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Objectives To describe, compare and examine self-reported anxiety levels and associated physiological responses of blood pressure, heart rate and respiratory rate of patients undergoing cardiac catheterisation (CATH). Methods Repeated measure design was used to assess a sample of 100 patients who had undergone cardiac catheterisation (CATH) in a major specialised heart institute in Jordan. Results Patients’ anxiety levels differed significantly across the three time periods (baseline, prior to and post CATH). The mean anxiety levels prior to CATH scored with State Anxiety Inventory (M = 52.14, SD = 6.0) was significantly higher than that at baseline (M = 48.35, SD = 5.6) and post CATH (M = 36.27, SD = 9.7). Conclusion Most patients experienced anxiety when scheduled for a CATH. The highest level of anxiety was within two hours prior to the procedure and the lowest was post procedure.

Cardiac hemodynamic assessment during cardiopulmonary exercise testing (CPET) is proposed to play an important role in the clinical evaluation of individuals with cystic fibrosis (CF). Cardiac catheterization is not practical for routine clinical CPET. Use of oxygen pulse (O2pulse) as a noninvasive estimate of stroke volume (SV) has not been validated in CF. This study tested the hypothesis that peak exercise O2pulse is a valid estimate of SV in CF. Measurements of SV via the acetylene rebreathe technique were acquired at baseline and peak exercise in 17 mild-to-moderate severity adult CF and 25 age-matched healthy adults. We calculated [Formula: see text]. Baseline relationships between SV and O2pulse were significant in CF ( r = .80) and controls ( r = .40), persisting to peak exercise in CF ( r = .63) and controls ( r = .73). The standard error of estimate for O2pulse-predicted SV with respect to measured SV was similar at baseline (14.1 vs 20.1 mL) and peak exercise (18.2 vs 13.9 mL) for CF and controls, respectively. These data suggest that peak exercise O2pulse is a valid estimate of SV in CF. The ability to noninvasively estimate SV via O2pulse during routine clinical CPET can be used to improve test interpretation and advance our understanding of the impact cardiac dysfunction has on exercise intolerance in CF.

The elimination of catheter-related bloodstream infections (CR-BSI) requires meticulous intravenous (IV) catheter care. There are three different types of needlefree connectors and one intraluminal protection device that require different care regimens, including the correct usage of disinfectants, flushing techniques, and clamping sequences. The nurse must be able to identify which connector is in use and select the appropriate care. This care must be followed not only in the inpatient unit by the bedside nurse but also in areas that are providing diagnostic procedures such as the cardiac cath lab. Since bacterial adhesion to the intraluminal catheter wall is the primary building block of a CR-BSI, which may not present until days after initial inoculation, preventing intraluminal fluid pathway contamination is paramount with every access. In addition, many institutions have more than one type of connector available. This complicates the provision of consistent safe care. Split septum, negative mechanical valves, positive pressure mechanical valves, and intraluminal protection devices have specific care and maintenance requirements. This article discusses the different connector types, why each requires special care, how intraluminal fluid pathway contamination can lead to CR-BSI, and how simple nursing care and maintenance practices of connector septum swabbing and catheter flushing by the cardiac cath nurse can help prevent this serious complication.

The highly specialized skills of registered nurses (RNs) in the cardiac catheterization laboratory pose unique problems for administrators when dealing with staffing shortages. Faced with a temporary reduction of 25% of the total RN labor and 50% of the procedural RN labor, a cardiac catheterization laboratory in north central Illinois resorted to cross-training RNs through all the phases of care, including preadmission, preprocedural, intraprocedural, and postprocedural care. This creative staffing solution solved the short-term staffing issue and had the added benefit of improving interpositional team knowledge and morale.