Cath Lab Digest - November 2007 - (Page 28)

28 ACVP MANAGEMENT CORNER NOVEMBER 2007 Remembering a Cardiac Cath Lab History Imaging in the Cath Lab: Thoughts on where we’ve been and where we are going Georgann Bruski, RT(R), CRT, ARRT Beth Israel Deaconess Medical Center, Boston, Massachusetts ACVP MEMBERSHIP PAGE Recruit-A-Member and Expand Your Circle of Professional Support A little investment of your time means a big investment in a colleague’s future. Ever wonder what it takes to recruit members to ACVP? A quick call or a conversation at a meeting can help a friend, colleague or associate succeed professionally. It’s a simple way to give back to the cardiovascular profession. As you know, the economy offers no guarantees for anyone. Actively learning, participating and taking advantage of ACVP’s benefits will hone your skills, position yourself for future opportunities and expand your circle of contacts. Now more than ever, a professional membership creates new opportunities to safeguard a career. We know your time is valuable, but in five minutes, you can help a colleague or friend achieve their professional goals by sharing the ACVP advantage. Hit the pavement for ACVP membership! 4 Easy Ways to Participate 1. Pass on a membership application to a colleague who should join ACVP Simply print your name on the application “who intro. duced you to ACVP” line. You'll receive sponsor recognition, earn a gift and increase your chances to win a prize. 2. E-mail peggymcelgunn@comcast.net or call (804) 632-0078, and request a Recruitment Kit, complete with prospective members in your geographic area along with membership applications, brochures, and sample recruitment letters. 3. Send ACVP the names of your colleagues who should join. We’ll check to see who is not a member and send them membership information.. E-mail peggymcelgunn@comcast.net or mail to: ACVP P Box 2007 .O. Midlothian, VA 23113 4. Recommend ACVP to a colleague from your desktop. Visit www.acvp-online for more details. When you recruit new members during the 2007–2008 ACVP Member-Get-A-Member Campaign, you help give yourself an advantage – participation in an organization with strengthened resources to provide you with greater benefits. And you also receive terrific gifts! ACVP’s way of recognizing your achievement: 5 Referrals: One ACVP Tote Bag or ACVP Coffee Mug 10 Referrals: One ACVP Cap or ACVP Shirt 20 Referrals: One ACVP Clock or ACVP Watch All new memberships resulting from referrals will place your name in a drawing for our grand prize: accomodations and complimentary registration for attendance at any ACVP-sponsored meeting. L et’s take a nostalgic trip down memory lane. If you are old enough to remember the equipment discussed here, you are probably a baby boomer; if not, consider this both a history lesson and a peek ahead into the future. As the old saying goes, “you need to know where you came from to appreciate where you are going.” In the infancy of cardiac catheterization, x-ray images were high-dose, lowquality image intensifier images that were recorded on 16-mm or 35-mm film with Aero techno film magazines and video reel-to-reel tapes for playback. Processing of the images was the Achilles heel for all cases. The Jamison or Combulator processor in the darkroom could eat up a whole day’s work. Many was the night I would be in the darkroom, with not even a Wraten B Kodak filter light, hand-fishing the film out of the Jamison and smelling rancid fixer. The dryer would blow it into my nose and mouth so that for the next eight hours it was all I could taste. We also loaded film magazines with 35-mm cine film in the dark, knowing how to make the perfect loop so that the film would not jam in the camera and to make sure the film gate was closed. I remember balancing transducers for 30 minutes and testing them to make sure they were linear for that “valve case,” when the cardiologist would switch the gauges to make sure your gradient was accurate. I would anxiously wait for Dr. Fifer to tell me if my tracings were technically perfect. Some of you may also remember green dye studies and Beckman bags. What about developing the thermal paper? How many of you remember burning your hands in the rubber roller that spread the developer on the paper or worse yet, running out of developer in the middle of a long case? Gone also is the challenge of turning patients up on an angle, on Spectrum cradle tables. (At that time, the table’s patient weight limit was a mere 275 pounds compared to today’s 350-plus pounds.) No longer are patients being propped up on sponges for complex angle views. These onceessential sponges have long been placed back in a strategic corner of the radiology hallway or hospital basement. When the digital age arrived, the need for file rooms that reeked of ammonia from the reticulation of the film was no more. We no longer had boxes of film to go through only to find out that the patient film we sought was missing. Our leap into the future started with cine loops from companies named Eigen, Angiotech, Camtronics and Heartlab, added onto our Siemens, GE and Philips radiographic equipment. Early on, even before this period, we had cut film in a Schonander or Fisher rolled film device. We moved onto Parallelograms, LUAs and C-arms, and then Aerotechnic cameras, mounted overhead as image intensifiers. Today, only the C-arm survives. In a typical day, a large portion of the morning was spent on film and processor quality analysis before anyone in good conscience would start a case. We checked and logged the sensitometer and densitometry readings, and of course, the Line Pairs grid. Today, what used to be the biggest equipment risk factor, the film, is now a memory. At our facility, we now have echo to assist in the cath lab as well as intrachamber echo from Siemens (Acunav). We have gone from electron-beam CT to 64-slice CT scanners, and soon we will be using a 256-slice CT scanner. Is this the new diagnostic tool that will turn the cath lab into the procedural OR arena? Or will this replace or join all the stress testing we do prior to a diagnostic cath? Will CT scanners become the new diagnostic tool in cardiology? Will diagnostic caths fade away? We have moved from image intensifiers, plumiconms, saticons, etc., to flat-panel technology, pulsed fluoroscopy, digital enhancing of images, subtracted images and bolus-chasing 3D imaging. It was farewell to the film file rooms and the order of reticulating film. We have moved on to cardiac PACS archival and transmitting images via the web. Viewing patient films has gone from a noisy Vanguard or Targano film-snagging projector to a digital computer-based PACS system that has also constantly needed our diligent attention and upgrading. Gone is the darkroom and file room person. Say hello to the high-tech, very wellcompensated PACS administrator.

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

Henry Ford Heart and Vascular Institute Treating Patients with Complex Vascular Disease with a Multi-Disciplinary Approach Improving Patient Compliance with Antiplatelet Medications Clinical Editor’s Corner Cath Lab Nurse/Tech Vascular Access and Closure Using the StarClose® Device The Clinical and Economic Impact of Measuring Fractional Flow Reserve FFR and Choosing an Optimal Revascularization Strategy Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential Use of a Mobile Lab to ‘Test the Waters’ at a Rural Hospital Remembering a Cardiac Cath Lab History ACVP• Membership Page What Do You Think? The Ten-Minute Interview with… Ernie Livingston, RN, BSN SICP* Chapter Updates Who’s in Charge? Working to Eliminate Bottlenecks: Florida Hospital’s Cardiac Cath Lab Achieves Greater Efficiency and Higher Satisfaction Preserving Left Ventricular Function during Percutaneous Coronary Intervention Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Making the Most of Your First Impression: Interviewing Tips and Techniques CEU Education Center Clinical & Industry News Meetings Calendar

Cath Lab Digest - November 2007

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