AB1593-HPR IMPACT OF COUNSELING TO PREVENT VASOVAGAL SYNCOPE AFTER INTRA-ARTICULAR INJECTION AND PREVENTING FACTORS IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES (IRDS): A STUDY BY RHEUMATOLOGY NURSES COUNSELOR
Authors: S. Baghel, K. Mehta, P. Chaurasiya
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Intra-articular injections play a pivotal role in managing inflammatory Rheumatic Diseases (IRDs). This procedure done by sterile needle and syringe is used to drain synovial fluid from patient's joint and medicine (corticosteroids-anti-inflammatory drug) is injected into the intra-articular space with needle and syringe. The injection is typically performed by rheumatologist in outpatient department (OPD) or hospitalized patients. Before administering the injection, skin over the joint is usually cleaned and sterilized to minimize the risk of infection. However, the occurrence of vasovagal syncope post-injection poses a considerable concern, impacting patient safety and procedural efficiency. This study, conducted by specialist nurses aims to investigate and identify the prevalence and preventing factors of vasovagal syncope in OPD. Counseling and explaining about the benefits of joint injection are following: To relieve joints pain, swelling, stiffness, inflammation and control disease. To prevent joints damage, deformities and to increase range of motion. To delay or avoidance of surgical intervention. <h3>Objectives:</h3> To assess the benefits of counseling in intra articular injection in patients with IRDs and to investigate the prevalence of vasovagal syncope in OPD settings and identify potential preventing factors. <h3>Methods:</h3> Patients with IRDs attending the Rheumatology clinic of this institution, willing to participate in the survey receiving intra-articular injections, were enrolled in this study. All the information including the follow-up details were recorded in a pre-designed form. Their demographic information (age, gender) and disease characteristics (diagnosis, duration, and co-morbidities treatment) were recorded. Data were collected by rheumatology nurses using structured interviews and medical record reviews. All the patients were counseled and explained about the procedure, preparation and post injection care of and their benefits during visit. The study assessed the prevalence of vasovagal syncope post-injection and examined associated preventing factors such as patient education, anxiety levels. <h3>Results:</h3> All the 110 patients given injection intra-articular in joints were included in the study were counseled by rheumatology nurses. 92.4%patients had no complaints after intra –articular injection. Only 7. 6 % patients developed mild form vasovagal syncope symptoms like anxiety, headache, dizziness, nausea/vomiting sensation, feeling cold, sweating, and palpitation.Symptomatic management is given like medications, comfortable position, vitals monitoring, and advice for rest at least 30min. Patients stabilized and advised to follow up with concerned doctors. Factors contributing to syncope included higher anxiety levels, and inadequate patient education regarding the injection procedure. Interestingly, disease duration and specific IRDs did not significantly correlate with syncope occurrence. The study also explored the impact of counseling regarding the procedure, such as adjusting the injection speed and incorporating distraction techniques, in preventing vasovagal syncope. <h3>Conclusion:</h3> This study sheds light on the prevalence of vasovagal syncope after intra-articular injections in OPD patients with IRDs. The identification of risk factors, anxiety levels, emphasizes the importance of tailored patient education and support strategies. Moreover, the exploration of procedural modifications provides valuable insights for enhancing patient safety during intra-articular injections. As rheumatology nurses' counselor play a crucial role in patient care. Future interventions and guidelines may benefit from incorporating these findings to enhance the safety and efficiency of intra-articular injections in rheumatology OPD settings. Health education and counseling given to all the patients before and after intra-articular injections procedure. Don't panic during intra articular injection. The patient is advised to continue treatment of the co-morbidities like HTN, DM, CAD, and Thyroid <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>