Cath Lab Digest - October 2007 - (Page 1)

Radiation Tracking in the Cardiac Cath Lab D. DuRee, RN, BN, CCVNII & D. Johnson, RN, BS, RCIS, CMRT Clinical Editor’s Corner: Morton Kern, MD Think about bleeding before and after cath. Page 21 Page 4 October 2007, vol.15, no.10 A Product, News and Clinical Update for the Cardiac Catheterization Laboratory Specialist Cath Lab Spotlight Clinical Update Fibromuscular Dysplasia in Children and Adolescents Kevin E. C. Meyers, MD1,2 and Neha Sharma BA IV1,2; The Children’s Hospital of Philadelphia1 and the University of Pennsylvania2 Philadelphia, Pennsylvania Saints Medical Center Cardiac Cath Lab is a TEAM is every sense of the word! Dave Green, RN, BSN, EMT-P; James Waters, MD, Medical Director, Cardiac Cath Lab; Jennifer McCarthy, MSN, RN, Director of Cardiovascular Services; Rich Snyder, RN; Stacey Cayer, RN, ASN; Jeff Peters, RT(R), BA; Carla Hayden-Muse, RT(R); Rosany Rosario, CVT-RCIS; Erin Boutin, RN, ASN, Nurse Manager, Cardiac Cath Lab; Christine Stratton, RN. Introduction FMD is a non-atherosclerotic, non-inflammatory disease that predominately affects the renal and carotid arteries, although it has been described in all vascular beds.1 Approximately 60–75% of all FMD cases involve the renal rather then the carotid vessels; the renal predilection, however, may be greater in children. FMD more commonly affects women and younger individuals, though the sex distinction has not been proven in children. While its pathogenesis is not completely understood, hormonal, mechanical, and genetic factors, as well as mural ischemia, are thought to play a role. The natural history may be relatively benign, with progression occurring in only a minority of the patients. Depending on the arterial layer that is affected, the disease may be characterized by multifocal, tubular, or focal stenosis, which is a narrowing of the arterial Saints Medical Center Contributions to this article were made by the entire staff in the cardiac cath lab and management team in Lowell, Massachusetts. What is the size of your cath lab facility and number of staff members? We currently have one cath lab and have a nurse manager, unit assistant, 5 registered nurses (RNs), 3 cardiovascular technologists (CVTs) and 2 radiologic technologists (RTs). The newest member has been here 3 months and our longest has worked here 4 years. We had a staff turnover when the lab went from diagnostic-only to interventional in 2004. Staff experience ranges from 1.5 years to 24 years. vessel caused by a deposition of collagen that extends into the lumen. In addition to stenosis, vessels with FMD may develop weak points in the vessel wall that then can become aneurysmal. The most prevalent form of FMD identified in children and young adults is intimal fibroplasia, typified by long, irregular or smooth, focal stenosis.1 Persons with FMD may be asymptomatic and only diagnosed at routine medical visits or even at work up for organ donation. continued on page 8 Carotid Stenting: An update Rajesh M. Dave, MD, FACC, FSCAI, Chairman, Endovascular Medicine Pinnacle Health Heart and Vascular Institute, Harrisburg Hospital Page 24 Harrisburg, Pennsylvania Case Report What type of procedures are performed at your lab? We perform elective heart caths, angioplasty, stent implants, pacemaker implants, trans-esophageal echos (TEE) and cardioversions. continued on page 17 HMP Communications Cerebral Vascular Accident Following a Pulmonary Embolism: Search for the Hidden Patent Foramen Ovale Alex Harrison, MD1, Ghalib Wahidi, MD2, Morton Kern, MD1 Division of Cardiology, Dept. of Medicine, University of California, Irvine, California1; Dept. of Medicine, University of California, Irvine, California2. See the full article on page 14 http://www.cathlabdigest.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - October 2007

Saints Medical Center Fibromuscular Dysplasia in Children and Adolescents Cerebral Vascular Accident Following a Pulmonary Embolism: Search for the Hidden Patent Foramen Ovale Contents Clinical Editor’s Corner Meetings Calendar CEU Education Center Radiation Tracking in the Cardiac Catheterization Lab Letter to the Editor Carotid Stenting: An update Release from Stent-jail: Beneficial Snow-Plowing? Patient Management Guidelines Searching for a Cardiovascular Position? Tips for Creating a ‘Stand-Out’ Resume Long-Term Implications of Short-Term Closure Decisions – The Evolution to Vascular Access Management and the Boomerang Catalyst System The Ten-Minute Interview with… Angie Bowles, RN, CCRN CMS Issues Final FY 2008 IPPS Rule ACVP• Membership Page Experience with a New Workhorse Guidewire Ask the Clinical Instructor: Q&A for Those New to Cath Lab A Glimpse of the Future of Clinical Education: Boston Scientific’s SimSuite Bus Visits Carnegie Institute 2007 Educational Fair Held at the Washington Hospital Center Research Update: Original Contribution Abstracts from The Journal of Invasive Cardiology What Do You Think? A Virtual Cath Lab Viewer (VCL): The Development of an Online 3D C-arm Simulator and Coronary Anatomy Viewer Clinical & Industry News Cost-Effectiveness of the Radial versus Femoral Artery Approach to Diagnostic Cardiac Catheterization

Cath Lab Digest - October 2007

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