Femoral/Brachial Sheath insitu Continuous ECG Bed rest Sterile Q 15 min X 4 - Sheath insitu - 3 hours post sheath band-aid *If arterial and Q 30 min until sheath - During removal removal/hemostasis, then venous sheaths removal ambulate D/C ECG are insitu at the - First ambulation with Sheath Removal - 1.5 hours after SAME access site, nurse Follow Protocol sheath removal remove arterial HOB Post sheath removal sheath FIRST - Up to 30 degrees first two Q 15 min X 4 hours of bed rest Q 30 min X 2 *BRACHIAL - Up to 45 degrees after two Q 1 hour X 4 (and/or ACCESS ONLY hours prior to discharge) Ambulate - Lateral position acceptable then Q 4 h according to [affected limb straight] physician order - NO limitations for brachial Femoral Venous Sheath insitu Continuous ECG Bed rest Sterile Access Only Remove immediately - Sheath insitu - 30 minutes sheath band-aid - During removal removal/hemostasis, then Sheath Removal ambulate Follow protocol D/C ECG - First ambulation with Bed rest Post sheath removal nurse completed Q 15 min X 2 HOB Q 30 min X 2 - Up to 45 degrees until first (and/or prior to ambulation discharge) - Lateral position acceptable [affected limb straight] Closure Device Post sheath removal Continuous ECG Bed rest Tegaderm Q 15 min X 4 - 1.5 hours after - 2 hours post device Q 30 min X 2 sheath removal insertion, then ambulate Q 1 hour X 4 (and/or - First ambulation with prior to discharge) nurse then Q 4 HOB - Up to 45 degrees after one hour of bed rest Radial Clamp Radial Clamp insitu Continuous ECG Bed rest Sterile Q 15 min X 4 - Clamp insitu - Until post clamp band-aid until first clamp release - During removal removal/hemostasis - Ambulate 15 min post Clamp Removal D/C ECG hemostasis Follow protocol - 1.5 hours after -First ambulation with Post Radial Clamp sheath removal nurse Removal or upon first HOB Q 15 min X 2 ambulation - No restrictions Q 30 min X 1 (and/or prior to discharge) then Q 4 h Appendix: Vital Signs, Monitoring/Assessment and Management for Diagnostic Procedures & PCI Percutaneous Coronary Intervention (PCI)
Femoral/Brachial *If arterial and venous sheaths are insitu at the SAME access site, remove arterial sheath FIRST *BRACHIAL ACCESS ONLY Ambulate according to physician order Sheath insitu Q 15 min X 4 Q 30 min until sheath removal Sheath Removal Follow Protocol Post sheath removal Q 15 min X 4 Q 30 min X 2 Q 1 hour X 4 (and/or prior to discharge) then Q 4 h Continuous ECG - Sheath insitu - During removal D/C ECG - 1.5 hours after sheath removal Bed rest - 3 hours post sheath removal/hemostasis, then ambulate - First ambulation with nurse HOB - Up to 30 degrees first two hours of bed rest - Up to 45 degrees after two hours - Lateral position acceptable [affected limb straight] - NO limitations for brachial Sterile band-aid Femoral Venous Access Only Sheath insitu Remove immediately Sheath Removal Follow protocol Post sheath removal Q 15 min X 2 Q 30 min X 2 (and/or prior to discharge) Continuous ECG - Sheath insitu - During removal D/C ECG Bed rest completed Bed rest - 30 minutes sheath removal/hemostasis, then ambulate - First ambulation with nurse HOB - Up to 45 degrees until first ambulation - Lateral position acceptable [affected limb straight] Sterile band-aid Closure Device Post sheath removal Q 15 min X 4 Q 30 min X 2 Q 1 hour X 4 (and/or prior to discharge) then Q 4 Continuous ECG - 1.5 hours after sheath removal Bed rest - 2 hours post device insertion, then ambulate - First ambulation with nurse HOB - Up to 45 degrees after one hour of bed rest Tegaderm Radial Clamp Radial Clamp insitu Q 15 min X 4 until first clamp release Clamp Removal Follow protocol Post Radial Clamp Removal Q 15 min X 2 Q 30 min X 1 (and/or prior to discharge) then Q 4 h Continuous ECG - Clamp insitu - During removal D/C ECG - 1.5 hours after sheath removal or upon first ambulation Bed rest - Until post clamp removal/hemostasis - Ambulate 15 min post hemostasis -First ambulation with nurse HOB - No restrictions Sterile band-aid Appendix: Vital Signs, Monitoring/Assessment and Management for Diagnostic Procedures & PCI Percutaneous Coronary Intervention (PCI)
HIU%20Sending%20Facility%20Reference%20Booklet%20-%202013.docx