OBJECTIVE: To examine the effects of ambulation at 3 versus 6 hours on delayed bleeding, pain, and anxiety in patients after cardiac angiogram. DESIGN: Experimental, pretest posttest, random assignment. SETTING: Western Canadian University-affiliated tertiary care hospital. PATIENTS: Thirty-nine patients who underwent cardiac angiograms. OUTCOME MEASURES: Delayed bleeding, pain, and anxiety. INTERVENTION: The experimental group ambulated at 3 hours after cardiac angiogram; the control group ambulated at 6 hours. Delayed bleeding was evaluated by sanguinous drainage through a standard gauze pressure dressing and/or the presence of a palpable hematoma greater than 5 cm in width. Melzack's Present Pain Intensity Scale and Spielberger's State Anxiety Inventory were used to evaluate patient comfort at 2, 4, and 7 hours after angiogram and the next day. RESULTS: None of the patients experienced any delayed bleeding. Student's t test was used to compare pain levels and anxiety scores. In addition, repeated measures analysis of variance was applied to pain scores taken at 4 hours, 7 hours, and the next day. The 2-hour observation data were used as a covariate and a basis for comparison of pain at the next three observations. Patients ambulating early had significantly less pain overall (p < 0.005) and less back pain at 4 and 7 hours after angiogram (p < 0.05). There was no significant difference in the mean anxiety scores. CONCLUSION: The significant decrease in back pain of patients who ambulated earlier demonstrates the need to consider patient comfort as well as the potential risks and sequelae of delayed bleeding.

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