Cath protocols and procedures Flashcards
What are flow directed catheters used for?
Right heart cath
What accessory should be placed on a swan that is to be left in the patient post catheterization?
Septi-Shield sterile sleeve
What needle is used in a modified seldinger technique?
18 gauge cook needle
What is the recommended amount of contrast?
3ml/kg
Elevation of the feet may assist with vascular access for which of the following approaches?
internal jugular
What substance is used in radiographic contrast that makes it radiopaque?
iodine
Which catheter is used for a right heart cath?
Swan-Ganz
Which drug is commonly used to achieve anti-coagulation during cardiac catheterization?
Heparin
Which anti-coagulation medication is better for diabetics and patients who are allergic to protamine?
Angiomax
What are the renal panel labs?
BUN
Creatinine
Why is a left ventriculogram performed?
measure Ejection Fraction
Left Ventriculogram is most likely performed using which catheter?
angled pigtail
Name a collagen based vascular closure device.
Angioseal / Mynx
Where is the three ring control syringe connected to?
Four port manifold
Which catheter is preferred during an angiography of the RCA?
6JR4.5
What kind of guide wires are “slippery when wet”?
Hydrophilic
If a patient has a history of contrast allergies, what should be done before the procedure?
premedicate with anti-histamines and steroids
How should the skin be prepped with each Povidone-iodine sponge prior to heart cath?
Begin at the inside and scrub away from the puncture site in a spiraling manner
Which needle would be the smallest and least traumatic to inject local subcutaneous anesthetic beneath the skin before deep infiltration with lidocaine and arterial puncture?
25 gauge
Guidewire diameters are usually measure in what?
thousandths of inches
Before catheters, needles and sheaths are inserted into the patient they should have what done to them?
Flushed with heparanized flush solution
What complication may occur with frequent and prolonged wedging of Swan Ganz catheter?
Pulmonary hemorrhage
During a Judkins coronary arteriography procedure, most strokes and TIA’s are caused by plaque embolizing from where?
Aorta
Before attempting a brachial or radial artery puncture, the pulses should be strong. The patency of the ulnar artery and Palmar arch can be checked using what test?
Modified Allen’s Test
Which closure device uses a suture based vascular closure system?
Perclose
After 6-8 hours after a coronary angiograph what are patients instructed to do?
drink 1-2 quarts of fluid
Why are large amounts of fluid given to a patient post angiography?
promotes excretion of dye by the kidneys
Name 4 complications that could occur with femoral access.
- Hematoma
- Distal embolization
- Vasovagal reaction
- Infection
How would you treat a vasovagal reaction?
- IV fluid bolus
2. Atropine 0.5 mg IVP
What should the ACT be before pulling the sheath?
160 seconds
