First, a "brute force" or "monster mash" technique is more uncomfortable for the patient. Second, it tends to cause more bruising and displaces the skin is a way that makes it difficult to assess if a hematoma is developing. Third, this technique is often not effective in our "well nourished" patients (specifically those with a tight, round belly). Finally, it is physically more demanding on the staff and often leads to the excuse "I'm just not strong enough to hold pressure," requiring calling upon your second hand to assist.
I learned manual compression in the days before closure devices, when we used 8, 9, and 10 French sheaths for interventions. Not to mention the patients often received 10-15,000 units of heparin during the procedure. So 40 minutes of manual compression was not uncommon. You quickly learn how to "efficiently" pull a sheath. On top of that, I had a physician who taught by "negative or humble" reinforcement, so when I was learning and had difficulty getting control of the bleeding, he would walk over and use one finger to achieve hemostasis.
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