Cath Lab Digest - January 2008 - (Page 1)

Ask the Clinical Instructor: Todd Ginapp, EMT-P, RCIS, FSICP Explaining the ACT test. Page 40 Clinical Editor’s Corner: Morton Kern, MD Do You Need an Intra-aortic Balloon Pump? Page 4 Januar y 2008, vol.16, no.1 A Product, News and Clinical Update for the Cardiac Catheterization Laboratory Specialist Cath Lab Spotlight Clinical Update Contrast Media Use in High-Risk Patients Cath Lab Digest talks with Roxana Mehran, MD Dr. Mehran is Associate Professor of Medicine at Columbia University Medical Center, Director of Outcomes Research, Data Coordination & Analysis for the Center for Interventional Vascular Therapies, Cardiovascular Research Foundation, Director of Data Coordinating & Analysis Center, New York City, New York. Left to right: Olivia Maynard, RT(R), Sara Calhoun, RT(R), Dee Mallory, RT(R), Dan Overton, RN, Nanette Jackson, RT(R), Director, Cardiovascular Services, and Becki Lawhorn, RT(R). Central Baptist Hospital Nanette Jackson, RT(R), Director, Cardiovascular Services, Debbie Gatewood, RN, BSN, Cath Lab Educator, and Christine McIntyre, RN, BSN, MHA, Director of the Central Baptist Heart and Vascular Institute, Lexington, Kentucky What is the size of your cath lab facility and number of staff members? Central Baptist is a 374-bed tertiary hospital. The invasive cardiology department includes 5 cardiac cath labs, 3 electrophysiology (EP) labs and a 28bed observation unit. The staff composition in our lab consists of: • 13 registered nurses (RNs); • 13 registered radiologic technologists (RT[R]s) • 1 clinical nurse educator • 3 patient transporters • 1 cardiac picture archiving and communication systems (PACS) administrator. continued on page 16 How big of a problem is contrast-induced nephropathy in the cath lab? Contrast-induced nephropathy (CIN) has traditionally been somewhat ignored. Only in the last few years has there been some light shed on this complication. We knew as early as 10 years ago, when the first published literature came out on CIN in the percutaneous coronary intervention (PCI) population, that the incidence of CIN after receiving contrast media was somewhere around 14-15% of the PCI population in the contemporary cath lab setting. Unfortunately, it really wasn’t until about 5 years ago that we really began to pay a great deal of attention. Now, as you know, it’s become a very important topic, because CIN is an important complication. It could be as high as 50% of the population if diabetes and chronic kidney disease are present, and it could be as low as 1–2% if there are few to no risk factors. If we look at a crosssection of the PCI population, the rate of CIN falls somewhere between 14–16%. What about acute myocardial infarction patients? In an acute myocardial infarction (MI) setting, we don’t know the patient’s baseline creatinine, so it’s very difficult to ascertain their risk profile. We have developed a risk score that continued on page 8 STEMI Interventions: Searching for the Key to D2B by Dan Scharbach, Regional Director, Invasive Cardiovascular Services Providence Health System, Portland Service Area, Portland, Oregon Cath Lab Staff Health Page 28 An Ergonomic Survey of Cath Lab Repetitive Stress Injuries Marsha Holton, CCRN, RCIS, FSICP Cardiovascular Orientation Programs, Indian Head, Maryland Introduction This article is written for cath lab staff and physicians. It is written for the government agencies and insurance carriers that look for ways to prevent injury and must pay the bills for those injuries that happen anyway. It is written for administrators and educators with the hope that the information we found will help them develop the tools and workplace standards for safety at work. Anyone can get hurt at work, but it should not hurt to do the work. That is the goal of ergonomics. Continued on page 10 http://cathlabdigest.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - January 2008

Cath Lab Digest - January 2008 Central Baptist Hospital Contrast Media Use in High-Risk Patients An Ergonomic Survey of Cath Lab Repetitive Stress Injuries Contents Clinical Editor’s Corner Takotsubo Cardiomyopathy, a.k.a., Transient Left Ventricular Apical Ballooning Syndrome: An Acute Coronary Syndrome Imposter Searching for the Key to D2B STEMI Intervention News STEMI Interventions: Commentary The Massachusetts Stent Study The Value of Educating Staff Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab SICP* Chapter Updates The Society of Invasive Cardiovascular Professionals Holds an RCIS Review Course at New Cardiovascular Horizons 18:20 To Denver — One Student’s First Clinical Experience CEU Education Center Meetings Calendar What Do You Think? Clinical & Industry News Classifieds The Ten-Minute Interview with…Heather Vardon, RN Advertisers Index

Cath Lab Digest - January 2008

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