What is lntra-Aortic Balloon Pump Therapy – It is a short-term cardiac assist device placed in the descending aorta to improve myocardial oxygen supply and reduce cardiac workload by decreasing afterload.

What are the steps required for such cases?

  1. A credentialed physician will oversee the IABP management and manipulation.
  2. Only competent nurses who have demonstrated competency may nurse and adjust IABP augmentation as per physician order.
  3. All IABP patients will be continuously hemodynamically monitored via an arterial pressure line.
  4. The following assessments will be done every hour and PRN:
    1. Level of Consciousness (LOC)
    2. Heart rate and rhythm
    3. Record systolic/diastolic/mean arterial pressures and diastolic augmentation.
    4. Peripheral perfusion – pedal pulses distal to the catheter site (Doppler may be necessary to assess pulse)
    5. Color, temperature and capillary refill
    6. Sensation and movement of both lower extremities
    7. Urine output
  5. Assess insertion site each shift for redness, ooze, signs of bleeding, infection, hematoma, pain, or compartment syndrome of the affected limb and skin integrity.

What are the PROCEDURES & RESPONSIBILITY for each healthcare provider dealing with this case?

  1. Nurse:
    1. Complete and maintain IABP competency.
    2. Inform the physician of any problems encountered during IABP therapy especially in terms of complications (i.e. difficult augmentation, changes in LOC, hemodynamic instability, decreased urine output, peripheral vascular compromise) and optimizing augmentation.
    3. Be guided by AACN Procedure Manual for Critical Care, Chapter 51, p.362-80, for IABP nursing management, assessment, and augmentation adjustment.
    4. Maintain documentation as per IABP Monitoring Record.
    5. Write an order for any authorized nurse interventions when arriving ICU.
  2. Physician:
    1. Obtain informed, written consent from the patient before insertion of IAPB catheter.
    2. Notify CCU / ICU nurse that IABP catheter is correctly positioned based on an assessment of CXR.
    3. Assess hemodynamic information to direct therapeutic interventions and determine the continued requirement for IABP to remain in-situ.
    4. Perform removal of IABP catheter and achieve hemostasis at discontinuation of therapy.