UAE (Uterine Artery Embolization)

 

Post Procedure Orders:

 

  1. Encourage po fluids.
  2. Resume diet.
  3. Bed rest and R leg straight x 5 hours if manual hemostasis; 2 hours if perclose used.
  4. Meds given during procedure:
    1. Versed (varies)
    2. Toradol 30 mg IV
    3. Fentanyl (varies)

 

  1. Check Vital Signs and R groin for hematoma/ bleeding q 30 minutes x 3, then q hour x 3.
  2. d/c foley when bed rest over.
  3. Doxycycline 100 mg po BID.  (antibiotic)
  4. Naproxen 500 mg po BID. (anti-inflammatory)
  5. Zofran 4 mg IV q 4 hour prn nausea

 

PCA Orders Post Procedure:

 

  1. Dilaudid PCA 0.2 mg/cc.
  2. Basal infusion 0.2 mg/hr.  d/c infusion @ 12 MN.
  3. Demand dose 0.2 mg.
  4. Lock-out interval 15 mins.
  5. Max dose 1.0 mg.
  6. d/c PCA @ 6 am.
  7. break thru pain:  0.2 mg IV q 15 mins.
  8. Percocet one to two tabs po q 4 hour prn pain after PCA stopped @ 6 am.
  9. Sedation scale as per hospital PCA protocol.

 

Potential Complications/Problems:  (ask about allergies)

 

  1. Pain: First, you can give 2nd dose of Toradol 6 hours after first dose given.  Second, you can add Dilaudid if needed.  Dilaudid is 5-10x more potent than Morphine (1 mg Dilaudid = 5-10 mg Morphine)  Typical dose Dilaudid 0.1 to 0.2 mg, which is comparable to 2 to 4 mg Morphine IV.
  2. Fever:  It is normal to get a low grade fever/ flu-like symptoms, called post-embolization syndrome.  You can give Tylenol 650 mg po.  However, if fever > 101F, call attending.
  3.  Hematoma/Bleeding:  If expanding/ large, see the patient to assess.  Patients are on the 4th floor of Lifter building typically, past the cafeteria.  Manually compress the groin.  Then call the attending.
  4.  Insomnia:  Benadryl 50 mg po once.
  5.  Nausea:  Zofran already ordered.  Can give Compazine 10 mg po q6-8 hours prn or Phenergan 25-50 mg po q 6-8 hours prn.
  6.  Diet:  Normal adult, encourage po fluids.

 

Other:

--Home meds:  Patient can have home meds (eg Anti-hypertensives) if have them with them in the hospital, or you can give a verbal order.

 

--Any other issues not addressed above:  If minor deal with them if you can, the nurses can be of great help and you can use their advice within reason.  For any major issues call the attending.

 

Who to contact:  Before 10 pm page the attending who performed the procedure; after 10 contact then attending on call .  If calling Dr. Brady please page first/ use cell phone and not home phone as his baby is asleep at 7pm.