Some Physiological Effects of the Bed Bath on the Cardiovascular System of Acute Myocardial Infarction Patients

At Loma Linda University, a protocol has been in effect that specifies the kinds and amounts of activity that acute myocardial infarction patients may have. The protocol has described six activity levels with each successive level permitting more activity. The patient must have reached the fourth level of progression before he is permitted to receive a complete bed bath. The problem studied in this research: As the result of receiving a bed bath, what physiological effects will occur in the cardiovascular system of patients with acute myocardial infarction?The theoretical framework for this study consisted of the following: recommendations for giving bed baths to patients with myocardial infarction; trends towards aggressive management of myocardial infarction; the Valsalva Maneuver; and the diving reflex.The null hypothesis was: Bed baths given to acute myocardial infarction patients will have no significant effect on the physiology of the cardiovascular system.A convenient sample was obtained from Loma Linda University Hospital and Redlands Community Hospital. The patients selected for the study met the following criteria: confirmed diagnosis of acute myocardial infarction, no complications, on a cardiac monitor, and had permission granted from the attending physician. The sample included eight baths given to five different patients. The actual sample size was small due to the small number of uncomplicated myocardial infarction admissions.Patients who met the criteria for inclusion in the study were given bed baths by the nurse researcher during their initial 72 hours of hospitalization. The bathing procedure was modified in the following ways: passive participation, support of the extremities, prevention of the Valsalva Maneuver, and protective positioning. Physiological criterion measures included: blood pressure; respirations; and ECG changes in rhythm pattern, number of premature ventricular contractions, and S-T segment position and duration. Continuous ECG strips were taken during the bathing procedure.Data were analyzed for clinical significance, using the case study method. The null hypothesis was accepted for the data collected, but was not generalized to include the entire population of myocardial infarction patients since the sample size was small. For the eight baths, the mean systolic blood pressure change was 3.80 per cent; the mean change in respirations was 6.31 per cent; and the mean change in heart rate was 9.22 per cent. There were no changes in the S-T segment, and no serious arrhythmias occurred. The bathing procedure, using the modifications listed above, did not appear to be detrimental for the five patients included in the study.