CCU - Removal of Femoral Sheath by Registered Nurses - page 4
Policy and Procedures of Femoral Sheath Removals by Registered Nurses. If you have any information on these topics please let me know? I need to benchmark , and set up some standards for our... Read More
May 4, '08Joined: May '08; Posts: 4We Pull The Sheath If Act Is Less Than 150,in Terms Of Femostop Use ,we Need To Have Doctors Order.to Cover Ourselve.we Prefer Manual Pressure Unless Patient Has Big Body Built,with Hematoma Or Bleeding.
Jun 12, '09Joined: Jun '09; Posts: 7; Likes: 4
Jun 12, '09Joined: Jun '09; Posts: 7; Likes: 4Quote from SEOBowhntrHowdy, I figured I'd throw my 2 pennies in here too.
I pulled my first sheath way back in Jan. 1996, and have pulled somewhere around 2000 or so since. I have seen a variety of hemostasis devices and still prefer the first I ever used which is the fingers I am typing with. I have yet to have a vasovagal (sudden drop in BP and HR, related to increase in vagal tone) while providing manual pressure. I also use c-clamps w/ Compressor discs, but really when I have time prefer the manual technique. Having performed many pulls in my 9.5yrs. of nursing, I started using a procedure about 7 yrs. ago where I would infiltrate an oozing site with lidocaine 1-2% with Epi 1:100,000 to shore up any small vessel bleeding. The technique worked quite well, resulting in a more comfortable patient and achieved hemostasis from the localized vasoconstriction. About 2yrs. ago, I authored my hospital's "Lido w/ Epi injection Policy." After getting several "ignorant" doctors on board and explaining to them how the procedure worked, and getting pharmacy approval, and getting approval of the hospital medical board, we finally got them on our Post Intervention orders last fall. If any of you guys are interested, PM me and I will forward you a copy of the policy. I have a friend and former co-worker who left my facility and took this procedure to another facility and they are currently working on a similar such protocol. This injection works wonders esp. with Perclose or Angioseal sites that have the never ending ooze. This WILL NOT be effective on an arterial bleed, but does quite well with moderate oozing sites.
I would love to see that policy for our hospital....can you email it to me? Click on the envelope icon, below my member name (above).
Thanks so muchLast edit by dianah on Jun 12, '09 : Reason: Removed email, as posting email is TOS (Terms of Service) violation
Mar 29, '10Joined: Mar '10; Posts: 2hi everyone.. i'm wondering wat is the proper method for blood sampling for ACT.. any recommendation... this is wat i've been practising
1. draw out 20mls of blood (as to remove to remaining heparin which used to lock the sheath)
2. draw another 2mls (for ACT reading)
3. return back 20mls blood been drawn in step 1
4. flush with 10mls 0.9% normal saline
5. lock with 2mls of heparin saline