In this section
Cardiac catheterisation is the insertion of a catheter into a vein or artery, usually from a groin or jugular access site, which is then guided into the heart. This procedure is performed for both diagnostic and interventional purposes. Diagnostic catheters are used to assess blood flow and pressures in the chambers of the heart, valves and coronary arteries, to assist in the diagnosis and management of congenital heart defects. Interventional catheters are used as an alternative to open-heart surgery when possible. These procedures include closure of septal defects (ventricular septal defect device closures, atrial septal defect closure), expansion of narrowed passages (pulmonary stenosis), stent placement, ablation of abnormal electrical pathways and opening of new passages (foramen ovale). In paediatrics, the procedure typically involves a general anaesthetic and is associated with varying complications. Although the advances in catheterisation techniques have reduced the prevalence of complications post cardiac catheter, statistics show that complications remain a significant source of morbidity and mortality in these patients. Specific management of a child post-cardiac catheterisation must utilise strategies to reduce the risk of complications. Additionally, vigilant monitoring of the patient after cardiac catheterisation is fundamental for early identification and management of complications. Nurses who are able to promptly identify complications are in the optimal position to prompt critical action and improve patient outcomes. Thus, nurses that are competent in the care of a patient post cardiac catheterisation are able to minimise mortality and morbidity rates for these patients within the post-operative period.
To provide nurses with the knowledge and skill set to competently care for a patient post cardiac catheterisation.
Refer to Nursing Assessment nursing clinical practice guideline (Link).
Include the following when taking the history of a child post cardiac catheterisation:
The physical examination should include surveillance of the following:
Assess puncture site for:
Assess and document intake and output.
On arrival to the ward assess and record patient observations - these should include:
In children who undergo diagnostic cardiac catheters no investigations are typically required unless complications are suspected.
View the evidence table for the Care of the patient post cardiac catheterisation nursing guideline here.
Please remember to read the disclaimer.
The development of this nursing
guideline was coordinated by Annabelle Santos, Nurse Educator, Koala Ward, and approved by the Nursing Clinical Effectiveness
Committee. Updated April 2017.