Radial | Successful (without complication) using femoral access with device closure | Successful (without complication) using femoral access—manual haemostasis | |
---|---|---|---|
Elective angiography | Observations/access site check every 15–30 min for 1st h. Mobilise immediately if no sedation. Discharge after 2 h | Observations/access site check every 15–30 min for 1st h. Mobilise after 30 min. Discharged min 2–3 h | Observations/access site check every 15–30 min for 1st h. Supine 1 h, sitting 2 h; mobilise 3 h. Discharge min 3–4 h |
Day case PCI | No ECG monitoring unless stated. Single 12-lead ECG post procedure. Observations/access site check every 15–30 min for 1st h, then repeated at 2 h. Mobilise when sedation worn off. Discharged at minimum 4 h | No ECG monitoring unless stated. Single 12-lead ECG. Observations/access site check every 15–30 min for 1st h, then repeated at 2 h. Mobilise >60 min and after sedation worn off. Discharge minimum 4 h | No ECG monitoring unless stated. Single 12-lead ECG. Arterial sheath removed ACT <150 s. Observations/access site check every 15–30 min pre and post sheath removal. Discharge minimum 5–6 h |
Complex PCI—elective | Cardiac monitoring required, post procedure 12-lead ECG. Observations and access site check every 15–30 min for as long as required. Mobilise when appropriate. Patients may require overnight stay, discharged following day | Cardiac monitoring required, post procedure 12-lead ECG. Observations and access site check every 15–30 min for as long as required. Mobilise when appropriate. Patients may require overnight stay, discharged following day | Cardiac monitoring required. 12-lead ECG post procedure. Arterial sheath removed when ACT <150 s. Observations and access site check every 15–30 min for as long as required. Patients may require overnight stay, discharged following day |
Inpatient PCI (urgent NSTEMI/STEMI) | Cardiac monitoring required for STEMI patients and patients with haemodynamic compromise during the procedure. Post procedure 12-lead ECG. It is recommended that access site and patient checked every 15–30 min for as long as required. Bed rest as per hospital protocol |
ACT, activated clotting time; NSTEMI, non-ST segment elevation myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST segment elevation myocardial infarction.