5 Oct


This next scenario did not happen to me, I only observed a nurse on my floor highly upset, extremely concerned, and well… mad, and worried.

*Remember that no names, gender, location etc will be disclosed and this may even be a fictitious made up story to make all nurses, new or not, remember certain aspects of care under our watch.*

The patient is scheduled for a cardiac catheterization. This is a test to see if a patient has a blockage of some sort in the coronary arteries or Coronary Artery Disease. A catheter is inserted into the groin or the arm–that will travel to the arteries of the heart. Dye is injected to block the rays of the x-ray so that the vessels can be visualized. Interventions to unblock the arteries will usually be implemented if possible.

The nurse assess the patient–the patient is stable, the patient has both pedal pulses present and marked with little -x- marks.

The cath lab nurses pick up the patient and escort the patient to the the cath lab.

The patient has the procedure and the floor nurse is getting report from the cath lab nurse in which the cath lab nurse explains, what happened, what were the blockages, any stents placed, etc.  The cath lab nurse tells the floor nurse that the angioseal was not sealed “it broke free.”  Assessment wise the patient is stable with positive pedal pulses, no hematoma, no bleeding and a pressure dressing applied.

What? Red flag here. What broke free? The whole thing? Is that real? Is it possible? Will it travel? Is there a chance that it will travel? To the brain? The heart? The lungs?

So the patient is received by the floor nurse. The cath lab nurses leave. Floor nurse starts with vital signs, puncture site and then on to the feet.

The feet.

The foot is cold and there is no pedal pulse to be palpated.

There is no audible doppler pulse.

The vascular surgeon was consulted immediately.

Here is a nice site with step by step instructions how to insert and anchorthe angioseal.


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