2. Introduction Cardiac Catheterization is
a procedure performed
both for diagnostic and
interventional purposes .
The role of nurse is
important while pre
catheterization , intra and
post catheterization.
3. Definition It is one of the invasive
procedure used to
visualize the heart
chambers , valves and
great vessel in order to
diagnose and treat
abnormalities of the
coronary arteries
7. Contraindication
â Hypersensitivity to contrast medium
â Pregnancy
â Severe systemic infection
â Irreversible brain damage
â Severe heart failure
â Acute GI bleeding
â Severe hypokalemia
â INR more than 1.8
â Acute renal failure
â Severe Anemia
13. Patient preparation
â Doctorâs order
â Informed consent
â Lab test CBC,ESR,Renal function, PT,INR, ECHO,X ray, Infectious markers and serology
tests
â Check for allergy to iodine and seafoods
â Skin preparation
â IV cannulation
â Placement of ECG electrodes
â Check pedal pulse and mark it .( Dorsalis pedis and Posterior tibial)
â Monitor hemodynamic status
â Keep NPO for 6 to 8 Hrs
14. â If creatinine above 1.5 IV fluid should be stated 6 hrs prior to angiogram
â ECG should be taken(12 lead ECG)
â Due per medications should be administered as per order( Aspirin, Clopidgrel,
Pantoprazole, Diazepam
â Empty the bladder before sending patient to cath lab
â Instruct the patient regarding procedure time and experience of hot flush during injection of
dye
â Sometime patient may have nausea and headache
â Assist the patient go wear OT dress
â Check for any implants ,dentures etc
â Handover the valuables to appropriate person
â Check and document height and weight to calculate the dose of dye or contrast media
15. Procedure â As per the site / type of catheterization, a
fluoroscopic catheter is inserted into the
appropriate vessel
â Advancement of catheter is visualized in X Ray
fluoroscopic image
â The images are recorded for evidence
â Once the cathternisnin position measured
amount of contrast media is injected
â Nurse during this time need to monitor the
hemodynamic status
â Advanced cardiac life support drugs and
supplies are kept ready
16. Procedure (contn..) â Patient should be monitored for any cardiac
arrhythmias
â The size of the chambers, pressures are checked
as per the need
â To visualize coronary arteries the catheter is
placed in ascending aorta and the contrast is
injected into coronary arteries
â If therapeutic is indicated ,it is done accordingly
â Patientâs pedal pulse is checked frequently during
the procedure for signs of poor perfusion of the
extremity
â Once the procedure is done the catheters are
removed and pressure dressing is applied
â Patient shifted to recovery room for observation
17. Post procedure care
â Bedrest for 6 hours with affected extremity
â Observe the catheter site for bleeding or hematoma
â Record 12 lead ECG and correlate the findings
â Check peripheral pulses in the affected extremity every 15 mins for 1 hour and 30 mins for next hour
and every hour
â Monitor hemodynamic status continuously
â Watch for signs of complications
â Advice the patient to keep the affected leg straight for 4 to 6 hours
â Head can be elevated to 30 Degree
â Started feeding and advice to drink more fluids
â Repeat LABS if needed