kcmosue

That is absoultely the best advice I think I've heard! I essentially do have my hand in a "c" position, but I like the doppler idea. I think that would help me verify that I do have my finger on the femoral pulse and the right pressure point. Since i"m not "checked off" to do this, I always have someone "monitoring" my attempts, usually the critical care educator...who, by the way, isn't much of a help, she has not given me any pointers but expects me to complete 7 pulls and then be skilled enough to do it...I think if I used this doppler method, my confidence level would go up, and I wouldn't feel like I was "guessing" every time I pull. I'm not sure that I want to do the fist technique, I think the educator would have a cow. although I'm sure it would be easier on my arm/hand. Thanks for the tip!

I recently took a job in a Cardiovascular recovery unit, partly because of the hours and partly because it is so close to home that I can get to work in I am inconsistent with my control, and I think I am having trouble knowing where to place my fingertips. I feel for a femoral pulse, but either because of nerves or age (I'm 52) I don't REALLY know if I'm feeling it or not sometimes...especially when the pt is female and has a fat pad there. I attempt to place my fingers above (maybe 1 fingerbreath) and medial to the groin site...but today I had a lot of trouble getting control, had to use 2 hands quickly and then covered the site and repositioned my hands with success....it felt like an eternity to me, but was probably less than a minute. My biggest problem is the educator. She is much younger than me (most are), and seems to think that sheath pulls should be my favorite thing to do. As I have not been checked off on all my required, she, or someone, has to be there when I pull. I'm not shirking my responsibilities, but if I live a million years and never see another groin sheath it won't bother me. Am I the only nurse out there that feels this way? ANyway, any pointers would be appreciated. I've thought about doppling the pulse to get a better idea of placement, but then I'd have to wipe off the gel and it IS a sterile area, so.....

This is big topic to me. I have been an nurse for 30 years, and just took a job on a CVRU floor. 70% of our caths come back with closures, but the ones that don't, it appears to be my time to pull It's been years...and my hand position isn't right yet! My facility wants fingers at or above the sheath site, and want a small spurt of blood to come out before you pull. Have the time I don't even know if I've really got that femoral pulse. Some reading revealed a good way to hold is to put the index finger on the pulse point, and hold with the other two fingers........is this a good idea" Any other hand positions out there that might be easier? Thanks!

I actually applied for a position such as this a couple years ago, but took a different position instead. So the job is out there, or at least was...i don't know if the job was ever filled, or if it got cut in an effort to "save money". I'm in agreement with you...we have asked for the last 2 years in our small ambulatory center to have someone who can get family members, take them back and forth thru locked doors, let them know about their loved one...it is a needed position.