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The Cardiology Ward cares for patients with coronary artery disease who often undergo coronary angiography and intervention. Patients receive investigations like echocardiograms and exercise tolerance tests, as well as interventions such as pacemaker insertion. The ward cares for a diverse group of patients with complex histories. The Cardiac and Thoracic Critical Care Unit has two sides - one for acute cardiac medical issues and one for post-surgery care. It admits patients for conditions like heart attacks, heart failure, and arrhythmias. It closely monitors patients and some require ventilation. The unit also cares for post-cardiothoracic surgery patients.

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46 views4 pages

Ad Assignment

The Cardiology Ward cares for patients with coronary artery disease who often undergo coronary angiography and intervention. Patients receive investigations like echocardiograms and exercise tolerance tests, as well as interventions such as pacemaker insertion. The ward cares for a diverse group of patients with complex histories. The Cardiac and Thoracic Critical Care Unit has two sides - one for acute cardiac medical issues and one for post-surgery care. It admits patients for conditions like heart attacks, heart failure, and arrhythmias. It closely monitors patients and some require ventilation. The unit also cares for post-cardiothoracic surgery patients.

Uploaded by

Abdul Rafay Yusuf
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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The majority of patients in the Cardiology Ward have some degree of coronary

artery disease, and most undergo coronary angiography and intervention at


some point during their stay.

Patients may also undergo other cardiac investigations including:

 transthoracic echocardiogram, during which a device called a transducer


is passed over the skin recording sound wave echoes which are converted
into moving images on a screen
 transoesophageal echocardiogram, in which the patient swallows the
transducer inside a flexible tube which is guided into the oesophagus
 exercise tolerance tests (ETT) 
 cardiac nuclear studies 
 cardiac MRI. 

Some patients require interventions including:

 insertion of a permanent pacemaker (PPM)


 internal cardiac defibrillator (ICD)
 electrophysiology studies (EPS)

radio frequency ablation, a procedure where catheters are placed inside the
heart and a map of electrical activity is charted. When the source of an
abnormality is found, high-energy radio waves are used to remove the tissue. 

Some of our patients have very complex clinical histories, including congenital
heart problems or previous aortic valve replacement. As a result, some are
suffering from heart failure and endocarditis, requiring further surgery and long
term antibiotics. They might be with us for weeks or months, meaning that there
is always a variety of patients on the ward, men and women, young and old,
short and long stay.

The Cardiac and Thoracic Critical Care Unit (CTCCU) is a specialist unit. We
admit patients with a range of cardiac, thoracic and vascular problems, both
surgical and medical

There are two sides to the unit; one for patients with acute cardiac medical
problems (Coronary Care Unit), and one for patients who have undergone
cardiac and thoracic surgery (Cardiothoracic Critical Care).

Coronary Care Unit


The Coronary Care Unit (CCU) cares for patients who have heart disease and
occasionally other medical or surgical problems.
Conditions such as myocardial infarction (heart attack), angina (chest pain), left
ventricular failure (LVF) and arrhythmias (abnormal heart beats) are common
reasons to be admitted to CCU.

A patient having a heart attack may be admitted directly to the CCU, transferred
to the Cardiac Angiography Suite for a primary coronary (cardiac) angioplasty
and then returned to the CCU for ongoing care. Patients with cardiac chest pain,
but not having a heart attack, may be admitted to the CCU before and/or after the
placement of stents in coronary blood vessels.

Patients with acute shortness of breath as a result of the heart not pumping
efficiently (LVF), are given medication and helped to breathe. A patient with an
abnormally fast, slow or irregular heart beat may be admitted to the CCU so that
we can monitor heart rate and rhythm and provide treatment.

The CCU can monitor the heart's rhythm, blood pressure and oxygen levels
continuously, and the nursing team record and interpret heart traces
(electrocardiogram/ECG). While a patient is in the CCU a cardiologist may
perform a specialised test, such as echocardiography, which looks at the
pumping function of the heart.

Most patients in the CCU can breathe without the assistance of a machine
(ventilator) - though some will need oxygen (either by nasal prongs or mask).
Patients who need additional support from a ventilator will be transferred to the
intensive care unit.

Go to top…

Cardiothoracic Critical Care


Patients are admitted if they need intensive monitoring and care following
cardiothoracic surgical procedures.

These include:

 coronary artery bypass grafting


 aortic or mitral valve replacements/repairs
 complex thoracic aortic surgery
 thoracic surgery
 'ventricular assist device' implantation
A mechanical pump that takes over the function of the damaged ventricle
of the heart and restores normal blood flow. 

Patients are admitted immediately from theatre and each is cared for by their
own nurse until they are able to come off the ventilator.
Once they are stable, they are moved to the High Dependency Unit (HDU), and
from there to the Cardiothoracic Ward to continue their recovery.

Patients who develop complications may stay for many days, or occasionally
months. They may require long-term support with drugs or devices that support
their heart.

Patients who come to the unit have either been on the waiting list for surgery or
come as emergencies. Patients are referred from within the Oxford University
Hospitals by local district general hospitals and also from further afield for some
specialist surgery.

A catheterization laboratory or cath lab is an examination room in a hospital or clinic


with diagnostic imaging equipment used to visualize the arteries of the heart and the
chambers of the heart and treat any stenosis or abnormality found.

Equipment[edit]
Most catheterization laboratories are "single plane" facilities, those that have a single X-
ray generator source and an image intensifier. Older cath labs used cine film to record the
information obtained, but since 2000, most new facilities are digital. The latest digital cath
labs are biplane (have two X-ray sources) and digital, flat panel labs.

A typical Cardiac Catheter Lab in the UK

A typical 'Cath Lab' will consist of:

 Patient Couch
 A floor or ceiling mounted Image intensifier
 Set of viewing monitors
 Realtime ECG/Blood pressure/Oxygen Saturation measurements with software to record
and measure these when needed
 Injector Pump used for imaging the Left Ventricle or Aorta
 X-ray software for the recording and playback of the Fluoroscopy runs acquired during
the procedure
 Diagnostic Catheters
 Guide catheters
 Guidewires
 Angioplasty balloons
 Stents (drug eluting and bare metal)
 Sheaths
 Closure devices
 General nursing supplies
 Defibrillator
 Drugs
 Wireless Headset Systems for Cath Labs [1]
 Recovery bays
 Reporting station
 Scrub area

Staff[edit]
Cardiac catheterisation laboratories (or Cath Lab) in the UK are usually staffed by a
multidisciplinary team. This includes a Medical Practitioner (normally either a
ConsultantCardiologist or Radiologist), a Cardiac Physiologist, a Nurse and a Radiographer.

Medical Practitioner The Consultant Cardiologist is responsible for gaining arterial access,


inserting a sheath into either the radial or femoral artery, passing a wire and catheter into the
coronary artery and selectively injecting contrast media into the coronary arteries. They then
interpret the images taken to ascertain where the narrowed or blocked artery has the
problem. They use a variety of techniques and imaging tools to work the size of things such
as balloons and stents.

Cardiac Physiologist Cardiac Physiologists usually set up what is known as a transducer to


monitor pressure in the arteries. They also have a live view of the patients ECG so they can
tell whether or not there is a problem being caused by the insertion of the catheter into the
heart to the electrical pathways. The physiologist will also set up a temporary pacemaker if
the procedure is an angioplasty or a PCI. Finally, they also set up defibrillators on to the
patient for emergency use if needed.

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