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arterial sheath pulling post catheterizations



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Sep 22, 2009 08:11 AM

arterial sheath pulling post catheterizations


hello!! i searched through other threads and found some great information, but i need more.
hoping someone can help.......
i am employed in a pre-post cardaic cath area. we have begun to train to pull sheaths.
my questions are.....

is there a standard policy for sheath pulling in north carolina?
is anyone willing to share their hospital policies with me?
in your hospital do you pull femoral, brachial, radial?
is it just diagnostic sheaths or do you pull with anticoagulants present?
how many staff members in a room during a sheath pull?
is it a rn-rn or a rn-lpn or a rn-nursing assistant or rn- tech or do you pull alone?

we want to be standard with other hospitals across north carolina and the USA

thank you in advance for any insight you are willing to give me.


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1 Comment
No. 1
from nurse171
Old Oct 10, 2009, 09:40 PM

Default Re: arterial sheath pulling post catheterizations
I am not a nurse in NC, but an RN in another state. I work in a unit that preps and recovers for Cath and EP labs. During sheath pulls, we work in pairs, one RN and one Cardio Tech. The tech actually pulls all femoral (by FAR the largest percentage) and holds pressure while I monitor and document and manage any problems that occur during the pull. Brachials and Radials are pulled by a NP or a Fellow. IJ's are pulled by RN's. This is the same for non-anticoagulated sheath pulls or interventional (PCI's, RFA's etc.) where a form of anticoagulation was used. If Heprin was used, protamine is administered in the lab prior to the patient being returned to us for sheath pull. However, we still check the ACT to make sure their blood is clotting at the protocol rate prior to pull. We have set protocols for venous and arterial pulls. A standard order set is provided for meds that the RN may administer etc., frequency groin site checks post hemostasis etc. so it's pretty cookie cutter. I hope this helps.
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