INTERVIEW: TR Band application post diagnostic procedure for radial approach
TR Band application post diagnostic procedure for radial approach
RADIAL ACCESS PROTOCOL
This Radial access protocol is followed for all patients undergoing Radial artery access for diagnostic Angiogram. All patients are assessed by a Cath lab nurse in pre-assessment clinic or in the day case unit, by performing an Allens test prior to procedure to assess if the radial access is suitable. Right radial artery access is the access of choice. However, we do perform left radial artery access in patients who are unsuitable for right radial approach.
TR BANDTM APPLICATION PROTOCOL
The radial band is applied with the green dot 2-3cm proximal to the puncture site and the Terumo writing aligned with the little finger 12mls of air is inserted into the port marked air and once the cuff is inflated the sheath is removed. If there is bleeding more air can be inflated into the band to a total of 18mls. If no bleeding is present, gradually remove air from the band until the site bleeds then re-insert 2 mls of air.
TR BANDTM (TERUMO) IS USED AS STANDARD DEVICE |
INITIAL VOLUME OF INFLATION |
PATENT HEMOSTASIS CHECK AT APPLICATION? |
|
12 |
|
TR BANDTM (TERUMO) IS USED AS STANDARD DEVICE |
|
INITIAL VOLUME OF INFLATION |
12 |
PATENT HEMOSTASIS CHECK AT APPLICATION? |
|
TR BANDTM DEFLATION & REMOVAL PROTOCOL
TIME BEFORE FIRST DEFLATION |
TIME BETWEEN OTHER DEFLATION(S) |
TIME BETWEEN DEFLATION IF REBLEEDING |
AVERAGE VOLUME AT EACH DEFLATION |
15 |
15 |
15 |
3 |
TIME BEFORE FIRST DEFLATION |
15 |
TIME BETWEEN OTHER DEFLATION(S) |
15 |
TIME BETWEEN DEFLATION IF REBLEEDING |
15 |
AVERAGE VOLUME AT EACH DEFLATION |
3 |
DISCHARGE PROTOCOL
A small mepore dressing is applied and the patient is discharged once haemostasis has been achieved and the band has been removed for at least 15 minutes.
TIPS & TRICKS TO IMPROVE RADIAL ACCESS & DAILY WORKLOAD
If a haematoma occurs another band can be applied above the TR band to remove the haematoma. The TR band remains in situ for a further 15 minutes after all air is removed, to prevent any further bleeding when the patient mobilises. A reverse barbeau test is undertaken once the patient is in recovery to ensure adequate radial flow by applying a saturation probe to the index finger. If no radial flow more air is released from the band and bleeding assessed.
|
4.28 |
||
Average time to hemostasis - Diagnostic Procedure |
64.55 mins |
||
Average RAO following completion of hemostasis |
0.00% |
