Cath Lab Digest - February 2008 - (Page 6)

6 CLINICAL EDITOR’S CORNER FEBRUARY 2008 Labeling as the Answer? In our laboratory at this time, all the labels are white, printed with small black letters indicating the contents of the syringe or container. For example, these labels would state normal saline, 0.45%; lidocaine, 1 mg per milliliter; nitroglycerin, 100 mcg per milliliter, and so on. Unfortunately, all the labels appear the same in the dim light of the cath lab (to me) and if labeled syringes are dropped in the sterile field, these syringes can easily get lost among the saline syringes. It is clear a better system needs to be implemented to avoid medication errors. One Solution to the Labeling Problem My preference is to attach colored labels to any medication syringe or cup. In addition, several companies make color-coded syringes with colorful pistons and printed names on the barrels. In the cath lab, it is difficult to read small lettering, due to a number of very good reasons (such as dim light, small type, old eyes, etc.) The similar small-size font and style of black-on-white labels can lead to confusion. However, this issue of colored labels does not have universal consensus. Some hospital pharmacies recommend avoiding colored labels, believing that depending on colored labels is also a source of error, as colors may indicate different things in different places. Since there is no foolproof system when human beings are involved, any system designed to reduce misidentification should be considered and implemented. For labels, I believe colorcoded is better than black and white. Now to the question of who is at fault? Is it the physician, the nurse, the hospital or the manufacturer of the medication bottle? I think that the manufacturers do a fair job at labeling the contents of their bottles. Some manufacturers may not label well, but the use of medication always remains in the hands of the user. Liability is an issue for the courts, but common sense would suggest that those of us who use these products are well-paid, welleducated and responsible people. We all take our job seriously, and would agree that any way we can prevent errors and protect our patients requires a continuous critical reappraisal and keeping it as a top priority. ■ ANNOUNCEMENT The Loss of a Cath Lab Pioneer I t is with great sadness that we inform you of the passing of Irene H. Seymour, RN, a southern California pioneer in the cath lab field. She passed away on Monday, January 21, 2008 from complications of renal failure. She was a treasured institution in cath labs throughout metropolitan Los Angeles, especially the San Fernando Valley. We will miss her so much, but hope to carry on in the ethical way she taught us all. Sarah Kattus, RN, I. Seymour — Cardiovascular Services, Northridge, California Following are excerpts from Cath Lab Digest’s October 2003 interview with Ms. Seymour: Irene Hinojosa Seymour did her first heart cath in 1968 while still working in the O.R. at Granada Hills Community Hospital, in Granada Hills, California. She ventured out on her own in 1971, working as the very first independent consultant to invasive cardiologists. During the 1970’s and early 1980’s, she worked with physicians in the San Fernando Valley, helping them open 8 cath labs, training nurses, and staffing each lab. Irene formed her first independent contracting company in 1983 (I Seymour Associates), and it became incorporated in 1988 (I Seymour Cardiovascular Services, Inc.). She both ran the company and worked in cath labs (as first assistant, circulating and monitoring) on an independent basis until early 2003. She spoke with CLD later that year: For me, it all began in 1968 when local cardiologist Dr. Edwin Zalis came to our institution with the goal of performing diagnostic cardiac catheterizations. He had completed an 8-week invasive cardiology fellowship at UCLA. I had worked as an O.R. nurse for about 12 years and was ready for a new challenge, so I accepted the offer to become a cardiac catheterization nurse. I made various changes in the catheterization laboratory in terms of instrumentation. Because we were all new at cardiac catheterization — the physicians included — it was definitely a case of “see one, do one, teach one.” And that is exactly what I did: I observed my first catheterization procedure, actually assisted on the second one, and proceeded to teach others from that point on. In 1971, I quit my job at Granada Hills Hospital Cath Lab. From that time on, I became an independent consultant to physicians who needed assistance in trouble-shooting problems at their cath labs or guidance in set up and training of staff. Since I worked with so many different cardiologists, I became a sort of conduit of information between them. These physicians were all in the learning phases — they all had roughly the same level of knowledge and skill in cardiac catheterization. They would often tap into each other’s knowledge through me. …I often served as the physicians’ “go-between,” perhaps because they wanted equality with their peers. On the other hand, they were perfectly comfortable coming to me! Ultimately, the patient was the beneficiary of this knowledge network. In 1983, I formed I Seymour Associates (ISA), a company which provided independent contract nurses to area cath labs. I felt that nurses should be able to have the same independence that I had over the years. Independent nursing allowed these nurses, many of whom had young children and busy home lives, to manage their own work schedules. In the beginning, the hours cath lab nurses worked were often odd, because most catheterization procedures in the San Fernando Valley were performed in radiology labs after hours. There were very few dedicated cath labs at that time. Invasive cardiology came into being and literally evolved before my eyes, beginning for me in the late 1960s. It has truly been fascinating to be a part of such a new and rapidly evolving field. ■ http://www.safeguardworks.com http://www.safeguardworks.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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