Impella

Daniels single access Impella - DRAFT

Equipment

• 16F Dryseal
• 8fr guide
• 6fr Shuttle 90cm

Hybrid OR Impella via Subclavian conduit

Equipment

• Pack*
• JR4
• Angled Pigtail
• .025 exchange for BP removal
• Perclose
• .035 exchange
• 6-8.5 statlock
• 18” cover for foot pedal*
• 500ml bag heparinized saline

*Trust me on this...

Procedure

• Enter an order for CCL in EPIC
• Open x-ray and McKesson using entered order.
• Procedure in McKesson is “(33990)INSERT VAD ARTERY ACCESS”
• Free-Text note that McKesson is open for billing and equipment only, not procedural charting. See Anesthesia and OR nurses notes.
• Put input 4in1 B on V-integration 2 for TTE on the fluoro screen.
• Open and cut femoral drape across entire width at the level of the femoral fenestrations.
• Place over legs after surgical draping using remaining adhesive area to secure.
• Put OR light camera in place to see the surgical site to monitor progress from control room.
• Tuck surgical drapes under mattress to expose controls.
• Ask OR for 1 pack Ray-Tec sponges for wipes.
• Do the thing (Insert 5.0 Impella)
• Remove the other thing (ECMO / Balloon pump / Impella)
• Statlock is for the chest/abdomen loop of the Impella similar to Leave in swan.
• Document times and doses in McKesson - Write down for book.
• Save 2 stickers
• Close x-ray and archive to EMIM_CATH
• Capture charges for McKesson
• Generate and sign McKesson, then print device list in CCL.
• Sticker goes in room 6 book for tracking, second sticker is for device list
• Bill device list in Epic

Axillary Impella/IABP - DRAFT

Equipment

(1)   Micropuncture

(1)   Perclose

(1)   Probe Cover

(1)   0-Ethebond Suture

(1)   Tournaquick

(1)   IABP/Impella

(1)   .035 X 150cm J Wire

Procedure:

Prior to prepping patient, place a rolled up towel down patients T-Spine between shoulder blades to lift the chest and allow the shoulders to drop and open up the axilla.

Prep and drape patient as you would for a pacemaker implant.

Access is ultrasound guided; use a dilator from the IABP/Impella kit to dilate before pre-closing. After pre-close is complete the device is delivered as usual.