Cath Lab Digest - April 2008 - (Page 44)

44 SICP PROFESSIONALS OUT IN FRONT APRIL 2008 seeing that one other time in my career in the cath lab. Last week we performed a percutaneous coronary intervention on this patient with great success. When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high? We all wake up in the morning, open our eyes, and put two feet on the floor. I believe at that moment we must choose, or decide, how our life that day is going to be and how we will respond to it. I try to decide that I will have a good day as often as I can remember. Having a career in healthcare gives me a daily reminder that there are many unhealthy people out there that need and benefit from the care we provide. If you don’t have your health, you really don’t have anything, so I thank God for the problems that I have. I believe our patients need us to stay focused on how they feel and what we can do to help them get better. Are you involved with the Society of Invasive Cardiovascular Professionals (SICP) or other cardiovascular societies? Yes, I was one of the founding board members and most recently, former chair, of the Gulf Coast Chapter of the SICP. This was the first chapter in the state of Texas and also the nation. I believe it started a grassroots effort to establish chapters across our great nation that continue to be focused on education for all the members of the cardiovascular team. Are there websites or texts that you would recommend to other CV labs? Dr. Frank Netter’s “Ciba Collection of Medical Illustrations” has amazing pictures of anatomy, pathology, and pathophysiology (Volume 5 is of the heart and great vessels). I would also recommend Dr. Morton Kern’s Cardiac Catheterization Handbook and J. Wesley Todd’s Cardiovascular Review Books. There are also many good internet links found at www.GCSICP.com (Gulf Coast Chapter of the SICP). This website was the creation of my friend Lynne Jones, co-founder of the chapter and former President of the SICP. If you could send a message back to yourself at the beginning of your CV lab career, what advice would you give? Keep an open mind. Gain as much knowledge and wisdom that you can. Love yourself, and try to find peace and harmony in all that you do. As Eleanor Roosevelt said, “Great minds discuss ideas, average minds discuss events and small minds discuss people.” And, as Bruce Willis said in Die Hard, “If you’re not a part of the solution, you’re a part of the problem.” Where do you hope to be in your career when it is time to retire? When it is time for me to retire, I would like to be a cath lab director in a friendly community near a lake or seashore, somewhere in the south. In my retirement, I plan on being a fishing guide and/or boat captain. Boating and fishing have been a lifelong hobby for me. Has anyone in particular been helpful to you in your growth as a cardiovascular professional? I feel very fortunate to have received my cardiovascular education, training, and experience in and around the Texas Medical Center. It has provided me with countless opportunities to work with and among so many amazing physicians, scientists, technologists and nurses. So many of these opportunities and experiences I consider priceless and find it difficult just to choose one. Most recently I have been a serious student of my boss, Sharla Shumaker, and am thankful for the things she has taught me over the last few years. Where do you think the invasive cardiology field is headed in the future? I still believe we are about to be knocked off our feet by all of the baby boomers (and following generations) who will need our tender loving care in the cardiac cath, electrophysiology and invasive vascular labs. We will continue to see decreases in typical surgeries, increases in percutaneous types of procedures and improvements in stroke care. Many more physicians will be trained to perform robotic surgeries and procedures. ■ Dale Hansen can be contacted at Dale.Hansen@HCAhealthcare.com IN MY VIEW Sometimes, You Just Know Michele Impreveduto, RN, BA, MPA Lead Nurse CCL Hackensack University Medical Center Hackensack, New Jersey The following is a clinical example which demonstrates the recognition of subtle signs and symptoms of an impending problem. My feeling was to monitor this patient closely, not knowing exactly what was wrong. I felt confident that something was not right. heart rate and was asymptomatic. The patient’s right groin remained soft and there was no hematoma noted. She denied having any back pain. I administered normal saline, her blood pressure normalized and I believed this was a transient event, with no further intervention needed. Within approximately 30 minutes, however, the patient again became hypotensive, again responded to fluids and the patient remained in no distress. Her cardiologist was notified of my findings as well as her responses to the interventions. No orders were received. My feeling was to monitor this patient closely, not knowing exactly what was wrong. I felt confident that something was not right. After yet another hypotensive episode, I notified her physician again, this time also expressing my feeling that something did not feel right. Unable to verbalize exactly what it was, I requested that the physician come and assess the patient, which he agreed to do. The physician witnessed exactly the same episode I had explained to him and a plan of action was instituted, consisting of a CT scan, blood work and a blood transfusion. The patient was subsequently diagnosed with a large retroperitoneal bleed (an insidious complication of any femoral puncture) and was then transferred to the cardiac care unit. The following day I went to check on the patient in the CCU and to my surprise, I was welcomed as her “Florence Nightingale.” As a seasoned critical care nurse for 23 years, I wanted to share this story as a reminder that sometimes, “you just know.” ■ Michele Impreveduto can be contacted at mimprev@aol.com P atient X was admitted for an elective cardiac catheterization/possible intervention procedure. Subsequently, a stent was inserted and the procedure was uneventful and successful. She was then transferred to the recovery room to await a bed assignment. After a short time in the recovery room visiting with her family, she became hypotensive with a stable http://www.GCSICP.com

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

Cath Lab Digest - April 2008 Kaiser San Rafael Medical Center Orbital Atherectomy: A New Treatment for Complex Peripheral Arterial Disease Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Contents Clinical Editor’s Corner CEU Education Center The Missing Link in STEMI Interventions — Thrombus Aspiration during Primary Percutaneous Coronary Intervention Predicting Stent Thrombosis Using A Clinical Risk Score Use of a New Guidewire: The Tigerwire Should I Stay or Should I Go? Weighing Options for New Opportunities Navigating Tortuous Coronary Sinus Anatomy Using a Bipolar Lead The National Society of Radiology Practitioner Assistants (NSRPA) Holds 9th Annual Educational Conference For Medical Imaging Physician Extenders and Mid-Level Healthcare Providers Cath Lab & Beyond: A Meeting Update The Ten-Minute Interview with… Dale Hansen RT, CVT Sometimes, You Just Know Twin Circumflex Arteries: A Rare Coronary Artery Anomaly What Do You Think? Meetings Calendar News from the American College of Cardiology (ACC) Scientific Session and the Society of Cardiovascular Angiography & Interventions (SCAI) Annual Scientific Sessions in Partnership with the ACC i2 Summit Clinical & Industry News Cath Laughs Classifieds Advertisers Index

Cath Lab Digest - April 2008

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