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Cardiac Catheterisation. Lancashire & South Cumbria Cardiac Network. Involves the introduction of hollow shaped plastic tubes into the chambers of the heart and surrounding vessels Under x-ray control Aim – to diagnose & treat heart disease. Procedures.
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Cardiac Catheterisation Lancashire & South Cumbria Cardiac Network
Involves the introduction of hollow shaped plastic tubes into the chambers of the heart and surrounding vessels • Under x-ray control • Aim – to diagnose & treat heart disease
Procedures • Angiography – injection radio-opaque dye to establish blood flow, contractility and establish anatomical stenosis and abnormalities • Intra-cardiac pressure recordings – to establish pressure status within individual chambers/vessels • Oximetry – to establish level of oxygen saturation across chambers/vessels • Cardiac output measurements – to establish cardiac output and calculation of shunts and vascular resistances
Techniques - LHC • Sones • Brachial artery ‘cut-down’ • Bed rest not required • Judkins • Seldinger method • Vessel/nerve damage less likely • Femoral or radial
Technicians Role • What are the common duties carried out by the technician for diagnostic/intervention procedures within the catheter laboratory?
Catheter definitions • Catheter • French size • Lumen • Length • Guide wire • Bolus • Flow • Radio-opaque • Radio-translucent
Catheter characteristics • List as many characteristics as possible
Instrumentation system • Catheter • Pressure line • Transducer • Pressure monitoring system
System criteria • Stability • Sensitivity • Adequate frequency response
Pressure line & transducer kit • Heparinised 0.9% saline • Maintain sterility • fluid filled – air free • Zero & calibration • Prevents backflow of blood
Transducer • Mechanical to electrical • Strain gauge – wheatstone bridge technology • Strain defined as fractional change in length RESISTANCE LENGTH
Pressure Vent to air
Electrical circuit R1 R3 R4 R2 V Resistances are equal – no current flows R1 & R2 and R3 & R4 - current flows
Arrangement of the equipment • Name as many reference points as possible
Pressure ranges • Left sided pressures what range? • Right sided pressures what range?
calibration • Ensure scale and linked sensitivity is correct calibration zero INCORRECT ADJUSTED
Damping • Reduction in amplitude & frequency of pressure waveform UNDERDAMPED OVERDAMPED CORRECT
Causes of Damping • List the reasons for damping during cardiac catheterisation • (1) • (2) • (3)
Overshoot & Sensitivity • Caused by compliance characteristics of the pressure system • Inclusion of ROSE will eliminate overshoot • ROSE ?