Marshall Ritchey, MS, MBA, RCIS, CPFT, Manager, Cardiac Cath Lab, Piedmont Medical Center, Rock Hill, South Carolina, writes:
“I am of the opinion that a patient coming in the cardiac cath lab and also in exiting the cardiac cath lab exam table should be slid across in order to not increase work load or demand on an injured cardiac muscle (this was the practice at John Peter Smith Hospital, Presbyterian UPMC, Conemaugh Memorial Medical Center, United Hospital Center, and Aiken Regional Medical Center when I was at these institutions).
I have now heard that if the patient is stable and not in great distress, it is acceptable to have them scoot over or move from the stretcher to the exam table on their own power with hips and shoulders.
Now I have to admit, I have all the answers. I have the right answers and the wrong answers. So before I make this a written protocol, I would like to survey the other cardiac cath labs and hear what their current practices are before I let it be written and done.”
CLD posted Mr. Ritchey’s question on our Facebook page (facebook.com/cathlabdigest) and readers responded as follows:
Marsha: There is no pat answer. Common sense and invasive lines are the qualifying factors. We did a little trial in the lab one year, actually transferred a few staff from one to the other – it is amazing to see the paradigm shift when they can actually feel the lift and heave on their bodies.
Mark: It depends on the situation and patient acuity, but for the most part, we slide them.
Georgann: No exertion on the patient’s part.
Brian: Toss-up here. Most of the time, we slide. Depends on patient’s presentation, anatomy, age, etc. I’ve worked 12-plus yrs in the lab, what is more concerning to me often times is the left main stenosis patients. 100% slide job there.
Vicky: I feel like this one falls into the ‘use your judgment’ category. I’ve yet to send someone over the edge by having them scoot.
Brandi: Any CP in 24 hours, we slide (even if this is a scheduled case – but esp emergent/urgent cases), slide all STEMIs. Post cath – slide everyone.
Dawn: Yes, it is a judgment call. If the patient isn’t terribly symptomatic and feels they can scoot, let them. If it’s not radial, it will be a long time before they can get up.
Wendy: We always slide our STEMIs.
Genevieve: If the patient is stable, we ask if they think they are able to scoot. Most men say it hurts too much. Most women scoot on over.
Simon: Scoot, if physically able.
Mistie: Slide STEMIs and all patients with active chest pain.
Dianne: We also slide STEMIs back and forth and slide all post caths.
Roberta: Any emergency, we use slide. In regular circumstances, if able to move, hips and shoulders. You have to access pt to see which way is best.
Janese: We ALWAYS slide STEMI patients, period!
Lisa: We always have the patient move over to the bed themselves. Some of the ACS patients even come down to the labs in a chair. STEMI pts move over themselves from stretcher to bed unless they are physically unable, for whatever reason.
Patty: Post procedure always slide, emergent or not, unless diagnostic with a transradial approach. A slide board is used to decrease back fatigue and strain of the cath lab staff and to eliminate “the gap” between the procedure bed and the stretcher.
Kathy: Slide. Even if it isn’t a STEMI. For some elderly patients it is so difficult for them, especially when you have three or four young employees coaching them over.
Annette: Slide STEMIs and post cath pts. Even radial.
Colleen: We slide STEMIs and NSTEMIs. All our patients, if physically capable, will move over themselves.
Rochelle: We slide STEMIs back and forth, and slide all post caths.
Pamela: Cath labs I’ve worked in slide patients with chest pain or STEMI pts.
Billy: We slide STEMIs, only scoot if pt has 0 pain.
Doyle: Slide everyone. There is no use having a sheath pop out because of laziness. Even if they have a closure device...
Summer: We use a slide for all non-stable and STEMI patients. If they are stable and healthy, they scoot themselves.
Doug: We always slide patients, STEMI or not, more out of concern for groin management. Not big closure device users, however.