Cardiac Cath Patients

hellonurse36 · May 31, 2006

I work in CICU and we routinely pull sheaths at bedside. If possible I would suggest you try to arrange for a day in the cath lab to pull sheaths - that's what I did and it really helped to do 4-5 in one day to get the technique down - the cath lab techs/RNs are also great teachers and gave me some good tips. The hardest part is your fingers get sore...they taught me to use my body weight rather than just pushing with my hands.

Most of the nurses on my unit don't really care for pulling sheaths...mostly because it takes so long and puts you behind on your other care/charting.

Terri in Greenville, NC

cdk001 · May 31, 2006

What is a sheath and why does it take so long to pull..

EricJRN, MSN, RN · May 31, 2006

What is a sheath and why does it take so long to pull..

http://www.mgh.harvard.edu/cardiology/cardiology/cath.html

cdk001 · May 31, 2006

Ooh I see.. Thanx.. Yea, I could see how your hand would get tired if your not using a clamp or are un-able to use one..

WOLFE, BSN, RN · Jun 1, 2006

same here... in cticu/sicu/ccu/micu the nurses pull sheaths.

TheRunner · Jun 1, 2006

I pull sheaths all the time, but I am sometimes concerned that some facilities consider it just a routine thing. I find it to be one of the most critical procedures a nurse can do. I've seen places where the patient care techs are allowed to pull without a nurse even in the room. I think this is very dangerous. Pulling sheaths is not rocket science, but it is very critical.

Oddly, one place I worked, which was a dungeon for pt care in every other way, actually mandated only an RN could pull, and another RN had to be in the room for the entire 20-30 minutes. They must have had someone die, because they told me they used to have a tech doing it.

jmgrn65, RN · Jun 2, 2006

we have a few trained nurses on one of our tele units that pull sheaths, and our ccu pulls them. They have to go thru a competency.

veegeern, BSN, RN · Jun 2, 2006

Our Cath lab nurses are the only ones that can pull sheaths at this time. They have to go through a compentency. Our CCU nurses may have to start going through training to pull them as we are making some changes in our facility.

Indy, LPN, LVN · Jun 2, 2006

We have a nurse, usually 11a-whatever time all sheaths are done, like nine or eleven pm, who pulls sheaths. If the patient's ACT and BP are okay in the cath lab, they'll pull the sheath there. Our sheath puller is for those who come out to the floor with the sheath in.

Usually the patient's nurse is in the room when this is done, as a second pair of hands to record vitals and in case of an emergency. I love having an experienced sheath puller. It's a critical procedure and we have people doing it who are experienced and competent. If I had to do my own I would probably pull another nurse off my unit for 30 minutes and that would put us all behind in our work.