Question for Cathlab/tele/Special proced RNs

[sharann, BSN, RN]

Hi,

We have been taking care of post cath lab patients(mainly non-interventional stable) and angio patients post-procedure for many years. Most of our patients have orders to stay for 1 hour then we send them to outpatient holding for the remainder of their stay. They usually have HOB flat to 20 degrees ordered times 4 hours.

Question finally is: What can we do in the PACU to make the patients more comfortable on those darn gurneys. The biggest complaint is always "my back is killing me". Whenever I hear that it drops my blood pressure because of course I have to always suspect a retro bleed. We have to give narcotics orally to many patients due to the length of time they need to be on the gurney with the leg straight etc...

Any ideas? Help! I dread getting these patients now because I feel like inept and incompetent in alleviating this common complaint!

much thanks

[heartbeat2]

Hi,

We have been taking care of post cath lab patients(mainly non-interventional stable) and angio patients post-procedure for many years. Most of our patients have orders to stay for 1 hour then we send them to outpatient holding for the remainder of their stay. They usually have HOB flat to 20 degrees ordered times 4 hours.

Question finally is: What can we do in the PACU to make the patients more comfortable on those darn gurneys. The biggest complaint is always "my back is killing me". Whenever I hear that it drops my blood pressure because of course I have to always suspect a retro bleed. We have to give narcotics orally to many patients due to the length of time they need to be on the gurney with the leg straight etc...

Any ideas? Help! I dread getting these patients now because I feel like inept and incompetent in alleviating this common complaint!

much thanks[/quote)

I don't work with those type patients directly and don't know how much if any at all they can bend their knees but support under that area would take care of their back discomfort if it's positional related.

[cathlabrn]

They can be rolled onto their side with pillow support behind them. They

are still able to keep their leg straight and also to get off of their back.

Also, have them bend up the unaffected leg. This takes pressure off of

their back. A rolled blanket or a semi-flat pillow under both knees often

helps. We have become very creative over the years.

[sharann, BSN, RN]

Thank you cathlabrn and heartbeat 2.

I will try both of those suggestions, anything to help the patients time go by more smoothly.

[loriann, BSN, RN]

Definitely a rolled blanket or pillow under the knees. I've never rolled anyone post-cath, but I suppose it would be fine as long as the affected leg remains immobile.

[UM Review RN, ASN, RN]

Some people can be made more comfortable in a reverse trendelenburg position.

[dutchgirl]

I swear by warmed blankets. If we get them on right away when they come out of the lab, they just go aaahhh, and really relax EVERYTHING. We also allow bending up of the unaffected limb, we tip the feet down (easy on the stretchers), and use pillows under the knees to reduce the pressure of the lower back. Sometimes nothing works. The hard core back pain patients will do whatever they want, we try to support that as safely as possible. (Arguing and threatening doesn't work, but I still see some nurses try it....(:angryfire)

[harley007]

Our patients go directly from the lab back to our pre-angio holding/post angio/PCI unit and into their lovely beds. Their relief to their backs in getting onto their stretcher from our table - which is just an ironing board in disguise - is incredible. I also love to wrap them up with warmed bath blankets - they thank you a million times. We do 25 -30 cases a day so we keep our post floor busy. Plus all PCI patients stay overnight.