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to maintain artery access we use what?
guidewires
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the length of guidewires
length ranges from 35-360cm
the average is 150-180 cm
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diameter of guidewires include?
diameter ranges from .012-.038 cm
- normal diagnostic: .035-.038 cm
- balloon intervention: .012-.018cm
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4 types of guidewire include?
- J-wire
- angled
- straight
- movable core
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J-wire
- most commonly used
- 3.0 mm for cardiac procedures
deflects vessels, decrease risk of perforation, easy to position or change direction of tip
avoids sm branches, won't fit into equipment
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angled wire
- tip has angle
- for peripherals
- has more pushability and strength
- don't deflect as much, it's directional and likes to find small branches
- increased perforation risk, tends to enter sm branches,
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straight wire or floppy wire
- very soft and flexible, great tracking
- "floppy" straights
- it fits in tight spaces
- high perforation risk
- can go off track, likes small vessels
- used on exchange wires
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movable core
- the mandral can retract
- high risk for perforation if core is not relaxed when entering into vessel
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2 types of coating for guidewires
- teflon
- polythylene-hydrophilic
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teflon coating
- slick feeling, non stick
- has ridges
- for cardiac procedures
- never leave in body for longer than 3-5 min
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polythylene
- plastic coating
- peripheral work
- stays wet and slippery
- "snot" wire
- NEVER PUT CATH THRU THIS WIRE!!! IT WILL SCRAPE PLASTIC OFF AND ADVANCE INTO ARTERY
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sheaths
decreases bleeding and increase speed of procedure
they are color coded, very important for length and diameter
used to dilate arterial hole so sheath can fit through them
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what are sheath sizes measured in?
french
each french is 1/3 of a mm
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color codes for sheaths
- 4f red
- 5f gray
- 6f green
- 7f orange
- 8f blue
- 9f black
- 10f purple
- 11f yellow
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length of sheaths are?
- 5-25 cm
- 5cm for child/infant/radial
- 25 for thicker pt/tortuous vessels/tighter vessels
average 11-12cm for groin and brachial
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