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Sheath size are measured _________ per French size.
0.33mm
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What color is 4 French?
Red
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What color is 5 French?
Gray
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What color is 6 French?
Green
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What color is 7 French?
Orange
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What color is 8 French?
Blue
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What is the length of a standard sheath for Femoral approach?
11cm long
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When the sheath will not canulate, what must you check for?
- 1) Fishmouth
- 2) Remove dilator
- 3) Remove, flush, try again
- 4) May need to start w/smaller dilators or sheath
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What is one view normally performed for LV?
30 degrees RAO
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When should you consider the use of an Allen's Test?
When there is a possibilty of doing a radial approach.
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What arteries are occulded in an Allen's Test?
Radial and Ulnar
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What is the indication of a negative Allens test?
Hand is still blanched after 10 seconds. Another site must be used for an approach.
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What is the length of a standard sheath for Radial approach?
10cm
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What are some symptoms of Vasovagal Reaction?
Hypotension (Low BP), usual Brady Cardia, Pallor and Diaphoresis
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When should you expect to see a Vasovagul Reaction?
During and after access, needle sticks, arterial punctures, during and after sheath pulls
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How should vasovagal reaction be treated?
Fluids open in IV 100-200ml, 0.5 mg atropine IV Push
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What meds does a doctor use to numb the access site?
Lidocaine. Used Routinely 10-20ml 2%
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If patient is allergic to Lidocaine, what medication is an alternative?
Procaine
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What palpations should be done on all femoral approaches?
Femoral pulse, DP (Dosalis Pedis), and PT (Posterial Tibias)
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What is the first thing to be done when there is resistance felt in the guidewire?
STOP!!!
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What are the possible access sites?
- 1st choice - Femoral (by the groin)
- 2nd choice - Radial (at the wrist)
- 3rd choice - Brachial (1 cm above crease in the arm)
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What size guidewire would be used on a femoral approach?
0.035 J-tipped 3cm
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What size guidewire would be used for a radial approach?
0.018 straight soft tip
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How do you measure the size of a JL catheter?
The distance between the primary curve and the secondary curve. Greater the distance; Bigger the catheter.
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How do you measure the size of a JR catheter?
Measured by the secondary curve only.
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What is dampening and how is it caused?
A drop in systolic pressure; caused by ostial lesion and/or miscanulation such as deep seeding or roofing
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What is ventriculization?
Decrease in diastolic pressure.
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Name indications for a left heart cath?
Chest pains, cardial clearance for surgery, myocardial infarction, STEMI or Non-STEMI, Valvular Heart Disease, Abnormal Echo, and Abnormal stress
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What is the first thing you should look for in the aorta (or any other chamber)?
Pressure
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How should the tip be position when giving an injection? Why is this important?
It shold be pointed down; This causes air in the syringe to raise to the top, and air does not mix with the injection
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List the wall motion terms.
Normal, Hypokinetic (slow movement); Akinetic (no movement)
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What does LIMA stand for?
Left Internal Mammary Artery
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What does RIMA stand for?
Right Internal Mammary Artery
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In 90% of CABG cases what is used?
LIMA
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What percentage of RCA CABG uses the RIMA?
50%
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