Cardiac Catheterization Flashcards
(12 cards)
What is cardiac catheterization?
Insertion of a catheter through a peripheral blood vessel to diagnose and treat cardiovascular conditions
What are the indications for cardiac catheterization?
Emergency (STEMI or NSTEMI with ongoing chest pain +/- ECG changes)
Urgent (STEMI treated with fibrinolysis, NSTEMI)
Elective (e.g. Stable coronary artery disease)
What are the contraindications for cardiac catheterization?
Pregnancy Anaemia Recent CVA Severe uncontrolled hypertension Arrhythmias - esp. ventricular Known allergy for radiographic contrast renal impairement (because contrast cannot be given thus procedure cannot happen) severe cardiac failure electrolyte abnormalities known coagulopathy Peripheral vascular disease Poorly controlled diabetes
What are the complications of cardiac catheterization?
MI Death CVA events Vascular injury and bleeding Allergy/anaphylaxis Renal dysfunction Arrhythmias CHF Infection
Why is the femoral route the route of choice for many operators?
Large vessel thus can take different sheath sizes
Does not suffer from spams
Why is the radial route safer and what are the benefits of using the radial route?
due to the presence of the palmar arch.
also its allows much easier and safer arterial access in obese pts
earlier ambulation
What should the ACT (Activated clotting be?
Less than 150-180s
What happens if the patient is hypertensive (>150mmHg) when removing the femoral arterial sheaths?
You need to apply prolonged pressure in order to achieve haemostasis
What should be done if a haematoma is present?
This can be impeding blood flow to the lower limb.
The nurse should assess pedal pulses, colour senstation and movement of the lower limb of the affected side.
She should ensure that the patient has been prescribed analgesia before removal of sheath.
Manual pressure or mechanical device should be applied to the haematoma.
Check medical notes e.g. ECG or ventricular report. Take greater caution if gelufundin needs to be administered to avoid developing pulmonary oedema
What are the post procedure complications?
Haematoma
Bleeding or oozing from angio site
Retroperitoneal bleed
Pseudoaneurysm
What is the assessment of a haematoma?
Record length and width
Watch the haemoglobin
Compression
Large haematoma cans lead to oedem of the lower leg with possible blood flow obstruction
Femoral nerve compression - neuralgia.
what are the four questions to ask for safe removal of sheaths?
Has heparin been administered?
What is the patient’s BP?
Is a haematoma present?
What is the patient’s left ventricular function?
