Elevated Procedure Vital Signs ECG Bed rest/ HOB Dressing Femoral/Brachial Sheath insitu Continuous ECG Bed rest Sterile Q 15 min X 4 - Sheath insitu - 3 hours sheath band-aid *BRACHIAL Q 30 min until - During removal removal/hemostasis, then ACCESS ONLY sheath removal ambulate D/C ECG Ambulate - First ambulation with Sheath Removal - After first according to nurse Follow Protocol ambulation physician order HOB Post sheath - Up to 30 degrees first two removal hours of bed rest Q 15 min X 4 - Up to 45 degrees after two Q 30 min X 2 hours Q 1 hour X 4 - Lateral position acceptable (and/or prior to [affected limb straight] discharge) - NO limitations for brachial then Q 4 h Closure Device Post sheath Continuous ECG Bed rest Tegaderm removal While on - 2 hours post device Q 15 min X 4 bedrest insertion, then ambulate Q 30 min X 2 D/C ECG - First ambulation with Q 1 hour X 4 - After first nurse (and/or prior to ambulation HOB discharge) - Up to 45 degrees after one then Q 4 h hour of bed rest Radial Clamp Radial Clamp Continuous ECG Bed rest Sterile insitu - Clamp insitu - Until post clamp band-aid Q 15 min X 4 - During removal removal/hemostasis until first clamp - Ambulate 15 min post D/C ECG release hemostasis - After first - First ambulation with ambulation Clamp Removal nurse Follow protocol HOB Post Radial - No restrictions Clamp Removal Q 15 min X 2 Q 30 min X 1 (and/or prior to discharge) then Q 4 h Bleeding/Hematoma Management Algorithm – Before and After Sheath Removal
Procedure Vital Signs ECG Bed rest/ HOB Elevated Dressing Femoral/Brachial *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 - After first ambulation Bed rest - 3 hours 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 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 h Continuous ECG While on bedrest D/C ECG - After first ambulation 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 - After first ambulation Bed rest - Until post clamp removal/hemostasis - Ambulate 15 min post hemostasis - First ambulation with nurse HOB - No restrictions Sterile band-aid Bleeding/Hematoma Management Algorithm – Before and After Sheath Removal
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