Post on 19-Nov-2021
transcript
THE MYSTERIES OF THE
CARDIAC CATHETERIZATION
LAB Cardiac Catheterization Lab
Rachelle Brink
Leanne Ritson
Presenter Disclosure
Rachelle Brink and Leanne Ritson
Relationships with commercial interests:
We have no conflict of interest or affiliations that have influenced this
presentation to disclose
Learning Objectives
At the conclusion of this activity, participants will be able to:
• Discuss the common procedures performed in the
TBRHSC Cardiac Catheterization Lab (Cath lab)
• Describe barriers and successes in the TBRHSC Cardiac
Catheterization Lab
• Pre op and Post-op care of patients
Welcome to the Cardiac Catheterization
Lab
What we do in the Cath Lab • Angiograms
• PCI (Percutaneous Coronary Intervention)
• Pacemaker Insertions
• TEE (Transesophageal echo)
• Cardioversions
• Our team consists of Registered Nurses, Medical Radiation
Technologists (MRT) and Cardiologists
Recovery Room Pre-Op
• Prior to procedure the flow sheet needs to be fully completed, this can take place before they arrive to the cath lab if time permits
• Special attention needs to be given to the patients most recent lab work especially the creatinine level and INR.
• IV access is preferred to be on the left side
• The right wrist should be shaved and Emla patch applied, along with the right femoral area
Medications Pre Angiogram/PCI
• All regular morning medications should be given to your
patient before coming to the cath lab
• Medications that should not be given the day of are
Metformin, lovenox and anticoagulation should be held
days prior depending on the physicians decision
ie..anticoagulants and novel oral anticoagulants (NOAC).
• ASA and Clopidogrel/Brilinta are the 2 very important
medications that must be given prior to coming and not be
held.
In The Lab
In The Lab
• The patient is monitored by ECG, O2 sat and Blood
pressure
• They are prepped on the table both wrist and groin
• Patients are given Midazolam and Fentanyl for sedation
• The procedure itself takes approximately 20 minutes and
if further intervention ie. Angioplasty, is needed then that
adds on more time depending on severity of the case
Sheath
Catheter
Stent
Coronary
Artery
Blockage
Coronary
Artery
Blockage:
Stent deploy
Coronary
Artery
Blockage:
Stent Placed
Recovery Room Post-Op
• Patient arrives back in Recovery room.
• Report is received about the Patient’s results
• Vitals are monitored
• Radial/Femoral sites are checked frequently
Post Care
Clamp TR Band
What to watch for….
Radial
• good CSM
• brachial pulse is palpable
• radial pulse is palpable
• hematoma (manual
pressure proximal to the site
needs to be held)
Femoral
• bruising, some is normal
• back pain could mean retro bleed
• hematoma (manual pressure needs to be held)
• numbness, discoloration could mean angioseal complication
Health Teaching
• Check groin site q30m x 2hours
• Hold fist over site when cough or sneeze
• No bath for 3 days, shower only
• No swimming or hot tubs for 2 weeks
• No creams or lotions
• Avoid strenuous activities for 7 days
• No heavy lifting
• Radial site- no bending or straining wrist for 7 days
• No driving for 2 days
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