EP Lab Digest - January 2008 - (Page 33) JANUARY 2008 EMAIL DISCUSSION GROUP 33 practices. As professionals who have this desire to provide advanced services to our patients move forward, we must do so carefully and make sure we have the approval of our department managers, physicians, and most importantly, hospital administration. Just as attorneys look for case laws to support their clients, we must have examples of programs that provide this service to their customers with excellent results. It is then and only then that we will be able to advance our practices and offer our customers (physicians, managers, and patients) an advanced level of service by qualified individuals that is acceptable to those who tend to question right and wrong. Good luck, and I wish you the very best in your endeavors. — James H. Combs RCIS, RCES, EMTP Wearing Hats and Masks / Bringing Food and Drinks Inside the EP Lab Help! We’ve been having major discussions about allowing food and drinks into the EP lab.Also, what is the protocol for wearing hats and masks during ablations? We would like to know what other facilities’ practices are. What do the policies and procedures read, and what is the actual compliance based on the policies and procedures? — Janice Christian, RN, CCRN (To reply to this question, please type “Inside the EP Lab” in your subject line.) Check your “Policies and Procedures” and Joint Commission rules. No food or drink inside the EP lab; covered drinks are allowed in the separate control room, but still, no food. During EP studies or ablations, hats and masks are worn by scrubbing staff. If the EP study is to be followed by a device, then all in the room have hats and are masked for both procedures. — D.L. Hart, RCIS, Valley Hospital, Las Vegas, NV Antibiotics Our electrophysiologist wants to know what is the standard practice for antibiotics post PM and ICD implants. He currently gives a second dose of IV antibiotics, and no oral antibiotic is given at home. Is it common to send patients home on oral antibiotics? — Janice Christian, RN, CCRN (To reply to this question, please type “Antibiotics” in your subject line.) Currently the practice in our EP lab is to give two doses of IV antibiotics, making sure that the first dose has infused completely a half hour prior to incision, and the second IV dose is given 8 hours following that, unless of course vancomycin is used. Our physicians also irrigate the pocket with a 50,000 units/liter solution of Bacitracin throughout the procedure, with one physician doing a dwell time of 5 minutes before the pocket is closed. Oral home antibiotics are given routinely. — K.T. Manfull, RN, Affinity Medical Center It is standard practice for antibiotics 24 hours post implant. Patients are not sent home on oral antibiotics routinely. — name withheld by request EP Training I have taken a job in the cath lab. I am an RT, wishing to obtain EP training. Could you please tell me where I could go to get effective training without being away from my children for months? Thanks! — Cyndi, Ft. Smith, Arkansas (To reply to this question, please type “EP Training” in your subject line.) There are a number of online resources that can increase your knowledge of EP, including NACCME, which EP Lab Digest links to (www.naccme.com), and the Heart Rhythm Society (www.hrsonline.org). But the most comprehensive is EPreward, who has outlined and organized links to the online education programs from a large variety of sources (www.epreward.com). Go to the “EP Links” section of their website. — Mona, RN HRS’ EP exam, and which exam do you feel is perceived as the more state of the art and respected more by peers and employers? — Dana St. John, RN (To reply to this question, please type “EP Exams” in your subject line.) Atrial Fibrillation Ablation We are newly starting to do atrial fibrillation ablations, and I was wondering if anyone could give me examples of their institution’s policy on AF ablations? — anonymous (To reply to this question, please type “AF Ablations” in your subject line.) Service for the EP-3i Stimulator At our hospital (E. Wolfson Medical Center), there is an EP-3i Stimulator that needs technical service (we need to buy a key pad). Is there a distributor in Israel? — S. Hanan (To reply to this question, please type “EP-3i Stimulator” in your subject line.) CT Scanner Integration I am currently working with a Toshiba 64-slice CT scanner, and would like more knowledge on the integration with CartoSync.Where can I find more information about CartoSync? — Michael J. Moore BSRT, CT (To reply to this question, please type “CartoSync” in your subject line.) Roles in EP Lab I have two questions.We are having trouble in our lab — hopefully you can help me out.We have three labs, and will be getting our fourth. One of our three labs is an EP lab. We have 3 RTs, 1 RN and an EP coordinator, who is also an RN. How do you handle call time, and what is the role of the coordinator? — anonymous (To reply to this question, please type “Roles in EP Lab” in your subject line.) Loop Implant/Explant I was just wondering what some protocols are for loop procedures, particularly explants. I have recently been told that loop explants should take place in a positive pressure room. Any comments on this matter would be appreciated. — Edward Muxlow (To reply to this question, please type “Loop Implant/Explant” in your subject line.) Other Questions for Discussion: DFT Testing in Patients with Low Ejection Fractions (EF) Less than 10-15% Shaking the bushes to see if anyone has any anecdotal data regarding defibrillation threshold testing during implant in patients with a low EF% of 10 or less: initial shock, second shock, third shock, rescuelimiting inductions and testing to one course or multiple courses. Single initial shock with number of joules 10 less than defib max. — Dana St. John, RN (To reply to this question, please type “DFT Testing” in your subject line.) EP Exams Has anyone used the online tutorial from HRS and taken the Cardiac Pacing and Defibrillation Exam in the same year? What are your thoughts about the tutorial with regard to passing the exam? How do you feel about the new RCES certification from SICP that was unveiled this year? Has anyone taken this exam? Did the SICP exam appear more difficult than the http://www.naccme.com http://www.hrsonline.org http://www.epreward.com http://www.epcatheters.com http://www.epcatheters.com
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.