THE MYSTERIES OF THE CARDIAC CATHETERIZATION LAB
Transcript of THE MYSTERIES OF THE CARDIAC CATHETERIZATION LAB
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THE MYSTERIES OF THE
CARDIAC CATHETERIZATION
LAB Cardiac Catheterization Lab
Rachelle Brink
Leanne Ritson
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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
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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
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Welcome to the Cardiac Catheterization
Lab
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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
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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
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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.
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In The Lab
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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
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Sheath
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Catheter
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Stent
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Coronary
Artery
Blockage
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Coronary
Artery
Blockage:
Stent deploy
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Coronary
Artery
Blockage:
Stent Placed
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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
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Post Care
Clamp TR Band
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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
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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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