Impella Groin Management
Best Practices for Patients Supported with Impella® (Part 5)
In this video, Dr. Behnam Tehrani discusses important groin management concepts for patients supported with Impella.
Most notably, Dr. Tehrani emphasizes the importance of removing the Impella peel-away sheath after confirming Impella position and before the patient leaves the cath lab. “Don’t leave the sheath in. Make sure you pull it back, you crack it, and you take it out.” Leaving the peel-away sheath in place can cause severe bleeding and damage to the arteriotomy site from cracking or breaking. Stasis and clot formation can occur in the dead space between the 9 Fr catheter and 14 Fr sheath. Leaving the peel-away sheath in the femoral artery post-procedure can lead to limb ischemia.
Other aspects of groin management Dr. Tehrani discusses include:
- Do NOT raise the head of the bed to higher than a 30-degree angle.
- Use a knee immobilizer as needed to maintain access site straight.
- Perform dressing changes per hospital protocol, using aseptic technique.
- Assess the access site for bleeding and hematoma.
- Do a neurovascular exam on patients.
- Have 3 people present when moving the patient, with one person solely focused on maintaining Impella catheter position.
- Monitor pedal pulses.
- Maintain an activated clotting time (ACT) of 160-180 or an equivalent activated partial thromboplastin time (aPPT).
Videos in this series:
- Part 1: Overview and Initial Management Tips
- Part 2: Impella Waveforms, Positioning, and Repositioning
- Part 3: Dr. Behnam Tehrani Discusses Hemolysis
- Part 4: Addressing Impella Alarms
- Part 5: Impella Groin Management (current page)
- Part 6: Impella Weaning and Escalation
- Groin Management at the Impella Heart Pump Access Site
- Assessing and Maintaining the Impella Access Site
- Femoral Access Site Management Recommendation Download
To learn more about the Impella® platform of heart pumps, including important risk and safety information associated with the use of the devices, please visit: abiomed.com/important-safety-information