Tamra Langley
University of Kentucky, USA
Title: Enhancing education in critical care: Complications from carotid artery stenting and implications for nurses and advanced practice providers in the ICU
Biography
Biography: Tamra Langley
Abstract
Introduction: Education on the possible complications after carotid artery stenting is briefly described in undergraduate nursing and graduate nurse practitioner studies. Because of the femoral arterial cannulation needed to access the area of stenosis of thrombosis and the path taken to both, damage can occur along the access route. Physical examination, proficient use of the National Institute of Health Stroke Scale (NIHSS) and the knowledge of abnormal anatomical changes post-procedure are paramount in ensuring the patient’s successful hospital course.
Methodology: Complications of carotid artery stenting include localized hematoma, pseudoaneurysm, arteriovenous fistula, retroperitoneal hematoma, carotid artery dissection, embolic stroke, intracranial hemorrhage, acute stent thrombosis, hypotension and bradycardia and carotid perforation. This report follows the complications of a 50-year-old female patient who had an elective carotid artery stenting (CAS). She developed subsequent retroperitoneal hematoma, catastrophic neurologic changes and eventual cerebral herniation. The importance of enhanced education for neurologic and neurovascular assessment immediately following the procedures and in the following days for those who are seeking certification in the acute care setting is of utmost importance.
Findings: Complications of the iliac arteries after femoral cannulation post CAS can lead to significant intra-abdominal hemorrhage. Education about the importance of early detection and continuous monitoring of these conditions can help to minimize negative outcomes.
Conclusions: Enhanced education for critical care nurses and nurse practitioners about the physical presentation of certain complications of CAS ensures the highest delivery of care.