Recommendations
The Allen test is performed.
The patient is informed on
the advantages and disadvantages of this approach.
A light sedative is
administered.
Bracelets, watches and rings
are removed from the wrist and hand.
The wrist is shaven and
wiped with iodine.
In the left hand or arm an
intravenous line is inserted. Keep the right hand and arm free, since you will obstruct
venous flow during establishment of hemostasis.
The right groin is shaved
and wiped with iodine, in case radial artery puncture fails or if right heart
catheterization, or intraaortic balloon pumping is required.
In addition, the patient should be aware
that intraarterial administration of a spasmolytic cocktail and
introduction and removal of the sheath may be associated with discomfort.
OLVG practice:
- The Allen
test is not performed
- The
patient remains dressed
- If
possible, the patients enters and leaves the catheterization laboratory
walking
Medication:
Heparin 5.000 IU for CAG
and
10.000 IU for PTCA
Aspegic 900 mg i.v. (contains 500 mg
aspirin)
Nitroglycerin 100 micrograms i.c. (repeated)
Aspirin 100 mg p.o. indefinitely
Clopidogrel 1 x 75 mg for
1 year; loading dose 350 mg post procedural
IIbIIIa blockers if indicated
Cocktail: Nitroglycerin 100-200 micrograms
i.a. and Verapamil 5 mg for spasm diluted to 10 cc with saline
Intraarterial injection causes
a burning sensation of the forearm and hand of short duration. The patient should
therefore be informed on this effect. |
