melissalynnfalkowski
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PRE-OP DIAGNOSIS: Cardiogenic shock.
POST-OP DIAGNOSIS: Same.
OPERATION: Insertion of right femoral arterial catheter.
SURGEON: ASSISTANT:
INDICATIONS: Patient in cardiogenic shock requiring constant arterial blood pressure monitoring while on intravenous vasopressor support of her hemodynamics.
PROCEDURE/FINDINGS: Above mentioned patient was requested by Dr for right femoral arterial catheter insertion for purposes of constant arterial blood pressure monitoring while the patient is intubated in cardiogenic shock and on intravenous vasopressor support. Informed consent was obtained from the patient's son/Health Care Proxy which is also concurs with the plan for arterial catheter insertion and also gives consent.
Patient's right femoral region was prepped with antiseptic solution and standard sterile draping was applied. Strict aseptic technique was utilized throughout the procedure. Approximately 5 mL of 1% local lidocaine was infiltrated over the right femoral artery. A large bore needle was then used to gain access to the right femoral artery with pulsatile blood from the large bore needle. A guidewire was then passed through the needle into the right femoral artery and advanced. The large bore needle was then withdrawn. At this point a long 20-gauge femoral Angiocath was inserted over the guidewire using Seldinger technique into the right femoral artery and advanced. Guidewire was then withdrawn. There was bright red pulsatile blood flow via the catheter. An arterial catheter tubing was then attached to the arterial catheter after being flushed clear with sterile normal saline. Appropriate pulsatile blood pressure curve was obtained. The arterial cannula was then suture secured to the skin at multiple sites and then a dry sterile occlusive dressing was applied over the catheter at the insertion site. Patient's blood pressure initially 70 mmHg after insertion of arterial catheter with the patient on Neo-Synephrine and dopamine infusions.
POST-OP DIAGNOSIS: Same.
OPERATION: Insertion of right femoral arterial catheter.
SURGEON: ASSISTANT:
INDICATIONS: Patient in cardiogenic shock requiring constant arterial blood pressure monitoring while on intravenous vasopressor support of her hemodynamics.
PROCEDURE/FINDINGS: Above mentioned patient was requested by Dr for right femoral arterial catheter insertion for purposes of constant arterial blood pressure monitoring while the patient is intubated in cardiogenic shock and on intravenous vasopressor support. Informed consent was obtained from the patient's son/Health Care Proxy which is also concurs with the plan for arterial catheter insertion and also gives consent.
Patient's right femoral region was prepped with antiseptic solution and standard sterile draping was applied. Strict aseptic technique was utilized throughout the procedure. Approximately 5 mL of 1% local lidocaine was infiltrated over the right femoral artery. A large bore needle was then used to gain access to the right femoral artery with pulsatile blood from the large bore needle. A guidewire was then passed through the needle into the right femoral artery and advanced. The large bore needle was then withdrawn. At this point a long 20-gauge femoral Angiocath was inserted over the guidewire using Seldinger technique into the right femoral artery and advanced. Guidewire was then withdrawn. There was bright red pulsatile blood flow via the catheter. An arterial catheter tubing was then attached to the arterial catheter after being flushed clear with sterile normal saline. Appropriate pulsatile blood pressure curve was obtained. The arterial cannula was then suture secured to the skin at multiple sites and then a dry sterile occlusive dressing was applied over the catheter at the insertion site. Patient's blood pressure initially 70 mmHg after insertion of arterial catheter with the patient on Neo-Synephrine and dopamine infusions.