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Discussion

pulling arterial sheaths

I'm curious to see what oter institutions have as policy. Where I work, we pull sheaths on the regular floor (not just in cath lab or icu) we do not flush the line before pulling, and we do it manually. If bleeding occurs after the pull and requires pressure for along period of time, we use a femostop. What about you all? Do you pull on the floor, use a c clamp or femostop vs manual , flush or not flush, etc.?

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I know we pull on our tele floor, only hospital in our state of hawaii (by rumor) we have to stand there and apply pressure personally for 20-60 minutes in order to watch the patient at the same time. cant tell you exactly yet, i transfer there in May. I don't even know how to do it yet! =)

We pull on the tele floor. Obviously you have to be trained and signed off to pull the sheath. We have 2 nurses in the room, one to pull and manually hold pressure for 20 min or more, and the other nurse can push Atropine, give meds for rising or falling BP, express hematoma, etc.

Our on-going discussion on our floor is pressure dsg vs. guaze and opcite after the pull. Some of us feel you can not visualize site well afterwards with a large pressure dsg and so much occlusive tape. But some nurses will only use the pressure dsg. What are others out there doing?

I didn't answer all of your questions:rolleyes:

we don't flush before we pull, and I've seen a pt come out of cath lab once with the femostop. She complained that is was very painful. We have one on our floor to use, but I can't see that it would be that easy to apply (putting the belt part around the pt) if you're having a hard time controlling the bleeding

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