airway assessments include | history of snoring, dysmorphic facial features, rheumatoid arthritis, short neck, mouth or jaw irregularities |
CABG meaning | coronary artery bypass graph |
TEE definition | transesophageal ultrasound |
absolute contraindications | lack of staff/ equipment, no consent |
relative contraindications | fever, anemia, hypokalemia, pregnancy, electrolyte imbalance, GI bleed, renal failure, hypertension, uncooperative, arrhythmias, recent strokes |
indication for cath suspecting coronary artery disease | new-onset angina, unstable angina, evaluation before surgery, silent ischemia, + exercise intolerance test, atypical chest pain |
indications for cath suspecting a MI | unstable angina, failed thrombolysis, shock, mechanical heart complications |
main indications for cath | coronary disease, MI, sudden cardiovascular death, valvular disease, congenital, aortography, EP studies, intervention, atrial closure device |
major cath risks | stroke, MI, arrhythmia, death |
other cath risks | aortic dissection, tamponade, congestive heart failure, contrast reaction, asystole, infection, thrombosis, embolus, vascular injury, vasovagal |
how to gain informed consent? | explain in simple terms risk and procedure, provide information, go over alternatives |
in cath lab time out check | patient ID, allergies, lab results, bp, pulses, anticoagulant status, access point |
starting the procedure check | paperwork, patient understanding, airways, IV lines, premedications, start documenting procedure |
risks to staff and patient | radiation, blood products, drugs, chemical solvents, lifting injury, falls |
before draping the patient establish 2 things | EKG lead and IV access |
what is the 2 minute time out used for in procedures? | allows time for nurses and technologist to catch up to the physicians orders and do them |
ASA 2 | mild systemic disease that doesn't effect this (controlled diabetes) |
what is the purpose of moderate sedation for these procedures? | reduce patient discomfort, retains their airway, able to respond to stimuli |
4 components to moderate sedation | preprocedural baseline assessment, drug dosage, monitoring, post-procedural monitoring |
airway assessments include | history of snoring, dysmorphic facial features, rheumatoid arthritis, short neck, mouth or jaw irregularities |
right heart caths include | RA, RV, pulmonary valve, pulmonary arteries, tricuspid valve, pulmonary wedge, pressures and O2 sats |
left heart caths include | coronaries, aorta, mitral valve, LA, LV, aortic valve, EP studies pressures and if right cath O2 sats |
right heart pressures are mandatory for | valvular disease |
left heart pressures are collected for | nearly all studies |
internal mammary artery angiographies are done | for patients that may need CABG procedures |
elective procedures are | scheduled |
urgent procedures are | needed very soon |
emergent procedures are | needed now |
relative contraindication definition | stabilize and correct before procedure |
absolute contraindication means | the procedure will not happen |
what puts patients at higher risk for procedures? | acute MI, old, aortic aneurysm, aortic stenosis, congestive heart failure, diabetes, 3 vessel coronary disease, LV dysfunction, obesity, stroke, renal insufficiency, coronary stenosis, hypertension |
stable angina definition | symptoms when exercising |
unstable angina definition | symptoms at any time, sign of MI |
thrombolysis definition | dissolving a blood clot with drugs |
what do papillary muscles do? | they hold the chordae tendineae, which holds the valve, loss of these can cause the valve to dismantle |
sedation where the person is awake is called? (campbell will lose it if you call it something else) | moderate sedation |
ASA 1 | healthy maybe varicose veins |
ASA 3 | severe systemic disease but not incapacitating (insulin dependant diabetes) |
ASA 4 | not expected to live 24 hours with or without surgery (hemorrhage coma) |