Ch 02 - Angio technique Flashcards
Convert Fr to mm
3 Fr = 1 mm
Ascending aorta technique for Sim
3-J reflected off aortic valve, Sim advance over wire until retroflexed in ascending aorta, wire then withdrawn
Treatment of vasovagal reaction
- Trendelenberg
- IV bolus 250-500 cc NS
- Atropine 1 mg IVP if severe
(atropine less than 0.5 mg may worsen bradycardia)
Treatment of MILD contrast reaction
- 100% O2
- Get IV access, get VS
- Benadryl 50 mg IV
- Hydrocortisone 100-250 mg IV
- Observe patient x4 hr
Treatment of MILD bronchospasm
- Albuterol 0.5 mL nebulizer OR
2. Epi (1:1000) 0.3 mL SC or IM
Treatment of ANAPHYLAXIS
- Call CODE
- Secure airway, give 100% O2
- Epi (1:10,000) 1 mL IV or via ETT
- Pressor support
- Methylprednisolone 125 mg or hydrocortisone 500 mg IV
Where can you use CO2 as contrast agent?
Portal vein, abdominal aorta, selective visceral, lower extremities
Not for use in ascending aorta, arms, carotids due to disk of vapor locking
Dosing for HTN crisis:
Labetalol
Hydralazine
Labetalol: 20 mg IV, can repeat q5-10 min up to 300 mg.
Hydralazine: 5 mg IV, repeat up to 20 mg
Treatment of carcinoid crisis
Octreotide 500 ug IV (infused over 20 minutes)
then continuous infusion of 100-200 ug/hr
How to dose and monitor intraprocedureal heparin
3000-5000 Units bolus, followed by 1000 U each hour
Monitor with ACT, target >250 seconds
How to reverse heparin
Protamine 10 mg for each 1000 units heparin presumed to still be active
In general, how big of a sheath can the axillary artery accept?
7 Fr
Preferred site of brachial artery access?
High brachial artery as it lies against the humerus
Post-brachial access care
Immobilize arm in sling x 6 hours, with HOB at 30 degrees
Periodic neurological exams of affected arm
Weakness or paresthesias are a sign of nerve compression/compartment syndrome
Management of suspected air embolism during venous procedure?
Left lateral decubitus, to trap air in the RA
