EP Lab Digest - February 2008 - (Page 33)

FEBRUARY EMAIL DISCUSSION GROUP Email Discussion Group: February 2008 The CartoSync is an older technology from Biosense Webster replaced by CartoMerge. To ensure that you get the best results, the contrast needs to be in the left atrium and pulmonary veins when you scan. So timing is critical. To integrate your CT scan with the long with four new questions this month, we also have software, you need to ensure that you are a lot of discussion happening with previous questions. utilizing the correct file format. The newer 64-slice CT scanners sometimes utilize DVD If you would like to join in on the discussion, please formats when burning to a disc. Make sure email us at eplabdigest@hotmail.com or visit us at that you are not using a DVD disc. The www.eplabdigest.com (click on the email discussion group Under Discussion: CartoSync needs the information on a CD. link). Remember, when posting or responding to the discussion The source image is actually what you need. group, please let us know if you would like your name, location, ACT Guidelines It is usually the largest file on an image scan. and/or email address listed.We look forward to hearing from you! I was just wondering what peo- Enter into the CartoSync application load ple are using for ACT guidelines the disc and scan it. Look for the largest file, New Questions: during pulmonary vein isola- usually it is greater than 250 MB. Corvert At our facility and surrounding tions. I am also curious as to what Highlighting it will queue it up. Then click the Catheter Recycling area hospitals, there has been a ACT machine they are using. start button in the middle of the screen. I have a concern regarding recy- debate about the use of Corvert — Heidi Helmer, RN, BSN Once the file is loaded, open it and close the cling medical catheters. I have to chemically convert patients (To reply to this question, please type dialog window. A white cylinder should be on been sending catheters to a recy- from atrial fibrillation to sinus “ACT Guidelines” in your subject line.) the screen now. Use the transfer function cling company for about 10 rhythm without the presence of editor, which is the last tool on the right on years. I have always sent the a physician. At our facility, our In our lab we have different doctors that the tool bar. This allows you to adjust the catheter tips in an envelope pro- current practice is to give the like different ACT ranges. One of our doctors color, white, and gray scale to your liking. vided by the company. I have drug in the presence of “trained keeps his ACTs between 250-300. We take The punch tools will allow you to slice away always sent it through secure and professionals.” We interpret this these ACTs every 20 minutes after the initial all of the other anatomy not necessary. If insured mail. I have no way of as: in the presence of someone 3,000 or 5,000 unit bolus of heparin, you erase something by mistake, there is an knowing the value of the tips who is ACLS certified. We depending on patient size. “undo” feature, so practice and play with it other than based upon the value recently had an ACLS-certified Our other doctor prefers an ACT above without worry. of the last shipment. The insur- professional refuse to give the 350 and most of the time during the case it — Dan Medell, RN, RCES, EP Coordinator, ance is only valid for the ship- drug without a physician pres- is greater than 400. In this case we initially Ogden Regional Medical Center ment; after it is signed for, the ent. What is the practice at your give 5,000 units of heparin, wait 20 minutes insurance is invalid. Recently, facility regarding chemical car- and give an additional 3,000 units of Service for the EP-3i within the last six months, I have dioversions? heparin. Then we check ACT after another 20 Stimulator not heard from the recycling From my own experience, I minutes. After that, we check ACTs every 15 At our hospital (E. Wolfson company, other than the return have worked at the facility for minutes. Medical Center), there is an EPsigned receipt. I am wondering five years and have given the We have had some trouble with oozy 3i Stimulator that needs techniwhat recourse we have as cus- drug several times without a groins and recently invested in “the wedge.” cal service (we need to buy a tomers when this happens. I have physician present. I do feel com- This is basically a big roll of gauze in the key pad). Is there a distributor in sent a letter requesting a response fortable doing this and often shape of a half circle wedge that we place Israel? as to why I have not received help other professionals admin- over the groin site and then apply pressure — S. Hanan payment for catheter tips. Any ister the drug when they are not dressing tape over the wedge. This is like (To reply to this question, please type “EPsuggestions or comments please. someone's hand holding gentle but firm 3i Stimulator” in your subject line.) comfortable giving it. — anonymous — Lisa Decker, RN, BSN, Genesis Medical pressure over the site until it has stopped (To reply to this question, please type oozing. We try to avoid FemoStop as much Center, Davenport, Iowa There is no distributor in Israel for EP “Catheter Recycling” in your subject line.) as possible. (To reply to this question, please type MedSystems. You may contact EP We also have to note that the majority of MedSystems directly at +1(800)361-6464 “Corvert” in your subject line.) I also sent catheter tips to a medical our a-fibs are done under general anesthe- for technical support and to order replacerecycling company and have not received In our facility, we tend to administer sia. Patients are taken to a PACU after the ment parts for your EP-3i Stimulator. payment. I have even hounded [the compa- Corvert when the physician is present, but procedure where monitoring is more fre- — David Montgomery, Product Manager ny] on the telephone, and now I have my this is only because our physicians are quent, which also reduces the incidence of Electronics and Software, EP MedSystems, Inc. purchasing department involved. always present. Our policy is as follows: groin problems. — name withheld by request measure baseline QT, administer 1 mg — Lisa Decker, RN, BSN, Genesis Medical Roles in EP Lab Corvert over ten minutes if warranted, and Center, Davenport, Iowa I have two questions. We are Inventory/Charging re-check QT prior to administering the sechaving trouble in our lab — Does any lab use technology (bar ond dose. Most of our nurses are fairly com- CT Scanner Integration hopefully you can help me out. coding, cabinets, etc.) to help them fortable administering Corvert and have I am currently working with a We have three labs, and will be with their catheter and equipment even been called into Cardiac Cath cases to Toshiba 64-slice CT scanner, and getting our fourth. One of our inventories and charges? What administer it. Because the likelihood of would like more knowledge on three labs is an EP lab.We have 3 technology, and how well does it administering Corvert outside of the lab is the integration with CartoSync. RTs, 1 RN and an EP coordinawork for you? Any input would be low, the likelihood of a physician being pres- Where can I find more informa- tor, who is also an RN. How do helpful.Thanks! ent is almost 100% at New York tion about CartoSync? you handle call time, and what is — Dale R. Beatty, RN — Michael J. Moore BSRT, CT Presbyterian. the role of the coordinator? (To reply to this question, please type (To reply to this question, please type — Edmund Donovan, Clinical Nurse II, New — anonymous “Inventory/Charging” in your subject line.) York Presbyterian Hospital “CartoSync” in your subject line.) (To reply to this question, please type Line Access and Cath Placement I would love any information supporting EP lab staff line access and cath placement. — anonymous (To reply to this question, please type “Line Access and Cath Placement” in your subject line.) http://www.eplabdigest.com

Table of Contents Feed for the Digital Edition of EP Lab Digest - February 2008

EP Lab Digest - February 2008 Creating the U-M Center for Arrhythmia Research: Interview with José Jalife, MD Texas Cardiac Arrhythmia Institute and St. David’s Medical Center Launch State-of-the-Art Training Center Contents Letter from the Editor Spotlight Interview: Caritas St. Elizabeth’s Medical Center 10-Minute Interview: Sue Deck, BS, RN, RCES Keeping Pace With a Blog Roundtable Discussion on Cryoablation Procedures Email Discussion Group: February 2008 Events Calendar Industry News and Products Classifieds Advertisers Index

EP Lab Digest - February 2008

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