wendypants

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!

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. Hoorah for evidence-based nursing!