Post-Cardiac Catheterization Care

Post-Cardiac Catheterization Care – Nick Pietrini

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
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    • 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
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    • 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