Hi, I'm curious to know what others hospital policies are regarding removal of epicardial pacing wires post cardiac surgery
Our policy requires baseline obs, remove wires, obs x2 30 minutes apart, pt to remain in bed 1 hour, watch for signs of tamponade (dec BP, tachy, SOB, pain)
We aim to remove wires during 'office' hours (plenty of staff around), on day 4-5 post-op and while INR is <2.5. Ofcourse this is all with Dr's orders on pt assessment.
Had pt last night: INR 3.4, day 6, due to be D/C next day, surgeon did round at 1900 hours & ordered wires to be removed now. Reminded Dr of policy & voiced concerns, Dr said to do it while he was on the ward.. this is fine but what about later if she tamponades? Made sure documentation was in order, & removed wires. No problems as far as I know (I am on a pm shift so hopefully she has gone home safely)
Some nurse feel the policy is over-kill as nobody has seen a pt tamponade post wire removal.
Thoughts please & what are others doing with this procedure?
don't ya just hate the ignorance or doctors..pulling wires with a inr of 3.4..duh what an [language edited by moderator]
Last edit by RNPATL on Jan 22, '05