Lesson 1History review focused on cardiovascular risk factors, medications, allergies, and last oral intakeOutlines a focused pre-procedure history tailored to cath lab, emphasizing cardiovascular risk factors, current and recent medications, allergies, and precise timing and content of last oral intake to guide safety and anaesthesia planning in Canadian practices.
Structured cardiovascular risk factor reviewDocumenting medication timing and last dosesClarifying drug, food, and contrast allergiesDetermining last oral intake and NPO statusIdentifying red flags requiring physician reviewLesson 2IV access strategies: peripheral vs central, sizes for contrast/medication administration, confirming patencyDetails selection of peripheral versus central venous access, appropriate catheter gauges for contrast and medications, techniques to confirm patency, and troubleshooting infiltration, spasm, or poor flow before and during cath lab procedures.
Choosing peripheral versus central venous accessGauge selection for contrast and drug deliveryTechniques to secure and label IV linesAssessing patency, blood return, and flowManaging infiltration, extravasation, or spasmLesson 3Patient identification protocols and two-person verification methods (ID band, verbal confirmation, chart cross-check)Covers legal and safety requirements for accurate patient identification, use of ID bands and verbal confirmation, two-person verification workflows, and resolving discrepancies between wristband, chart, and electronic records before any invasive step.
Required identifiers for cath lab patientsVerbal ID checks with cognitively impaired patientsTwo-person verification workflow at procedure startReconciling ID band, chart, and EMR dataDocumenting and escalating ID discrepanciesLesson 4Pre-procedure fasting rules, premedication (analgesia, anxiolytics), and allergy prophylaxis protocols (contrast/iodine allergy)Explores fasting intervals for solids and liquids, safe use of premedication such as analgesics and anxiolytics, and evidence-based allergy prophylaxis for contrast or iodine reactions, including screening, risk stratification, and documentation.
Standard NPO times for solids and clear fluidsPremedication choices and timing in cath labScreening for prior contrast or iodine reactionsSteroid and antihistamine premedication regimensManaging high-risk allergy or anaphylaxis historyLesson 5Medication reconciliation and peri-procedural medication management (antiplatelets, anticoagulants, antihypertensives, nitrates, diabetic meds)Focuses on structured medication reconciliation, identifying high-risk drugs, and planning peri-procedural management of antiplatelets, anticoagulants, antihypertensives, nitrates, and diabetic medications to balance bleeding, ischemic, and hemodynamic risks.
Collecting a complete pre-procedure drug listManaging dual antiplatelet therapy before PCIHandling warfarin and direct oral anticoagulantsAdjusting antihypertensives and nitrates safelyPeri-procedural management of diabetic agentsLesson 6Assessing and optimizing comorbidities relevant to PCI: hypertension, diabetes, chronic kidney diseaseReviews assessment of hypertension, diabetes, and chronic kidney disease before PCI, including vital signs, glycemic status, renal function, and strategies to optimize blood pressure, glucose, and nephroprotection to reduce peri-procedural complications.
Pre-procedure blood pressure assessment targetsGlycemic control and hypoglycemia preventionEvaluating renal function and eGFR thresholdsHydration and contrast minimization strategiesWhen to delay PCI for comorbidity optimizationLesson 7Consent verification, documentation, and handling questions about risks and benefitsExplains legal and ethical aspects of informed consent, verifying that consent is valid and complete, ensuring documentation is accurate, and addressing patient questions about risks, benefits, and alternatives in understandable language.
Elements of valid informed consentChecking form completeness and signaturesAssessing patient capacity and surrogatesExplaining common cath lab risks and benefitsDocumenting questions and provided answersLesson 8Communication techniques to reduce anxiety and provide brief procedural explanations in lay termsDescribes patient-centred communication methods to reduce anxiety, including building rapport, using plain language explanations, checking understanding, and addressing common fears about pain, sedation, and outcomes in the cath lab setting.
Establishing rapport on first patient contactUsing lay terms to explain PCI and angiographySetting expectations about pain and sedationResponding to common fears and misconceptionsTeach-back methods to confirm understandingLesson 9Interpreting pre-procedure labs and investigations relevant to cath lab (CBC, electrolytes, creatinine/eGFR, coagulation panel, troponin, ECG)Covers interpretation of key pre-procedure tests, including CBC, electrolytes, creatinine and eGFR, coagulation studies, troponin, and ECG, and how abnormal results influence timing, access choice, and anticoagulation strategies.
CBC parameters relevant to bleeding riskElectrolyte abnormalities affecting arrhythmiasCreatinine, eGFR, and contrast risk assessmentCoagulation panel and anticoagulation planningECG and troponin in acute coronary syndromes
