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IR CLINICAL PARAMETERS SHORTLIST:

 

  1. Allergies (esp contrast or mod sedation):

  2. GFR >45 (last 2-3 results):

    1. ​Consider use of CO2 contrast agent or gadolinium based agent

  3. Platelets >50k:

    1. If low, 10U plts will inc count 50-100k

  4. INR <1.5-2.0 :

    1. check for liver dz or consumptive coagulopathy

  5. PTT (nl 25-30 sec):

  6. Last meal / NPO status (6 hrs for CS):

  7. Mallampati class / oral airway exam:

    1. (1):  uvula, soft palate, and tonsillar pillars

    2. (2):  uvula only

    3. (3):  base of uvula

    4. (4):  no soft palate

  8. ASA Class:

    1. (1) is normal, (5) patient needs procedure to live.  (2,3,4) is mild, mod, severe disease.  (3) is usu safe bet. (4+) need ASA consult

  9. Check for anticoag / antiplatelet meds:  

    1. Coumadin- hold, give vit K 1-3 mg IV, give FFP 2-4 bags

    2. Heparin- hold heparin gtt 2-4 hrs prior

    3. Lovenox- hold 12 hrs prior dose (or 24, varies)

    4. Plavix (has to be held 7d), check for recent coronary stent

    5. ASA, also should hold 7-10 d but varies

    6. newer anti-thrombin agents- stop agent, look up parameters

  10. Antibiotic Periprocedural:

    1. Tunnelled Venous Access: 1-2G of Cefazolin, 600 mg Clinda if PCNA

    2. Biliary (not for changes, acc. to KV): 1 G Ceftriaxone, PCNA:  Vanco

    3. EndoUrologic procedures (not changes, acc. to KV): 1 G Ceftriaxone, PCNA:  Vanco, Cipro and Cefazolin also reasonable (Christiano)

    4. If in doubt, from brief lit review, appears 1 G of Ancef aka Cefazolin is reasonable for many procedures (SG)

    5. good link- guidlines

  11. DNR / DNI

    1. Know if the patient is DNR/ DNI and have THE ATTENDING sign the form

    2. Different perspectives, some attendings have it rescinded all times, some are ok with the pt's preference

    3. This does come up (form is signed and pt. dies)

  12. Young Female Pt. with ?Pregnancy

    1. Have pt. fill out radiation risk form or check urine beta HCG 

 

 

IF DONT KNOW ABOVE--> DONT SCRUB - SG

 

 

DysCath

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ANTICOAGULANT GUIDLINES

 

Pregnant Patient Guidelines

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