Verify the doctor’s order, including the amount of pressure to be applied and the length of time the device should remain in place.

Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.¹

Explain the procedure to the patient and answer any questions to decrease anxiety and increase cooperation.

Perform hand hygiene and put on gloves and protective eyewear.²,³,⁴

Position the patient on the stretcher or bed; don’t flex the involved extremity.

Assess the condition of the puncture site, obtain vital signs, perform neurovascular checks, and assess pain, according to your facility’s policy for arterial access procedures.

Place the device strap under the patient’s hips before sheath removal (in cases that warrant the use of a sheath).

With the assistance of another nurse, position the compression arch over the arterial puncture site, not the skin puncture site. Apply manual pressure over the dome area while the straps are secured to the arch.

Once the dome is properly positioned over the arterial puncture site, connect the pressure inflation device to the stopcock that’s attached to the device. Before inflation, verify the amplitude and location of the pedal pulse. Turn the stopcock to the open position and inflate the dome with the pressure inflation device to the ordered pressure. Typically, a venous sheath is removed at 20 to 30 mm Hg and an arterial sheath is removed at 60 to 80 mm Hg. Immediately after removal of the arterial sheath, inflate the device to 10 to 20 mm Hg over the systolic blood pressure. After 2 to 3 minutes, a reduction in pressure, usually a value between the patient’s systolic and diastolic blood pressure, is ordered. Follow the doctor’s specific orders for pressure changes.