Pacing wire removal

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Hi, I am a new grad RN and would like to know your policy in removing pacing wires after patients having CABG's or AVR. As in my ward we remove them day 4 post op unless Doctors need to extend the use. We remove with doing pre obs and patients holding breath in and then remove and do post obs and ECG and patients ly in bed for 30minutes. I have also seen at another hosptial, whereas they do pre obs, auscultate apex of heart whilst feeling the radial pulse, remove wires, do post obs, ecg and patients to ly in bed for 1 hour. There seems to be different ways and that is why I would like to know what different protocols there are.

Look forward to your reply

Kylie

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Specializes in cardiac/critical care/ informatics.

We have them take a deep breath hold, pull wires. vitals q15 x4. That was just started in the last few years. I have been pulling pacing wires for 14 years, and when I was first taught we just pulled them, with no observation. As far as i know there has not ever been any complications from pulling wires.

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Specializes in Critical Care, Cardiothoracics, VADs.

We recently experienced some tamponade after pacing wire removal.

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Specializes in cardiac med-surg.

pull PMW day before or am of discharge if NSR, INR OK and no other contraindication. VS pre and post and 20 min. br. no holding of breath.they want us pulling chest tubes also-i don't think so.

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Specializes in cardiac/critical care/ informatics.
pull PMW day before or am of discharge if NSR, INR OK and no other contraindication. VS pre and post and 20 min. br. no holding of breath.they want us pulling chest tubes also-i don't think so.

We pull Pacing wires, chest and plueral tubes, and Central Lines.

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On my unit the NP does it shortly before discharge (either a day or two or that morning). They check the INR before, and the patient just lays flat for an hour after. We don't do EKG's (our patients are on tele) and we don't check VS pre and post, just at our normal times.

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