Emergency angioplasty: the charge nurse's role
Stuart Callow is charge nurse on the coronary care unit at the Norfolk and Norwich University Hospital.
Once the ambulance crew has called to say they are on the way, we register the patient, prepare their notes and find out as much about them as possible, including allergies, medical history, and if they’ve had heart surgery before.
We meet them at the ambulance bay, the doctor does an assessment and we take them up to the coronary care unit. Brian was conscious but in a lot of pain and he was very grey. We gave him strong pain relief and anti-sickness drugs and explained what was going to happen.
After the procedure, we kept him on the unit and monitored him. We hooked him up to a continuous ECG and also checked the wound where the catheter was inserted to make sure there wasn’t any bleeding.
Even after a successful procedure, the heart muscle that’s been damaged can get uncomfortable when the blood supply is restored. This can cause heart rhythm disturbances (arrhythmias), which are usually harmless but can be more serious.
We also checked blood pressure, kidney function and did other blood tests, and kept him pain-free and comfortable for 24 hours
Brian did have some unusual arrhythmias, which we corrected easily with potassium supplements. We also checked blood pressure, kidney function and did other blood tests, and kept him pain-free and comfortable for 24 hours.
We give the patient information about their tablets, which can include beta blockers, ACE inhibitors and other drugs to reduce the risk of another heart attack, such as cholesterol-lowering statins and aspirin.
Brian then went up to the ward for another two nights before being sent home. At this hospital, we call the patient 24 hours after they go home and make an appointment for them to see the cardiac rehab team a week later. They will be invited to more cardiac rehab sessions after that.