Arterial Line Removal Protocol - Sheath vs Single Lumen

[TakeBack]

Hello all. I'm a CT PA and we are looking to standardize our fem line pulls, wanted to see what folks are doing elsewhere.

We generally use manual compression for standard fem a lines, which is a single lumen 14 ga central catheter.

Cath sheaths and IABPs get a femostop.

I've seen a few hematomas from standard a lines pulled without a femostop.

Anyone using femostops for non-sheath fem a lines?

I feel that the coag abnormalities in a postop heart (platelets, factors, ASA, etc) add to the risk over a typical fem a line removal.

Any thoughts?

Thanks all....

[dianah, ASN]

I did a google search using the words "femoral artery sheath removal protocol" and came up with MANY hits.

Here are two:

http://www.cathlabdigest.com/article/2802

Early Ambulation post PCI with Use of Direct Thrombin Inhibitor, Bivalirudin

http://journals.lww.com/jncqjournal/Abstract/2001/10000/Developing_Best_Practice_in_Arterial_Sheath.6.aspx

Developing Best Practice in Arterial Sheath Removal for Registered Nurses

Perhaps you can tweak the words to narrow the search for fem sheath removal in pts w/coag abnormalities.

We don't use femostop in our lab but I attended a presentation at NTI by an RN whose lab uses it exclusively, with good results (interventional lab).

Good luck!

[velardern]

Hi,

Just recently left an EP lab and we did manual holds for all of our sheath pulls. We never used hemostasis devices due to the amount of heparin we administered (even though we gave protamine at the end of the case) and due to the size of sheaths we were pulling. Our largest was a 14 french and we typically held those approximately 40 minutes. We never had a problem with hematomas, etc.,but everyone was thoroughly trained in pulling.