What is the recommended course of action if hemostasis is not obtained after initial venous pressure application?

If hemostasis is not achieved after the initial venous pressure application, the recommended course of action is to repeat the initial steps for applying pressure. This approach is based on the understanding that achieving hemostasis often requires consistent and adequate pressure directly over the puncture site.

Reapplying pressure ensures that the site remains adequately compressed, which is critical in preventing hematoma formation and ensuring that bleeding stops. It is essential to maintain continuous and sufficient pressure for a designated period, especially in areas prone to bleeding, such as those involving venous access.

While consulting a vascular surgeon, waiting, or switching to manual closure methods might be necessary in certain situations, these actions are typically reserved for cases where simple measures fail. In many practical scenarios, simply reinforcing the initial pressure application can be sufficient for effective hemostasis. Thus, repeating the initial steps is seen as the most straightforward and immediate response to address the situation.

This step is preferred as a first response before escalating to more complex interventions or specialist consultations, making it a fundamental skill in interventional radiology practice.