Diagnostic Tests

[Nurse Mary]

I am hoping some of you can help me with these questions....
A little back ground..I am the charge nurse for an out patient surgery department in a small rual hospital. We have recently started receving the post procedure patients from the intervention radiology department (that was the cardiac cath lab but the volumes have been so low that the intervention radiology services have been added to increase patient volumes).
My experience with arterial access is from my ICU days...then an arterial access was for monitoring purposes only.
A patient was recived to our post-op area from intervention radiology (IR) that had an bi lateral lower extremety angiogram. When the patient was brought to our department the arterial sheath was still in place with 0.9 NS infusing at 50cc/hr via pump per Dr. order...?? The nurses that work in the IR department are from our cardiac rehab, ICU, and ER department. But these are all new procedures for this hospital. I have major concerns that I want adressed by our hospitals senior nursing administration. But I need some info on what other places are doing. Please share some insight.

My foremost concerns are:
1.) We are a post-op area the staffing ratio to patient is not 1:1, or do we have the ability to "monitor" unless the nurse stays at the bed side.

2.) The insertion site was oozing despite pressure being applied, the patient was sent back to IR and was flighted out to a larger hospital that deals with this type of patient on a daily basis.

3.) Staff has had little if any training/inservice on the post care of this type of patients.

4.) Is this "infusing fluids thru the "sheath" common practice (I'm not talking about a 3cc heparinizing
infusion) should I be concerned about an order to infuse IV fluids at 50cc/hr thru femoral sheath ??

5.) Oh here is another kicker...there is no vascular surgen on staff at our hospital. Thats why the patient had to be careflighted out.

[UroDoc]

Sounds like an inservice needs to be done by the doctors performing the procedures