The Guiding Catheter Case Summary

Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the movement of the walls of the heart to see if the pumping action of the heart is normal.

Usually, accessing vascular structures is done through a needle to puncture the vessel percutaneously, followed by a wire introduced through the needle to secure the vascular access. The needle is then removed and a sheath is advanced over the wire. Vascular sheaths are hollow structures with a built in diaphragm to prevent bleeding. Catheters are then placed into and out of the sheath with a minimal loss of blood.11

I am going to discuss the central and PICC line insertion. I will to base about the safety of the insertion process. The benefits that come along with choosing to insert a PICC line verse a peripheral IV. Like most topics, there will be risks involved, but with proper technique, you can prevent these risks

an artery in the neck. Once the catheter is in place, the needle is removed and a

Groin access, guiding catheter navigated to the internal carotid artery, then intermediate catheter and microcatheter are pushed through and slightly passed the clot.

The physician inserts a tissue valve into the bigger artery there, and then takes the valve up to the

peripheral line- IV line inserted into a vein in the arm, leg, or scalp in an infant

• A needle will be inserted into your arm to administer the IV contrast material.

Medical staff will clean and shave your groin or arm for the insertion of the catheter. A local numbing agent will be administered, but you will be awake during the procedure. Medicines for anxiety could be given if patient is having trouble relaxing during the exam. Next, a small catheter will be inserted into an artery. The doctor then uses x-rays to guide the catheter to the area of interest. Once the catheter is in place, dye will be inserted through tube. This allows for visualization of your blood vessels. Very minimal movement will be aloud during this exam to ensure safety and high quality images. This procedure could last one to two hours. If this is a planned procedure and not an emergency, this is normally only scheduled in the

PICC lines, or peripherally inserted central catheters, are a convenient healthcare treatment. A PICC line is a thin catheter that is inserted in the large veins near your forearm at the flex point. It can be inserted by a physician or by a specially trained nurse and is minimally invasive. People who can get PICC lines include "patients who have to receive IV therapy longer than five days, when there is difficulty maintaining peripheral access, for any infusions known to damage the inside of the vein, for infusion of total parenteral nutrition, patients with respiratory ailments that increase risk for using other central venous access devices, for patients receiving chemotherapy, and for any patients needing prolonged outpatient treatment that requires use of an IV." http://www.cpmc.org/learning/documents/nur-piccline-ws.pdf. I am going to further discuss how a PICC line is inserted, the benefits and the risks, safety of PICC lines, and caring for a PICC line.

PROCEDURE: Patient was taken to the OR where she was given spinal anesthesia. She was then prepped and draped in the usual fashion for cesarean section. A Pfannenstiel incision was made carried down to the fascia. The fascia was (__) lateral and was directly separated from the rectus muscle. Rectus muscle was divided, the peritoneum cavity was entered. The O access ring was placed,

The lesson and case studies presented for evaluation was a great learning exercise. A better understanding of how to interpret data was gained. Also, weighing the clinical significance versus the statistical significance to show relevance is invaluable. All research is not quality research and one must be equipped to recognize bias, threats to validity and proper population representation. Moreover, critiquing the credibility of a study is essential to the health care advances.

Intervention Procedure: Following the diagnostic portion of the procedure, the left femoral vein was accessed under ultrasound guidance with a 21 gauge thin wall needle. A double lumen 4 -French (5 cm in length) was placed percutaneously into the left femoral vein by modified Seldinger technique with guide-wire exchange. Blood was withdrawn from all lumens and flushed with normal saline. The catheter was sutured in place and a sterile dressing was applied over the site prior to removal of drapes.

Cardiac catheterization a long flexible thin tube place in blood vessel in arm, groin, or neck looks in coronary arteries. Dye can be added to see how well the heart is pumping.