What is a cardiac catheterization:
Cardiac catheterization refers to the delivery of a cardiac catheter  to the heart through the femoral vein or femoral artery to examine the structures and functions of the heart and blood vessels, in order to provide the basis for further diagnosis and treatment.

Pre-cardiac catheterization preparation:

  1. The doctor will explain the purpose, process and potential risk of cardiac catheterization to the guardian . If the guardian consents this procedure, he/she needs to complete an informed consent for examination and anesthesia. 
  2. According to the child's cognitive development, the doctor and family can together explain the purpose and process of cardiac catheterization, the reason for fasting, the site of wound after the examination and the purpose of pressing a sandbag to the child.
  3. Fasting (including water, milk and food, etc.) for at least 4-8 hours before cardiac catheterization to prevent aspiration pneumonia caused by vomiting during the cardiac catheterization process.
  4. Clean both sides of groin in the shower at the night before cardiac catheterization procedure.

Examination process: 

  1. After receiving the notice from the cardiac catheterization room, nurse will ask your child to empty the bladder or change the diaper, and then take your child to the cardiac catheterization room.
  2. The doctor will give general anesthesia, in order to relieve discomfort and fear before the cardiac catheterization.
  3. A physiological monitor will be used throughout the whole process for  monitoring heart beat, respiratory rate  and oxygen saturation.
  4. After your child is asleep, the doctor will deliver a cardiac catheter to the heart via the femoral vein or femoral artery, and inject the contrast medium to check the structures and functions of the heart, or perform necessary treatments.
  5. Depending on your child’s condition, the catheterization procedure takes about 1 to 2 hours. During the examination, please wait outside and do not leave because the doctor may explain the condition or discuss further treatment options with you  in any time.

Precautions for post-examination and home care:

  1. After the cardiac catheterization, your child will need to lie flat for about 6-8 hours. The puncture site is usually pressed by a sand bag for 2 to 4 hours. Please keep the limb on the side of the puncture site straight. And do not bend it to prevent bleeding from the catheter insertion site.
  2. Within 24 hours after the procedure, please avoid the excessive movements of the limb on the side of the catheter placed. If the child is irritable, you can cradle the child in your arms. Avoid strenuous activities that can lead to wound bleeding.
  3. As your child wakes up, let him drink some water. If there is no nausea or vomiting, then start eating gradually.
  4. 24 hours after cardiac catheterization, nurse will change wound dressing.
  5. After discharge, keep the site clean and dry. So, your child can have a sponge bath first and take a shower 2 days after the procedure. No tub baths until the wound is healed completely.
  6. Bruise may appear around the wound area and this can absorb or go away on their own after a few days. If the range of bruise is gradually enlarged, please seek the medical attention immediately.
  7. If the wound is bleeding, please use a clean and dry cloth to press on the wound for 3-4 minutes. If continuous bleeding happens, please seek the medical attention immediately.
  8. The abnormal signs such as redness, swelling, or drainage at the cath site, or a fever over 38°C, or pale, painful and numb limbs, please seek the medical attention immediately.
  9. If a stent or occluder was inserted, do not pat the child’s chest and back hardly to prevent loosening.

References

  1. Brown, L., Hinsley, K., Hurting, M., Porter, C. L., & Connor, J.A. (2018). The current practice and care of paediatric patients post cardiac catheterisation. Cardiology in the Young, 29(2), 146-151. https://doi.org/10.1017/S104795111800197X
  2. Chang, Y. L., & Su, W. C. (2019). A project to reduce back discomfort in post-percutaneous coronary intervention patients. National Taiwan University Hospital Journal of Nursing, 15(2), 187-202. https://doi.org/10.6740/NTUHJN.201907_15(2).0017
  3. Zhou, L. N., & Chen, J. Y. (2019). Children's cardiology technology. In S. X. Li (Ed.), The Skills of Obstertic and Pediatric Nursing (4th ed., pp. 244-248). Hua Xing.
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