EECP® Therapy Patient Assessment
Thorough pre, during and post treatment patient assessment help promote the effectiveness of treatment and prevent adverse events. Vital signs, observations and patient comments may be recorded on the "EECP® Therapy Daily Record" [in Unit 7-13, 7-14, Samples in the The Therapist's Guide to Enhanced External Counterpulsation] or an equivalent treatment document.
- As a general guide, changes in body weight are the most reliable gauge for measuring short-term changes in fluid status. Changes in weight greater than two pounds overnight or four pounds in a week may indicate exacerbation of heart failure. If this occurs, withhold treatment and advise the physician.
- With pressures greater than 180/110, less than 80/50, or with a narrow pulse pressure, withhold treatment and notify the physician.
- Note the heart rate and rhythm. Resting tachycardia or changes in heart rate or rhythm may indicate changes in heart function. Withhold treatment and advise the physician.
- Count the respiratory rate and chart characteristics. Rapid, shortened breaths or a new wet cough may indicate fluid overload. If this occurs, withhold treatment and notify the physician.
- "Rales", "crackles", or any change in breath sounds may indicate fluid overload. If this occurs, withhold treatment and notify the physician.
Monitor Oxygen Saturation
- Oxygen saturation (SpO2) should be monitored before, during and after each EECP® treatment hour. The frequency of SpO2 assessments during treatment is determined by the patient's clinical status.
- If a 3-5% decrease in SpO2 should occur during pre-treatment from one day to the next, withhold treatment, notify the physician, and monitor the patient.
- A decrease in SpO2 may be noted during EECP® Therapy as the patient may relax, and/or treatment pressure may induce shallow respiration.
- If SpO2 decreases without accompanying symptoms of pulmonary congestion, the patient should be encouraged to take several deep breaths. If this does not increase oxygen saturation to the pre-treatment level, stop treatment and notify the physician.
** Changes in vital signs, skin color, edema, "crackles" (fluid in the lungs) and oxygen saturation should be discussed with the physician. Do not begin or resume EECP® treatment until physician assessment has been completed **
Interview The Patient And Note:
- Angina frequency or pattern (review patient's Angina Diary if available). Establish an "angina baseline" during the initial treatment. Measure patient status against baseline as the patient progresses
- Medications (assess need for adjustments and report to the physician)
- Energy level (ask specific questions regarding activities)
- Inspect the skin of the lower extremities for irritation or blistering
- Address patient's questions and concerns