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(Continued from page 7…. Cardiac Devices Update)
Elevate head of bed if not contraindicated. On occasions, a femoral venous approach is used with CRT-D's when
the subclavian approach fails to insert the LV
lead.
Watch for signs of pneumothorax.
Watch for adverse reactions to medications. Versed, Fentanyl, Phenergan, Benadryl, Propofol are the medications
commonly used for sedation. An antibiotic is also used IV and as an irrigant to the device pocket prior to incision
closure.
For cardiac emergencies and external defibrillation is necessary, keep paddles off the device, use anterior-lateral or
anterior-posterior paddle position.
DISCHARGE INSTRUCTIONS:
Carry identification card at all times
Watch incision for signs of infection
Do not wet, submerge incision in lake, tub or pool for 4 weeks
No heavy lifting, strenuous activity, no activity involving raising the elbow above shoulder for 4-6 weeks.
Avoid highly magnetic fields, construction sites, junkyards
No MRI, lithotripsy, nerve stimulators, OK to have CAT Scans
Use cell phones on opposite side of device.
Discuss any surgery of procedure to your doctor. Re-programming your ICD before and after surgery may be necessary.
For ICD shocks, call the doctor ASAP after one shock, for 2 shocks, must call the doctor immediately, for 3 shocks, must call 911 to be transported to emergency room immediately.
Medications ordered by the physician should be continued and should be used in conjunction with having a device
REFERENCES:
Hope for Patients with Heart Failure, 2004 Guidant Corporation.
Guidant Institute For Therapy Advancement Allied Health Professional Program Manual, updated February 2005, St Paul, Minneapolis.
Medtronic Basic ICD Workshop Manual, Kansas City District, Overland Park, Kansas, January 2005
Medtronic Advanced ICD Workshop Manual, Kansas City District, Kansas, January 2005
http://www.Guidant.com
http://www.Medtronic.com
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