Each hospital has its own protocol, but in general, Angio-Seal patients should be on bed rest for 2.5 to 4 hours post-Angio-Seal placement if there is no GPIIb-IIIa infusion, such as eptifibatide, initiated during the procedure. On GPIIb-IIIa, the patient should be supine for 6 hours with head elevated gradually to less than 30°.
If manual removal is ordered, discontinue the sheath(s) when ACT is less than 180 to 200 seconds depending on your hospital guidelines. If no closure device was used, bed rest should be for 4 to 6 hours post sheath removal with gradual head elevation and ambulation prior to discharge. Difficult or multiple femoral cannulations should receive individualized care with additional observation time.