Contraindications

1. Uncontrolled hypertension - Uncontrolled hypertension is defined as an average

systolic blood pressure ≥140 mmHg or an average diastolic blood pressure
≥90mmHg, among those with hypertension. Over time, uncontrolled
hypertension damages the arteries, contributing to their stiffening. As the arteries
become narrower and less flexible, the heart has to work harder to move blood
through the body

2. Severe anemia -  Anemia occurs when there are not enough healthy red blood cells
to carry oxygen to your body's organs. Severe anemia corresponds to a level less than
7.0 g/dl.

3. Ventricular fibrillations - is a type of abnormal heart rhythm (arrhythmia). During

ventricular fibrillation, disorganized heart signals cause the lower heart chambers
(ventricles) to twitch (quiver) uselessly. As a result, the heart doesn't pump blood to
the rest of the body

4. Acute stroke- occurs when the blood supply to the brain is disrupted, injuring brain
cells and tissues. 

5. Gl bleeds- GI bleeding is not a disease, but a symptom of a f a disorder in your

digestive tract or disease.

6. Allergy to contrast - Contrast is a substance used in many types of imaging

procedures. It helps your doctor see the inside of your body more clearly. Contrast is
also called contrast dye, contrast agent, or contrast media. Immediate reactions take
place within an hour after injection of the contrast medium. These reactions can be
mild (nausea, vomiting, mild urticaria, pallor), moderate (severe vomiting, extensive
urticaria, dyspnea, rigor, laryngeal edema) or severe (pulmonary edema, cardiac
arrhythmias or arrest, circulatory collapse).

7. Renal failure - ccurs when your kidneys suddenly become unable to filter waste
products from your blood. When your kidneys lose their filtering ability, dangerous
levels of wastes may accumulate, and your blood's chemical makeup may get out of
balance.

8. Decompensated congestive failure- is functional change in the heart leads to its

inability to eject and/or accommodate blood within physiological pressure levels.

9. Active infection or febrile illness - marked or caused by fever : feverish.

10. Electrolyte abnormalities -The symptoms of electrolyte imbalance are based on

which of the electrolyte levels are affected. If your blood test results indicate an
altered potassium, magnesium, sodium, or calcium levels, you may experience
muscle spasm, weakness, twitching, or convulsions.

11. Severe coagulopathy- condition in which the blood's ability to clot is impaired. This
condition can cause prolonged or excessive bleeding, which may occur spontaneously
or following an injury.
Equipment and materials needed

 Noninvasive hemodynamic monitoring that includes BP and multiple ECG tracings is necessary to
continuously observe for dysrhythmias or hemodynamic instability.

 Noninvasive hemodynamic monitoring most common method of measuring

blood pressure both in outpatient and inpatient settings. It involves an air-filled
cuff that can measure the blood pressure manually (by the operator) and
automatically (by the device).
 Noninvasive hemodynamic monitoring system can safely monitor previously
unmonitored, at-risk patients to assess and rapidly respond to formerly unseen
changes in hemodynamic status by getting accurate, real-time blood pressure
and hemodynamic measurements has never been easier or safer.
 The use of smaller (4 or 6 Fr) catheters, which are more amenable to shorter recovery times, is
common in diagnostic cardiac catheterizations.

 Cardiac catheterization Various instruments are available for arterial access for cardiac
catheterization. The basic components include a needle, wire, and sheath.

During a cardiac catheterization, a long, narrow tube called a catheter is inserted

through a plastic introducer sheath (a short, hollow tube that is inserted into a blood
vessel in your leg or arm). The catheter is guided through the blood vessel to the
coronary arteries with the aid of a special x-ray machine.
 There are several methods available to achieve arterial hemostasis after catheter removal, including
manual pressure, mechanical compression devices such as the FemoStop (placed over puncture site
for 30 minutes), and percutaneously deployed devices. The latter devices are positioned at the
femoral arterial puncture site after completion of the procedure. They deploy collagen (VasoSeal),
sutures (Perclose, Techstar), or a combination of both (AngioSeal).

 FemoStop is an exciting new femoral compression device being used on patients by

critical care nurses. It is now common practice in many settings for the nurse to
remove post-angioplasty and post-cardiac catheterization sheaths.

 (VasoSeal) in reducing patient immobilisation after cardiac catheterisation from a

percutaneous femoral arterial approach. 
 Sutures (Perclose, Techstar) -  Percutaneous suture repair of the femoral artery after
cardiac catheterisation is a safe and effective method to achieve immediate
haemostasis.

 Angio-Seal is a closure device. It stops the bleeding after angiography procedures,
such as cardiac catheterization.