Guidelines for appropriate patient assessments after procedures are often not evidence based. The standard after removal of temporary pacer wires is to monitor “routine” vital signs (VS) at set intervals. To determine if current procedures for obtaining VS after temporary pacemaker wire removal (TPWR) effectively identify risks for cardiac tamponade (CT), Mahon and colleagues reviewed 23 717 cardiothoracic surgery cases with 23 reoperations for CT following TPWR. Blood pressure changes were the most common single symptom after TPWR and before reoperation for CT. Other findings were bleeding in 6 cases (26%), dyspnea in 26% of reviewed patients, and infrequent heart rate changes. Based on these findings, the authors suggest the following:
Broadening VS polices after TPWR to focus on 3 areas: hypotension, abnormal bleeding, and dyspnea.
Educating patients on potential symptoms of CT after TPWR and seeking help immediately if changes occur.