Cath Lab Digest - February 2008 - (Page 54)

54 ASK THE CLINICAL INSTRUCTOR FEBRUARY 2008 “The only foolish question is one left unasked.” Cath Lab Staff: Your suggested topics and questions are needed! (You are welcome to remain anonymous.) medical condition that requires the use of oxygen, make sure to contact the cardiologist to see how they wish to proceed. Don’t take oxygen off of a patient that needs it. We mentioned that the Fick CO is based upon the extraction of oxygen from the tissues. In order to properly calculate this, we would need to know the HIGHEST and LOWEST saturations in the body. The HIGHEST arterial saturation would be obtained from the pulmonary veins. However, we can not easily obtain a sample from that region. The closest we can realistically come to that is Email: tginapp@rcisreview.com When the patient is brought to the room, the oxygen should be removed for at least 10 minutes prior to obtaining oxygen saturation samples. This will allow the oxygen saturations to move to a more normal representation of the body’s condition. In the event that your patient has a the aorta. The LOWEST saturations in the body would be right before the blood re-enters the lung. The distal pulmonary artery is the reasonable place for us to obtain that sample. They are then run via an oximetry device, or in the respiratory therapy department. Let’s assume that we have the following values for the variables: O2 Consumption: 125 BSA: 2.0 Hgb: 12.6 SaO2%: 97% SvO2%: 58% The numerator is easy to figure out: CLD Volunteer Survey 125 ml/min x 2.0 m2 = 250 ml/min/m2 Please complete the questions below and fax to 216-393-0445 or visit www.cathlabdigest.com to complete the survey online. 1. Do you volunteer to help raise awareness regarding heart health in your community? 2. If yes, how do you choose to donate your time regarding community heart health? Yes No 3. Does your hospital have a Heart Walk team? Yes No AHA affiliates all around the U.S. sponsor annual Heart Walks. Walkers can organize teams at the companies where they work or with family and friends. Walkers ask others to support their walk effort by sponsoring them with a donation to the American Heart Association. 4. Does your hospital follow the AHA’s “Get with the Guidelines” format for patient education and discharge planning? (“Get with the Guidelines” is a national program. Numerous studies have shown a reduction of mortality and morbidity the greater the number of guidelines that are implemented and adhered to.) Yes No 5. Prior to this survey, were you aware of the Go Red for Women campaign from the American Heart Association? Yes No 6. If yes, do you participate in the campaign in some way? Yes No We will have to work out the denominator. With the oxygen saturations, we can not use them as a % in the formula. We will have to change them to the equivalent of the value of 1, i.e., 97% becomes 0.97 and 58% becomes 0.58. If you accidentally forget to do this, you will have a very ‘off’ CO and you will know something is wrong. Working the denominator: (SaO2% – SvO2%) x Hgb x 1.36 x 10 (0.97 – 0.58) x 12.6 x 1.36 x 10 0.39 x 12.6 x 1.36 x 10 4.9 x 1.36 x 10 6.7 x 10 67 What we then have is: 7. Prior to this survey, were you aware of the Start! Walking program from the American Heart Association? Yes No 8. If yes, do you participate in the campaign in some way? Yes No 250 ml/min/m2 67 = CO = 3.73 If you work the same numbers, but change the venous saturation to 64% or 66%, or a higher number, then you can see a demonstration about the less extraction, the better the cardiac output (until it can become TOO high). These three ways to calculate cardiac outputs can not only help you in the lab to obtain the necessary information for the physician to help them guide the patient’s medical management, but you can also be more prepared for the RCIS examination. ■ 9. Prior to this survey, were you aware of the Power to End Stroke campaign by the American Stroke Association? Yes No 10. If yes, do you participate in the campaign in some way? 11. Does your hospital plan to become Stroke Certified? Yes Yes No No Yes No 12. Prior to this survey, were you aware of the Alliance for a Healthier Generation? 13. If yes, do you participate in the campaign in some way? Yes No 14. Do you have school-age children who participate in Hoops for Heart or Jump Rope for Heart programs at their school? Yes No 15. If you have volunteered in the fight against heart disease, you are welcome to share thoughts about your experience: Thank you for completing our survey! Cath Lab Digest will publish the results in an upcoming 2007 issue. http://www.cathlabdigest.com http://www.cathlabdigest.com

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

Cath Lab Digest - February 2008 Bay Regional Medical Center ENDEAVOR IV: A Zotarolimus-Eluting Stent Versus a Paclitaxel-Eluting Stent in a Randomized Clinical Trial A 3D CT Vessel “Roadmap” Over Live Fluoroscopy for Chronic Total Occlusions Contents Clinical Editor’s Corner An Evaluation of Cath Lab Turnaround Time Commentary: An Evaluation of Cath Lab Turnaround Time Excerpts from Chapter 19. STEMI Interventions – Future Perspectives The Potential Clinical Utility of Intravascular Ultrasound Guidance in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents The Ten-Minute Interview with…Debbie Charlton, RN The Society of Invasive Cardiovascular Professionals (SICP) at Transcatheter Cardiovascular Therapeutics (TCT) 2007 The Cath Lab is a Business: Do You Have the Knowledge to Stay Afloat? Incidence and Predictors of Vascular Complications after Invasive Coronary Procedures: A Prospective Analysis Ask the Clinical Instructor: A Q&A Column for those New to the Cath Lab Volunteer Survey SICP* Section Meetings Calendar What Do You Think? CEU Education Center Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - February 2008

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