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  /Title (tr-band-removal.pdf)
  /Creator (Cheatography)
  /Author (educator)
  /Subject (TR Band removal Cheat Sheet)
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{TR Band removal Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{educator} via \textcolor{DarkBackground}{\uline{cheatography.com/131177/cs/26338/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}educator \\
  \uline{cheatography.com/educator} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 27th January, 2021.\\
   Updated 27th January, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{p{0.4977 cm} p{0.4977 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{TR band removal without anticoagulation}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{1.Pt will return from cath lab with TR band applied and inflated. Cath lab personnel will bring the special TR band syringe to the bedside with the patient.} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{2.The band holds up to 18ml of air, please clarify with cath lab RN how much air is in the balloon upon arrival.} \tn 
% Row Count 7 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{3. Maintain initial pressure for 45 minutes. This is from the time it was inflated. Clarify with the cath lab RN what that time was.} \tn 
% Row Count 10 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{4. At the 45 minute mark, start deflating the balloon by 3 ml every 15 minutes.} \tn 
% Row Count 12 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{5. If bleeding occurs, reinflate the TR band to the previous volume (but never more than 18ml) and maintain that volume for 30 minutes before starting the weaning process again.} \tn 
% Row Count 16 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{6. As long as no bleeding occurs, take 3 ml of air from the TR band Q15 minutes until the band is completely deflated.} \tn 
% Row Count 19 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{7. Keep the deflated TR band in place for 60 minutes before attempting removal.} \tn 
% Row Count 21 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{8. After 60 minutes has passed and no bleeding has occurred, the TR band may be removed and sterile gauze with tegaderm should be applied.} \tn 
% Row Count 24 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{9. The patient may ambulate during the 60 minute period when the band is deflated. Otherwise, they should remain in the bed or chair during the weaning process.} \tn 
% Row Count 28 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{TR band removal WITH anticoagulation}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{1.Pt will return from cath lab with TR band applied and inflated. Cath lab personnel will bring the TR band syringe to the bedside with the patient.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{2.The band should remain at the initial pressure for 2 hours after the Angiomax gtt has completed.} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{3.At that time, start to remove 3 ml of air Q15 minutes.} \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{4. Continue step 3 until the balloon is completed deflated.} \tn 
% Row Count 9 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{5. If bleeding occurs, re-inflate the balloon with 3 ml to the previous pressure (no greater than 18ml) and wait 30 minutes before restarting the weaning attempt.} \tn 
% Row Count 13 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{6. Continue deflating the TR band by 3 ml of air Q15 minutes until completely deflated.} \tn 
% Row Count 15 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{7. After all the air is removed, the TR band should stay in place for 60 minutes.} \tn 
% Row Count 17 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{8. If no bleeding occurs, remove the TR band and apply a sterile 2X2 gauze and tegaderm.} \tn 
% Row Count 19 (+ 2)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{9. The patient may ambulate during the 60 minute period when the band is deflated. Otherwise, they should remain in the bed or chair during the weaning process.} \tn 
% Row Count 23 (+ 4)
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\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Nursing assessment}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{1. Monitor VS Q15 minutes X 4, Q30 minutes X 2, Q1H X 4} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{2. Use the non-procedure arm for blood pressure measurements if able.} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{3. Monitor and assess Neurovascular function of the procedural limb with the ordered VS.} \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{4. Monitor SpO2 on the index finger distal to the TR band.} \tn 
% Row Count 8 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{5. Notify MD for absent or cool, pale, painful extremity of procedural extremity.} \tn 
% Row Count 10 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{6. If after the TR band is removed and a hematoma develops, apply direct manual pressure over the puncture site using three fingers for at least 10 minutes.} \tn 
% Row Count 14 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{post procedure instructions}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{1. Instruct patient not to manipulate wrist for 24 hours. Avoid activities such as golf, tennis or carpentry.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{2. Dressing can be removed after 24 hours. They may leave it OTA at that time or cover with a band-aid.} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{3. Instruct patient If minor oozing occurs late (after D/C), apply a band-aid.} \tn 
% Row Count 8 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{4. No soaking wrist for 3 days. Showering is permissible.} \tn 
% Row Count 10 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{5. No driving for 48 hours.} \tn 
% Row Count 11 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{6. No lifting greater than 5 lbs, with affected arm for 7 days.} \tn 
% Row Count 13 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{7. If late severe bleeding should occur, instruct patient on how to hold pressure on the puncture site and call for medical help.} \tn 
% Row Count 16 (+ 3)
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{TR band QR code for application and removal}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{5.377cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/educator_1611712074_Generated_QR_Code TR band application and removal.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{at approximately 4 minutes in the video, it shows the removal process of the TR band.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

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