Kortney Squibbs

25 February 2021

Dr. Calcagni

Cardiac Cath Lab

A cardiac cath is the gold standard for assessing coronary arteries. It can be used to measure

ventricular function, intracardiac pressure and the extent of coronary artery disease. Left-hearted

catherization is more common and is primarily used to determine patency of coronary vessels.

This procedure provides assess for interventions. This can include percutaneous transluminal

coronary angioplasty, placement of stents, and intracoronary delivery of the thrombolytic drug.

This procedure allows for assessment and intervention without extreme invasive techniques.

Granted the wires go directly into the heart but is less invasive then open heart surgery.

In the cardiac cath lab, nurses have many responsibilities. There is a scrub nurse (or tech) that

is in charge of assisting the doctor in the actual procedure. This person was in charge of handing

objects to the doctor as well as running the X-ray. There was another nurse who was also in the

room assisting the doctor. This nurse’s job was to pull and administer medications during the

procedure. The job of this nurse was also to pull any guide wires, stents that the doctor requested.

There was also a nurse behind the wall that was in charge of charting. Anytime a medication was

administered it was shouted out and repeated by the charting nurse. Any guide wire or stent used

was also shouted out and packing was handed to that nurse that was in charge of charting. All

nurses back in the procedure room was in charge of cleaning up and preparing the room for the

next procedure.

When I asked the nurse about what medications were avoided, he mentioned that a lot of

medications are okay to be taken such as antiplatelet medications. He did mention that they still
discourage the use of coumadin before this procedure. During the procedure they are given

lidocaine, fentanyl and propofol to help calm the patient before the procedure begins. During the

procedure heparin can be given if the vessel is hard to pass the guide wire through. He said that

sometimes in the radial artery the blood can clot, and the heparin can help prevent clotting. Also,

nitro can be given to help vasodilate the vessels to also make it easier to pass the guide wire

through. Aspirin and nitro can also be given after the procedure. I learned that during the stent if

someone is experiencing chest pain this is common after the vessels are dilated. Metformin is a

medication that is omitted on the day of the catherization as well as for 48 hours after due to the

contrast dye.

For a patient post operatively, it is important to keep constant pressure right after the

procedure. When they are taken back to their room or recovery the people with a radial cover

have a pressure cuff on to hold pressure. It is decreased over the hour. The patient is instructed

not to use that arm for a few days to allow the artery time to heal. In a femoral site, patients are

told to lay flat for at least one hour. I know that they are not allowed up for at least 4 hours. Any

patient that had a femoral site was made observation and sent up to a unit for the night. It is very

important that the patient does not get the dressing wet, so bleeding is prevented.

This experience was honestly one of the best experiences I have had for an “offsite” rotation.

The staff was very friendly and gave me not only the information for the unit, but also advice for

the future as a nurse. I would most definitely recommend this for students, but I would make sure

they know some about what is done during this procedure and why each of the patients are

receiving it.