures. Very similar to Syvek but in most cases costs 30% less. A study was done at Cleveland Regional Medical Center that compared Syvek, Chito-seal, D-stat and Neptune and all products had similar results. Hold times consistently stayed around 6-10 minutes, but I would stay with hospital protocol.
Jeffrey R., Oregon, USA, September 25, 2006

• Syvek is not a placebo. There was a double-blinded randomized study with Syvek versus a placebo patch. Syvek decreased the time to hemostasis by 37% with decreased complication rates.
Heather Whaley, RN, BSN, Syvek Sales, Little Rock, AR, RN, BSN (hwhaley@webmpt.com) on Saturday, January 21, 2006

• I feel C-clamps could be dangerous if left on a pt without consistent supervisior which is often the case if left on for an hour, also complete bedrest usually last 6-12 hours depending on the Dr. femstops tend to bruise and is also like the clamp very uncomfortable for the patient. I like manual pressure, syvek patch, D-stat, perclose and the angioseals
Marsha Bellamy, Travel Nurse currently assigned to Piedmont Hospital for 13 weeks, Atlanta Georgia, December 28, 2005

• I am looking to make contact with cathlab practitioners who has had experience with using topical devices like Syvek, CloSur in their labs. Please contact me.
Jacky Meeding, Vanson HaloSource, Redmond WA, June 20, 2005

• No.
John Smiyh, City Hospital, Auburn, Alabama, USA, June 15, 2005

• Syvek patches are great. My techs love them and have had phenomenal success with them. We do about 600+ angios per year and use Syvek in about 95%. We even use them after a perclose or angioseal fail!
Michelle Stuart, RN, CCRN, Stevens Hospital, Edmonds, WA, USA, RN, CCRN (astuart@stevenshealthcare.com) on Monday, January 03, 2005

• We have a <1% hematoma rate ever since the inception of using the Syvek patch. We also use the SyvekNT patch on interventional patients while increasing the hold from 10 minutes to 20 minutes with the same hematoma outcomes. We have been using Syvek for approx 2 years. Some say that the Syvek patch is a placebo. I pull the sheaths, and I'm a firm believer in the product and do not see a placebo effect. I would love to see some data on studies stating that the syvek is a placebo. I just don't see it at all. The patch is remarkable, and I'd work for the company and sell the product if I could!
Robert Gonzales, R.N., Pomona Valley Hospital Medical Center, Pomona, CA 91767, 19 Nov 2003

• Syvek patch? I presented a paper at SCAI. Another poster was about Syvek patch and how they are no better than placebo. What do really have for proof besides anecdotal experience? Need more data to continue a $50 patch vs. 10 minutes of fingers.
Andrew Rashkow, Bassett Health Care, Cooperstown, NY, USA, 01 May 2003

• I would like information on the best closure device post PTCA. We usually manage these patients with manual compression x thirty minutes but are looking into closure devices. I am interested in information on syvek patch, angioseal, & compress ar. We have femostop available and have not used it in > 1year.
L Grove, Susquehanna Health System, Williamsport, PA, 09 Feb 2003

• If you have the benefit of current vascular closure devices (angioseal, perclose, vasoseal, or the syvek patch) no compressor clamps or femstops are routinely needed. The syvek patch is the only device which is actually approved for post interventional patients however as long as ACT is not much over 300 we routinely use all these devices. We are a 2 lab facility which did approx. 1000 interventions last year and had minimal complications when pulling sheaths on the table and patients recieving 2b3a.
J Hansel, Terre Haute Regional Hosp., Terre Haute Indiana, USA, 22 Apr 2002

• Absolutely not, I currently manage a cardiac Intevention Unit at Providence Hospital in Mobile Al. We see about 800 post Intervention patients with most on IIB-IIIA Platelet Inhibitors. We use Compressar Clamps. After the Sheath is removed we keep the patient on the clamp for about 1 hour. We keep the patients on complete bedrest until after the IIb-IIIA platelet inhibitors have been stopped. We only use Femostops when complications occur. Our complication rate is <1%. We been open for 2 years.
David Baldwin RN, Providence Hospital, Mobile Alabama, USA, 18 Mar 2001

• How are you managing hemostasis after interventions when patients are receiving IIb/IIIa infusions? Is this an automatic indication to use the Femostop device?
Susan Corliss, RN, Concord Hospital, Concord, New Hampshire, USA, November 12, 1999

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