Intra-arterial anaesthetics for pain control in arterial ...
Arterial access
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Arterial access ןןןן' ןןןןן ןןןןן הההה הההההה ההההההההההה ההההההה הההה ההההה ההה"ה, הההה
description
Arterial access. פרופ' אריאל רוגין מנהל היחידה לקרדיולוגיה פולשנית מרכז רפואי רמב"ם, חיפה. Arterial access. 1. Basic principles. 2. Selection of puncture site. 3. Preparation of puncture materials. 4. Patient installation and monitoring. 5 . Sedation if indicated. - PowerPoint PPT Presentation
Transcript of Arterial access
Slide 1
Arterial access' ",
Arterial access
1. Basic principles
2. Selection of puncture site
3. Preparation of puncture materials
4. Patient installation and monitoring
5. Sedation if indicated
6. Palpation of the artery
7. Skin preparation
7. Skin preparation. Radial
Arterial Puncture (1)
Arterial Puncture (2)
Arterial Puncture (3)
Common Errors in Punctures
Common Errors in Punctures
Common Errors in Punctures
Common Errors in Punctures
What if the wire wont pass?
Advantages
Advantages
Disadvantages
Disadvantages
Major contra-indications
Allen test
Allen test
Relative contra-indication
Radial puncture
Radial puncture
What if the wire wont pass?
From the radial puncture to the ascending aorta
Radial approach
Radial artery compression
Radial or femoral?
Why radial or femoral?
Vascular complications
The cardiac catheterization handbook. 4th ed.2003. Moron J. KernIndications for alternative routes to Trans Femoral approach
Anatomy of Radial vs Femoral Artery
Vascular access Site management(2003 estimate use)
Radial approach in western Europe
Description of studies included in the Meta-Analysis
Results - clinical conditions
Safety favors RadialEntry site complications
TRA-Meta-analysis discussion
Secondary outcomes
Conclusions of this Meta-Analysis
Radial versus Femoral? Conclusions
Complications of femoral puncture
Bleeding
Hematoma
Hematoma
Pseudo-aneurysm
Pseudo-aneurysm - treatment
Distal Embolisation
Site/ Treatment of Embolisation
Preventing Puncture Site Thrombosis
Complications of radial puncture
Summary
Methods of Haemostasis
1. Manual compression
1. Manual compression: femoral artery
1. Manual compression: femoral artery
1. Manual compression: femoral artery
1. Manual compression: radial arterySheath removal
Manual compression: radial arteryBandage
Manual compression: radial arteryPatient care
1. Manual compression: brachial artery
2. Mechanical compressionFemostop
2. Manual compression:Compression with C-clamp
3. Percutaneous closure devicesAngioseal
MYNX
Exco-seal
STARCLOSE
