One hour up and two out post cath.

What I'm trying to set-up is a policy, following the various company's recommendations, on ambulation and discharge following correct deployment of an internal closure device,[Angioseal or Perclose]. This would be for diagnostic procedures only. Our I.R. M.D.'s already ambulate within 30 mins., making sure they are not under the influence of a sedative, but our Cardiologists are alittle more conservative. I'm looking to see if anyone else is doing the same. Thanks for your help.

I had a cardiac cath with an AngioSeal-- and they still kept me in bed for 6 hours! I thought the whole idea behind the plug was to avoid that-- and it was never explained to me why it was done. The nurse at the end of the night had no idea why I'd been kept there that long, either.

Also if any antiplatelet is used like integrillin or aggrastat, you should be down for at least 2-4 hours no matter what closure system they used. Anyone agree?

Also if any antiplatelet is used like integrillin or aggrastat, you should be down for at least 2-4 hours no matter what closure system they used. Anyone agree?

I do and we keep our diagnostics around for a minimum of 4 hours not matter what the closure device.

We only have Angioseal, PerClose and StarClose in our lab. We have Clo-sure P.a.d. in the lab, but I've never seen it used. We rarely use PerCLose d/t pt c/o severe pain with deployment. We mostly use Angioseal.

Angioseal pts are on bedrest for 2 hrs post deployment, then can d/c if VSS, no other issues, etc. We do this regardless of anticoagulation status.

StarClose states that their pts can ambulate almost immediately. Our MD's still insist on 2 hr bedrest.

I feel better having my patients remain flat w/leg straight for 6 hours. I don't see any reason to rush them out the door. My mother had one last Friday, they used Per close. She didn't have any problems other than bruising. She said the whole thing was a piece of cake and she wished she had not worried ahead of time. I tired to tell her I've never had a patient come back c/o that it was bad, or hurt, or anything negative other than being thirsty, hungry or having to pee.

If your patient's are in bed for 6 hours post-cath there is no need to charge them for a closure device as they could do without it. If the doctor insists on bedrest for that long after AND uses a closure device then the patient is being charged for something they didn't need. this is with the caveat that the device didn't fail and they are on bedrest simply "because that's what the doctor ordered."

The entire idea of arterial closure devices are to have the patient ambulating and discharged in the minimum amount of time. These developments are due mainly in part to the patient demands....why do I have to lay flat for so long, why can't I move my leg, I won't use a urinal/bedpan I have to get up to pee, etc.

Yes, it's also because the doctors want to move the patien'ts through faster and I am n ot saying that's the best thing. But, we have the technology why not keep up with the advances and use these things to their fullest advantage?

Hello, TVCCRN

No matter what the technology is today. It takes one patient to have a complication that may cost his or her life. Then the policies will change to prevent any type of mishap again.

Therefore, caution is always on the side of the nurse and assumption is on the side of those who wants to rush the patient out.