View source for Left Subclavian IABP



ROMICK 

LEFT SUBCLAVIAN IABP

'''IF LEFT SUBCLAVIAN IS OCCLUDED OR OTHERWISE INACCESSIBLE PROCEDURE IS ABORTED. IABP SHOULD NOT BE INSERTED THROUGH RIGHT SUBCLAVIAN PER CT SURGERY.'''

= EQUIPMENT =

* MICROPUNCTURE 
* (2) 4/5F SLENDER RADIAL SHEATH
* AMPLATZ EXTRA STIFF 260CM WIRE
* .035 150CM JWIRE
* 5F PIGTAIL CATHETER
* 5F JR4 DIAGNOSTIC CATHETER
* IABP KIT
* 8F 23CM SAFESHEATH (EP)
* PERCLOSE
* TR BAND

= PROCEDURE =

* PREP LEFT SIDE NECK AND CHEST (EAR TO NIPPLE AND SHOULDER TO MIDLINE)
** '''NOTE:''' The access site is not an absolute (may become axillary or subclavicular) hence the large site prep.

* PREP LEFT RADIAL 
* LEFT RADIAL ACCESSED AND 4/5F SLENDER SHEATH INSERTED
* PIGTAIL ADVANCED AND ANGIOGRAM PERFORMED. PIGTAIL LEFT IN PLACE AND USED AS REFERENCE FOR SUBCLAVIAN ACCESS.
* SUBCLAVIAN ACCESSED WITH ULTRASOUND AND FLUORO GUIDANCE USING MICROPUNCTURE KIT AND RADIAL SHEATH INSERTED.
* PIGTAIL CATHETER REMOVED
* J WIRE AND JR4 INSERTED AND DIRECTED TO DESCENDING AORTA.
* CATHETER AND SHEATH REMOVED, 8F DILATOR INSERTED, AND PERCLOSE ADVANCED FOR PRE-CLOSURE
* AMPLATZ WIRE ADVANCED, PERCLOSE REMOVED, 8F SAFE SHEATH ADVANCED.
* IABP INSERTED 
* SHEATH PEELED AWAY
* IABP SECURED WITH SUTURE AND SITE DRESSED.
* RADIAL SHEATH REMOVED AND TR BAND APPLIED