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Placing pressure

• The sheath should be partially removed from the artery prior to applying pressure.
• With the sheath still partially in the artery, the StrongArm should be lowered so that the 3-Finger Jack Disc is positioned on the body surface immediately proximal and medial to the sheath. The body surface should be dry. Confirm that the Disc is positioned properly over the femoral artery. Firm pressure should not yet be applied.
• Gently but firmly, pull the sheath and allow a very brief spurt of blood -- this clears any thrombus which may have already started to form.
• Immediately following the spurt of blood, push gently and firmly down on the Arm until bleeding from the puncture site stops. Downward pressure should be applied over the Release Lever. There should be no blood oozing. The Arm is held in place without screws or complicated clamping mechanisms by a unique friction design which enables easy, quick adjustment. To avoid patient discomfort, firm pressure should be applied in a single, smooth downward motion.
• Clean away all blood from the area inside the V-Notch so that any further bleeding or oozing from the puncture site can be easily seen. This is especially important when gradually releasing pressure, so that new oozing or bleeding can be easily seen.
• Immediately check distal (pedal or popliteal) pulse. Some clinicians will place compression which completely occludes the distal pulse -- complete occlusion should occur for no more than three minutes. Partial occlusion, where a faint distal pulse is palpated, can alternatively be applied as long as there is no oozing or bleeding at the puncture site. Such partial occlusion should occur for no more than ten minutes.
• The Arm Lock should be positioned just above the Arm and tightened, to block accidental upward Arm slippage.
• Monitor the patient, and intervene if necessary, as per institutional procedure.
• Clinicians should not leave the patient unattended while the CompressAR® System is being used.