My Nursing Responsibilities in the Cardiac Cathlab

Summary

In this video, Nico, a cath lab nurse in London, shares insights into working in a cardiac catheterization lab. She describes the key procedures performed, such as angiograms, angioplasties, and pacemaker implants, while emphasizing the collaborative nature of the multidisciplinary team. Nico walks viewers through pre-procedure preparations, patient care protocols, and the importance of safety, hygiene, and effective communication. She also highlights the critical post-procedure recovery process, providing a holistic approach to monitoring patient health and ensuring comfort. Nico concludes by inviting fellow nurses to share their best practices for improving patient care.

Takeaways

• 🏥 The cardiac catheterization laboratory (cath lab) is a hospital department where minimally invasive procedures are performed to diagnose and treat cardiovascular diseases.
• 🩺 Common cath lab procedures include coronary angiograms, angioplasty, right heart catheterization, MitraClip valve repair, TAVI, ablations, and device insertions like pacemakers and ICDs.
• 👩‍⚕️ The cath lab team is multidisciplinary, consisting of interventional cardiologists, scrub and circulating nurses, physiologists, and radiographers working together during procedures.
• 📋 Before the procedure, nurses assess patients by verifying identity, checking medical history, allergies, vital signs, medications, and recent blood results to ensure safety.
• 💉 Nurses also perform ECGs, establish IV access, encourage toileting, and prepare patients by shaving, cleaning, changing into hospital gowns, and ensuring consent forms are signed.
• 🚫 Patients must fast for at least six hours before the procedure, with clear liquids allowed up to two hours prior, and remove jewelry and nail polish before entering the lab.
• 🧴 Infection control and radiation safety are top priorities in the lab — all staff must follow hand hygiene, wear protective equipment, and maintain a clean, organized environment.
• 📡 During the procedure, the nurse monitors vital signs, assists with sedation management, and ensures the patient’s comfort and safety while collaborating with the medical team.
• 🩹 After the procedure, patient recovery follows the ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) to identify complications like bleeding or sensorium changes.
• 🏠 Once stable, patients are reoriented, given food, pain relief or antibiotics as needed, and discharged with clear instructions and follow-up care after 4 hours of observation.
• 🤝 The nurse emphasizes teamwork, patient safety, and holistic care before, during, and after the procedure to ensure positive outcomes and continuous improvement in cath lab practices.

Q & A

What is a cath lab, and what procedures are typically done there?

A cath lab (cardiac catheterization laboratory) is a department in a hospital where minimally invasive procedures and tests are performed to diagnose and treat cardiovascular diseases. Common procedures include coronary angiograms, angioplasty, right heart catheterization, microclip bulb repair, TAVI (Transcatheter Aortic Valve Implantation), ablation, pacemaker insertion, and the placement of devices like ILRs (Insertable Loop Recorders) and ICDs (Implantable Cardioverter Defibrillators).

What roles do the different members of the cath lab team play?

The cath lab team includes: 1) Interventional cardiologists who perform procedures, 2) A scrub nurse who assists with sterile technique, 3) A circulating nurse who monitors the patient’s comfort and assists the doctor, 4) A physiologist who monitors the heart’s function during procedures, and 5) Radiographers who operate specialized X-ray equipment used in the lab.

How do nurses ensure patient safety before a procedure in the cath lab?

Nurses ensure patient safety by verifying patient identity using multiple identifiers, checking medical history for allergies, previous surgeries, or cardiovascular issues, and ensuring the patient hasn't eaten (or followed NPO guidelines). They also ensure vital signs are stable, an ECG is performed, blood tests are checked, and the patient is properly prepared, including ensuring they sign the consent form and are comfortable.

What pre-procedure checks are done on patients?

Before a procedure, nurses verify the patient's identity using at least two identifiers, confirm allergies and medical history, check vital signs and ECG results, review recent lab tests, confirm the patient is fasting as per guidelines, and ensure they have signed the consent form. They also prepare the patient physically by ensuring they are clean, in a hospital gown, and that any jewelry or nail polish is removed.

What does the ABCD approach refer to in the cath lab?

The ABCD approach refers to a post-procedure assessment method: A for Airway, B for Breathing, C for Circulation, D for Disability, and E for Exposure. It’s a comprehensive way of assessing the patient after a procedure to ensure there are no complications, and it helps nurses monitor recovery and check for issues like bleeding or abnormal heart rhythms.

Why is infection control important in the cath lab?

Infection control is critical in the cath lab because the procedures are invasive, and any infection can lead to serious complications. This includes proper hand hygiene, the use of sterile gloves, gowns, and masks, and ensuring all equipment is sterile. All team members must adhere to these protocols to reduce the risk of infection.

What are the radiation safety protocols in the cath lab?

Due to the exposure to radiation in the cath lab, all team members must wear appropriate personal protective equipment (PPE), including a thyroid shield, lead gown, mask, and caps. This ensures that everyone is protected from harmful radiation during the procedure.

How do nurses manage patient comfort during a procedure in the cath lab?

Nurses manage patient comfort by establishing rapport before the procedure, checking vital signs, monitoring for signs of discomfort, and ensuring the patient is relaxed and calm. During the procedure, they adjust sedation levels if needed and ensure the patient is positioned comfortably. After the procedure, they continue to monitor the patient’s recovery and provide pain management if required.

What are the key responsibilities of nurses during patient recovery in the cath lab?

Nurses are responsible for monitoring vital signs, ensuring there are no complications like bleeding, and following up on the patient's comfort. They use the ABCD approach to assess the patient, check for any issues like bruising or sensorium changes, and ensure that the patient is fully alert and stable before discharge. Nurses also provide post-procedure instructions and ensure any required follow-up care or medication is provided.

How do nurses prepare the cath lab for the next patient after a procedure?

After a procedure, nurses ensure that the cath lab is thoroughly cleaned and sanitized, all used materials and equipment are disposed of properly, and any machines are cleaned. They also double-check the lab’s readiness by ensuring all required equipment and supplies are restocked and organized, ensuring the lab is safe for the next procedure.