Checklist after a cardiac cath done femorally to check for retroperitoneal bleeding

[deweydecimal13501]

Hello everyone,

I am a librarian and have been asked an interesting question by one of the nurses at my hospital. I hope you can help me find some answers to her question below. I would be very grateful.

QUESTION: She wants to create a checklist for Cardiac Cath procedures done femorally. What she is looking for is looking at all femoral caths that have high sticks to the femoral artery that can be at risk for retroperitoneal bleeds. She wants to know if any other facility has a checklist that they perform after a cardiac cath done femorally, to check for retroperitoneal bleeding? This checklist would be done in the Cath Lab directly after the procedure.

Do you have a checklist and would you be willing to share? Please send to the email below. I would be very appreciative.

Thanks so much in advance,

Deweydecimal

[email protected]

[offlabel]

That is a really tall order...Check lists go only so far and what really matters in these patients is the experience of the providers and caretakers and the index of suspicion specific to more proximal femoral artery punctures. Care takers need to be trained and experienced in recognizing hypotension relative to blood loss. It's pretty basic nursing assessment stuff.

What I would suggest to the nurse asking is instead of a "checklist", reinforce learning the signs and symptoms of retroperitoneal bleeding and hypotension in the setting of blood loss. Routine assessment items such as confirming the presence of distal pulses and ischemic leg pain should already be part of the focused assessment of these patients.

A rigid negative check list could very well show no problem at all and give a false sense of security with a patient in need of emergent surgery.

[deweydecimal13501]

Thank-you for your excellent comments. Does anyone else have a checklist they can share? She is still hoping for find someone willing to share.

[offlabel]

Would it be better if she communicates directly with the group she hopes to gain a resource from? Clinician to clinician communication can address specific issues with what she's doing now vs. what she hopes to accomplish with resources from others. If there is a deficiency that needs to be addressed first, that can be teased out and a more coherent plan devised.

[deweydecimal13501]

Thank-you for your help. I will submit this to my nurse/patron. I will assume this topic is closed.