Cath Lab Digest - March 2008 - (Page 26)

26 SPOTLIGHT continued from page 1 MARCH 2008 EmmyLou Mercado, RN, BSN, CCRN. Saint Joseph’s Hospital Cardiac Cath Lab What types of procedures are performed at your facility? Our cath lab performs diagnostic and interventional procedures. Diagnostic procedures include right and left heart catheterization, SwanGanz insertion, coronary and peripheral intravascular ultrasound, WaveWire™ (Volcano Therapeutics, Inc., Rancho Cordova, CA), carotid arteriograms, peripheral arteriograms and runoffs. Interventional procedures include coronary and peripheral angioplasty and stent implantation, rotational atherectomy, directional atherectomy, intraaortic balloon pump (IABP) insertion, and thrombectomy. We also perform cardiac biopsies pre and post transplant (including fresh transplants), and tilt table tests. We perform approximately 201 procedures per week, including peripheral procedures. Our peripheral volume in 2007 was 430 patients. Does your cath lab perform primary angioplasty with surgical backup? Our cath lab performs primary angioplasty with surgical back up. The cardiothoracic OR receives daily schedules from the cath lab and they are aware of the number of procedures that are scheduled in the cath lab. If there is an emergency situation and the patient requires immediate surgery, the surgeon will arrange to have the OR receive the patient emergently. What procedures do you perform on an outpatient basis? All diagnostic caths, biopsies (except for fresh transplants), diagnostic and interventional peripheral procedures (except carotid stent patients). What percentage of your patients are female? In 2007, 33% of patients were female. What percentage of your diagnostic cath patients go on to have an interventional procedure and what percentage of your diagnostic caths are normal? In 2007, 19% of patients who came in as cath/possible PCI had an intervention done. Eight percent of diagnostic caths were normal. Who manages your cath lab? The manager of the cath lab is Deryck Yarde, RN, BSN, CCRN. He has 19 years of nursing experience and nine years of cath lab experience. Deryck reports to Tony Petrillo, RN, Director of Invasive and Non-Invasive Cardiology. Do you have cross-training? Who scrubs, who circulates and who monitors? All staff are cross-trained to perform all roles. We do have several newer CVTs who only perform monitoring and scrubbing, but the goal is to have all staff able to perform all three roles. Does an RT (radiologic technologist) have to be present in the room for all fluoroscopic procedures in your cath lab? No, an RT does not have to be present in the room for all fluoroscopic procedures. Which personnel can operate the x-ray equipment in your cath lab? All personnel can operate the x-ray equipment in our cath lab, i.e., position the II, pan the table, change angles, and step on the fluoro pedal. How does your cath lab handle radiation protection for the physicians and staff that are in the lab day after day? Our physicians wear lead, most wear lead glasses and some use added lead arm sleeve to protect the long bone of the arm closest to the x-ray source. Each room has a lead shield hung from the ceiling to cover the image intensifier/flat detector and lead aprons that hang from the table to cover the x-ray source. Also all staff and physician use radiation badges, monitored monthly by the hospital-wide and department radiation safety officers. If there is too much exposure, the staff or physician will receive a letter and have to meet with the Hospital Radiation Safety Officer to go over ways to decrease radiation exposure. The radiation badge reports are posted in the staff lounge and provided to the physicians. The staff is required to take a radiation safety test annually as part of their credentialing process. The cath labs are inspected each year by an outside company to measure the amount of x-ray produced by the C-arm. All lead aprons Beth Collins, RN, BSN, CCRN and Tara Hicks, RCIS. Mike Robinson, Cardiac Aide. are inspected bi-annually to assure that they are in working condition and any found to have cracks or holes are replaced as needed. If your lab performs peripheral interventions, what disciplines are involved? Do interventional radiologists and cardiologists perform procedures in the same area? Cardiologists perform both coronary and peripheral interventions. We do have vascular surgeons who perform peripheral procedures in the cath lab. Interventional radiologists perform their procedures in the special procedure department. Deryck Yarde, RN, BSN, CCRN, Cath Lab Manager. What are some of the new equipment, devices and products introduced at your lab lately? We have just upgraded our intravascular (IVUS) machines to

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

Cath Lab Digest - March 2008 Are You Being Paid Fair Market Value in 2008? A Cardiac Cath Lab Professionals Survey by Cath Lab Digest and the Society of Invasive Cardiovascular Professionals Saint Joseph’s Hospital Invasive Imaging Tools for Optimizing Coronary Stent Deployment Contents Clinical Editor’s Corner A Workflow Revolution in Cath Lab Reporting Advantages of a New Digital Lab at Baystate Medical Center Cardiac Computed Tomography: What Does it Mean for the Cath Lab? The Latest in Cardiac Magnetic Resonance Imaging (MRI) Cellular Cardiomyoplasty and Cardiac Regeneration Intravascular Ultrasound in the Cath Lab: A Powerful — and Underutilized — Tool to Improve Patient Outcomes The Stentplus™ Patient Success Program Cardiac Cath Lab Clutter — or, Spring into Action! Groin Bleeds and Other Hemorrhagic Complications of Cardiac Catheterization: A List of Relevant Issues Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab What Do You Think? Experience with a New Guidewire: The Terumo Runthrough NS The Ostial Pro™ Stent Positioning System: Perfecting Aorto-Ostial Stent Placement Precious Minutes The Ten-Minute Interview with…Mark Bowles, BSN, CCRN Vascular Care in the Cath Lab: Planning a Smooth Transition Cath Laughs CMS 2008 OPPS Final Rule Review An Extensive Set of Review Courses for the CCI Basic Science, Non-Invasive Echocardiography and Vascular, and ARDMS Ultrasound Exams Meetings Calendar CEU Education Center Clinical & Industry News STEMI Interventions Classifieds Advertisers Index

Cath Lab Digest - March 2008

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