|
1.Pt will return from cath lab with TR band applied and inflated. Cath lab personnel will bring the special TR band syringe to the bedside with the patient.
|
|
|
2.The band holds up to 18ml of air, please clarify with cath lab RN how much air is in the balloon upon arrival.
|
|
|
3. Maintain initial pressure for 45 minutes. This is from the time it was inflated. Clarify with the cath lab RN what that time was.
|
|
|
4. At the 45 minute mark, start deflating the balloon by 3 ml every 15 minutes.
|
|
|
5. If bleeding occurs, reinflate the TR band to the previous volume (but never more than 18ml) and maintain that volume for 30 minutes before starting the weaning process again.
|
|
|
6. As long as no bleeding occurs, take 3 ml of air from the TR band Q15 minutes until the band is completely deflated.
|
|
|
7. Keep the deflated TR band in place for 60 minutes before attempting removal.
|
|
|
8. After 60 minutes has passed and no bleeding has occurred, the TR band may be removed and sterile gauze with tegaderm should be applied.
|
|
|
9. The patient may ambulate during the 60 minute period when the band is deflated. Otherwise, they should remain in the bed or chair during the weaning process.
|
|
1.Pt will return from cath lab with TR band applied and inflated. Cath lab personnel will bring the TR band syringe to the bedside with the patient.
|
|
2.The band should remain at the initial pressure for 2 hours after the Angiomax gtt has completed.
|
|
3.At that time, start to remove 3 ml of air Q15 minutes.
|
|
4. Continue step 3 until the balloon is completed deflated.
|
|
5. If bleeding occurs, re-inflate the balloon with 3 ml to the previous pressure (no greater than 18ml) and wait 30 minutes before restarting the weaning attempt.
|
|
6. Continue deflating the TR band by 3 ml of air Q15 minutes until completely deflated.
|
|
7. After all the air is removed, the TR band should stay in place for 60 minutes.
|
|
8. If no bleeding occurs, remove the TR band and apply a sterile 2X2 gauze and tegaderm.
|
|
9. The patient may ambulate during the 60 minute period when the band is deflated. Otherwise, they should remain in the bed or chair during the weaning process.
|
|
1. Monitor VS Q15 minutes X 4, Q30 minutes X 2, Q1H X 4
|
|
2. Use the non-procedure arm for blood pressure measurements if able.
|
|
3. Monitor and assess Neurovascular function of the procedural limb with the ordered VS.
|
|
4. Monitor SpO2 on the index finger distal to the TR band.
|
|
5. Notify MD for absent or cool, pale, painful extremity of procedural extremity.
|
|
6. If after the TR band is removed and a hematoma develops, apply direct manual pressure over the puncture site using three fingers for at least 10 minutes.
|
|
1. Instruct patient not to manipulate wrist for 24 hours. Avoid activities such as golf, tennis or carpentry.
|
|
2. Dressing can be removed after 24 hours. They may leave it OTA at that time or cover with a band-aid.
|
|
3. Instruct patient If minor oozing occurs late (after D/C), apply a band-aid.
|
|
4. No soaking wrist for 3 days. Showering is permissible.
|
|
5. No driving for 48 hours.
|
|
6. No lifting greater than 5 lbs, with affected arm for 7 days.
|
|
7. If late severe bleeding should occur, instruct patient on how to hold pressure on the puncture site and call for medical help.
|
No comments yet.
Cheatography n. The art of mapping complex subjects into clear, instantly navigable reference guides.
