Post-Cardiac Catheterization Care

Catheterization Documentation

• The most appropriate guidance for post-cath care in the cardiac catheterization report
• VUMC: Epic  Cardiac tab  Cardiac Catheterization/Intervention Report
• VA:  Note tab  Post-Procedure note and Cardiac Catheterization note
• If there is a delay in filing the final report at VUMC: Review the Cardiac Catheterization Nursing Documentation, which shows if stents were deployed

Post-Catheterization Heparin

• Medical management (ie no intervention):  continue heparin gtt (or lovenox) for 48 hours
• PCI: stop heparin and continue/start DAPT as directed by cardiology
• Left main, proximal LAD, or other indication for CABG: Continue heparin gtt until surgery
  • • •  
  • Separate medical indication for anticoagulation (DVT/PE, atrial fibrillation):  restart ~ six hours after catheterization

Cath Site Checks:

• 6- 8 hours post catheterization, only needed for femoral arterial access:
• Look, listen, feel: evaluate for hematoma & pseudoaneurysm; call fellow if concerned
  • • •  
  • Small amount of bruising and mild tenderness at the site is normal
  • Listen above and below the site for a bruit; the area should be soft
• Hypotension after femoral access: STAT CT AP & call the cardiology fellow for RP bleed
• Femoral oozing: Cardiology fellow, will need to hold pressure
• Radial oozing: instruct nurse to re-inflate the TR band and restart the clock on deflation