Lesson 1History review focused on cardiovascular risk factors, medications, allergies, and last oral intakeOutlines a focused pre-procedure history suited to cath lab needs, stressing cardiovascular risk factors, current and recent medications, allergies, and exact timing and type of last oral intake to guide safety and anaesthesia planning in resource-limited settings.
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 choice of peripheral versus central venous access, suitable catheter sizes for contrast and medications, methods to confirm patency, and fixing issues like infiltration, spasm, or poor flow before and during cath lab procedures in Zambian clinics.
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 rules for correct patient identification, use of ID bands and verbal checks, two-person verification processes, and sorting out differences between wristband, chart, and electronic records before any invasive action in Zambian facilities.
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 periods for solids and liquids, safe premedication like analgesics and anxiolytics, and evidence-based allergy prevention for contrast or iodine reactions, including screening, risk grouping, and record-keeping in Zambian cath labs.
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, spotting high-risk drugs, and planning peri-procedural handling of antiplatelets, anticoagulants, antihypertensives, nitrates, and diabetic meds to balance bleeding, ischaemic, and blood pressure risks in local settings.
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, blood sugar levels, kidney function, and ways to optimise blood pressure, glucose, and kidney protection to cut peri-procedural problems in Zambia.
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 sides of informed consent, checking that consent is valid and full, ensuring records are correct, and answering patient questions on risks, benefits, and options in simple language suitable for Zambian patients.
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-focused communication ways to ease anxiety, including building trust, using simple language, checking understanding, and tackling common fears about pain, sedation, and results in the cath lab environment in Zambia.
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 reading key pre-procedure tests like CBC, electrolytes, creatinine and eGFR, clotting studies, troponin, and ECG, and how odd results affect timing, access choice, and blood thinning plans in Zambian healthcare.
CBC parameters relevant to bleeding riskElectrolyte abnormalities affecting arrhythmiasCreatinine, eGFR, and contrast risk assessmentCoagulation panel and anticoagulation planningECG and troponin in acute coronary syndromes
