I don't know, but would love to learn more if you find out. It looks like a great place to live. When I worked in Fort Collins CO as an RN it seemd that all the CRNAs had 100% oversight and at my hospital did not do Neuro surgery or CABG cases.
We use the clo-sur pads, which I think is very similar to what you're talking about. As far as MD order for pulling sheaths, it depends on what unit/what MD. In the SICU, we use the clo-sur pad almost exclusively, don't need a MD order, they don't care as long as the line gets pulled and the site looks okay, or they are notified if there are problems. In our CCU, sometimes the docs write specifically to use manual pressure, sometimes femstop, sometimes they leave that line on the order set blank and it's the RN's choice what to use.
I can tell you I see much less hematoma formation with the clo-sur pad and it would be great for your arthritis. We usually hold about 15 minutes (requires a lot less pressure too), I have never had any site problems with it, pt is mobile much quicker. In CCU I floated first femstop I ever used was horrible, pt had huge amount of bruising, hematoma formation, I would have rather used manual pressure than the femstop, but MD wanted femstop.
This link on the FDA web site seems to say that the clo-sur pad is not FDA aproved for use with arteral sheath removeal
"In addition, a September 9, 2002, press release found at http://www.scioncv.com/PressReleases.html, entitled "Scion Cardio-Vascular Announces Agreement With Medtronic For Distribution Of The Clo-Sur P.A.D., An Innovative Device Used For Rapid Bleeding Control After Catheterization," states that the device is used for rapid control of bleeding associated with all vascular access sites. The press release
refers to use of the device
for the rapid control of bleeding associated with catheter removal following a catheterization procedure such as coronary stenting, as well as other minimally invasive procedures. For the more than 5.8 million Americans each year who undergo angioplasties, cardiac catheterizations, PTCA, stenting and other minimally invasive procedures, the Clo-Sur P.A.D. represents a dramatic step forward in the healing process.
These materials suggest that this topical device can be used following a catheterization lab procedure to achieve closure of the arterial puncture site. Such uses are not included within the cleared intended uses for hydrophilic wound dressings. We invite you submit a 510(k) to support the use of the Clo-Sur P.A.D.™ for closure of the femaral artery site; however, in the absence of 510(k) clearance fur this use, your promotion of the Clo-Sur P.A.D.™ for this use creates a new inEnded use for this device that is not cleared by the FDA."
I have had my NM tell me that she will not give me a good review untill I have worked as an ICU nurse for 2 years. I am a good nurse and she says my skills are were they should be at this point, but does not feel any icu nurse should go to CRNA school with out 2-3 years experance. what to do, what to do?
I don't know, but would love to learn more if you find out. It looks like a great place to live. When I worked in Fort Collins CO as an RN it seemd that all the CRNAs had 100% oversight and at my hospital did not do Neuro surgery or CABG cases.
This link on the FDA web site seems to say that the clo-sur pad is not FDA aproved for use with arteral sheath removeal
"In addition, a September 9, 2002, press release found at http://www.scioncv.com/PressReleases.html, entitled "Scion Cardio-Vascular Announces Agreement With Medtronic For Distribution Of The Clo-Sur P.A.D., An Innovative Device Used For Rapid Bleeding Control After Catheterization," states that the device is used for rapid control of bleeding associated with all vascular access sites. The press release
refers to use of the device
for the rapid control of bleeding associated with catheter removal following a catheterization procedure such as coronary stenting, as well as other minimally invasive procedures. For the more than 5.8 million Americans each year who undergo angioplasties, cardiac catheterizations, PTCA, stenting and other minimally invasive procedures, the Clo-Sur P.A.D. represents a dramatic step forward in the healing process.
These materials suggest that this topical device can be used following a catheterization lab procedure to achieve closure of the arterial puncture site. Such uses are not included within the cleared intended uses for hydrophilic wound dressings. We invite you submit a 510(k) to support the use of the Clo-Sur P.A.D.™ for closure of the femaral artery site; however, in the absence of 510(k) clearance fur this use, your promotion of the Clo-Sur P.A.D.™ for this use creates a new inEnded use for this device that is not cleared by the FDA."
http://www.fda.gov/foi/warning_letters/g4147d.htm
This was noted in Jul 2003. perhaps it is ok to use the device now for sheath removal.
I have had my NM tell me that she will not give me a good review untill I have worked as an ICU nurse for 2 years. I am a good nurse and she says my skills are were they should be at this point, but does not feel any icu nurse should go to CRNA school with out 2-3 years experance. what to do, what to do?