Cath Lab Digest - November 2007 - (Page 29)

29 Today, we can automatically, without radiation exposure, collimate our images (and I am positive every cardiologist and technologist is utilizing this feature) by using the previous images to collimate on and thus saving dose to our patients. We have lowered our frame rates from 60/second to 30-to-15/second and some say we may be able to go down to 7.5 (I am not so sure about that). We calculate and record our patient doses. We have patients sign consents that they understand they are receiving a radiation dose and may experience skin erythema or other radiation complications due to the accumulative doses they receive during cath and electrophysiology (EP) studies. Now our patients may also receive a high-dose CT study. How many patients undergo all three — CT, catheterization and EP studies? We see and accumulate more information, and we do more intervention. Some of our volumes are declining due to the introduction of statins and the general smoking cessation of the population, but I do believe our volumes will come back in time. The 20- and 30-somethings are still smoking, so don’t put your cath labs in mothballs yet. We will return to our old volumes in a few years, if we are not all retired at that point. What else will we see if we look ahead? Procedure rooms are becoming the operating rooms of the future. I have opened two rooms in the OR and am working on my third. I have seen the cardiologist and the surgeon partnering into one cardiovascular institute, working with thoracic, neuro and peripheral vascular surgeons to form a seamless model of care for our patients. We are able to decrease open procedures, putting down the scalpel to embrace the maneuvering of catheters and insertion of drug-eluting stents, percutaneous valves, left ventricular assist devices (LVADs), and the many more procedures to come under the guide of fluoroscopy, endovascular imaging and simulation 3D technology. Now we need the equipment vendors to build radiographic tables to meet the needs of the surgeons, who today must also tilt and cradle. We need tables that must, of course, be radiolucent and have a brake in the middle like other conventional OR tables. Another thing I have discovered as we build these rooms of the future is that ceiling geography has become precious. How many lights and booms can you fit in a ceiling and still be able to move the C-arm? Today, life is definitely more challenging and our tasks more technical. I am happy to have outlived analog in the cath lab. I am proud have helped usher in the digital age and witness diagnostic cases advance to interventions. After taking my trip down memory lane, I can truly say I do not miss the old days. I never want to be in a dark room at 2 am rethreading the Jamison again. I can still smell the fixer and feel the hot air of the dryer on my face as I bend over the Jamison, standing on a stool in the dark and wondering who put that weak splice on the leader. The good old days are over! ■ Georgann Bruski has recently been promoted to the Director of Contracting and Facilities for the entire Cardiovascular Institute of Beth Israel Deaconess Medical Center. She notes, “This is what happens to old war horses.” Georgann can be contacted at: gbruski@bidmc.harvard.edu Make the right move Place a classified ad in For deadlines, rates, and more information please contact: Classified Ad Manager Lucinda Beska-Ext 235 Erin Fehr-Ext 271 Classified Ad Associate Phone: (800) 237-7285 Fax: (610) 560-0501 Email: lbeska@hmpcommunications.com efehr@hmpcommunications.com

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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