I need info on post angio bed rest

Tinkerbell-rn · Jan 27, 2001

I work on an Interventional Cardiology floor in Sacramento, California. As standard post angio protocol, we keep patients on bedrest for 6 hours, just like your facility. We are though, trying out newer procedures that are supposed to be more technologically advanced, and should require less bedrest for patients. One of them requires the insertion of a collagen plug into the artery or vein at the site of the catheterization, and is secured by tying off the plug with sutures.

Morph · Jan 30, 2001

Thanks Tinkerbell. That info will come in useful

CardiacRN · Feb 11, 2001

As one of the larger catheterization/angioplasty center son the east coast, we are always trying to reduce the bedrest for the patient. As already posted, generally people stay on bedrest for 6 hours post sheath pull. We are also using Angioseals(collagen plug) in which case bedrest is 3-4 hours.

prayedone · Feb 17, 2001

As already stated, manual removal of sheaths, in our cath lab, requires 6 hours of bedrest. We also use Angioseal, a collagen plug, that requires 1-3 hours of bedrest. Also available to our doctors to use is Perclose which is a suture device that requires only 1 hour bedrest. Our patients and doctors prefer angioseal. The majority of our patients bedrest is 1-2 hours with discharge 1 hour after ambulation.

stellaCat4 · Sep 1, 2001

Our interventional patients are on bedrest for 6 hours as well, unless they are on reopro, agristat, or integrilin, in which case, it is until the gtt is finished. If they are a perclose, it is one hour. Angioseal or duett, one to two hours. Our radial procedures are not on any bedrest, unless they are on the above gtts.

wheelie · Sep 17, 2001

I work for a cardiologist. He typically begins with a 5 or 6 Fr. sheath. If no intervention is required, 3-4 hours of bedrest is required.

If angioseal is used 2 hours of bedrest is all that is usually needed.

ICUBecky · Oct 3, 2001

sheaths: lay flat, pull sheath, lay flat for # hours as size of sheath i.E. 6 fr. sheath =6 hours laying flat. then end of BR...unless on integrelin, reopro, ect.

angioseal: 2 hours BR

perclose: 1-2 hours BR

if angioseal and perclose fail and pressure needs to be held. they need to lay flat for 5 hours after.

wendypants · Oct 8, 2001

Where I work we have recently started using a mobile cardiac cath lab and I have been reviewing the current literature regarding achieving femoral haemostasis and bed rest. At the mo' we use 5Fr sheaths, some patients have angio-seals but the majority have manual compression. Those with angio-seals are allowed to sit up in bed one hour after the suture is cut and half an hour later mobilise...... Although there is French research stating that patients can mobilise as soon as the suture is cut! Those having the sheath pulled on our day-case ward have to lay flat 2 hours post-removal, half hour sat up in bed with leg straight, then mobilise. All, without complications, can be discharged one hour after mobilising. Looking at more research it looks like we could change this too. There seems to be a consensus that immediately after sheath removal the back of the bed can be elevated by 30 degrees, sat up with leg straight after an hour (for 30 mins) and then mobilise without any higher incidence of bleeding, early or late haematoma formation. Patients are happier as it reduces back and leg pain, mobilise earlier and don't always have to pee on a bedpan or bottle while lying down. :cool:

Hoorah for evidence-based nursing!

psnurse · Oct 11, 2001

Bedrest....

Standard 6 hours after intervention if no closure device is employed.

1 -3 hours for Angioseal.

We also trialed Perclose. The rep said they could be up in one hour but we had a lot of venous bleeds that prevented them from getting up for a while (approx 3 hours)

We also use a radial artery approach where I work. No flat time is necessary, but we do keep them in bed a couple of hours. Mostly to keep them from using their right hand to get around (i.e. pulling on rails, pushing self off bed, opening bathroom door, ect)

The radial approach is a HUGE hit with the patients and the staff.

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · Dec 1, 2001

With those of you performing Perclose and Angioseals, Perclose being generally 1 hour of bedrest, Angio 4 hours. How often are you doing vital signs. Our standard protocal is to do vital signs q15*4, then q30* 2 then q1 hour. But with these cath 'em and boot them techniques what is everyone else doing. Do you do something different for inpatients?

wendypants · Dec 1, 2001

Hi, I spoke with the Rep from Angio-seal last week while recovery post diagnostic cardiac cath patients. She said that the back of the bed should be elevated by 30 degrees on return from the lab as this creates extra tension and will help the seal to do its job. It should then be cut 20-45 mins after deployment (she suggested a nice round 30 mins) when they can then sit straight up and can mobilise an hour after deployment:eek:

We do obs every 15 mins for the first hour, then half hourly for 2 hours, and hourly 'til discharge. It's the same for in-patients only they have hourly obs for 4 hours and then back to their own requirements for monitoring.

I've got quite a lot of the current research if you want any references.

Hope this helps. Haven't got any experience of the Perclose device as none of the 3 cardiac centres I've worked in have used them.... they seem to like the Angio-seal best in the UK!