EP Lab Digest - December 2007 - (Page 30)

30 EMAIL DISCUSSION GROUP DECEMBER 2007 given at home. Is it common to send patients home on oral antibiotics? — Janice Christian, RN, CCRN As far as guidelines for ACT readings in (To reply to this question, please type pulmonary vein isolations (PVIs), we like to “Antibiotics” in your subject line.) keep the ACT as close to 300 as possible, ± 20 points. To achieve this end, we administer Wearing Hats and Masks / roughly 2,000–3,000 units when the right Bringing Food and Drinks atrial catheters are inserted, followed by Inside the EP Lab another 4,000–5,000 units post first Help! We’ve been having major transseptal puncture and heparin drip start- discussions about allowing food ed at 1,000 units/hour. Our first ACT is and drinks into the EP lab. Also, checked roughly 15 minutes after the drip is what is the protocol for wearing started. If the ACT is therapeutic, or close to hats and masks during ablations? being therapeutic, we will then check anoth- We would like to know what er ACT roughly 60 minutes later. If the ACT is other facilities’ practices are. lower than we like, we follow the ACT more What do the policies and proceaggressively, i.e., every 15 minutes until the dures read, and what is the actudesired range is achieved. After this, the ACT al compliance based on the poliis checked every hour. The heparin drip is cies and procedures? turned off just prior to when the left atrial — Janice Christian, RN, CCRN catheters are returned to the right atrium (To reply to this question, please type and the patient is extubated. The ACT “Inside the EP Lab” in your subject line.) machine we use is Hemochron Response (SN #4105). Atrial Fibrillation Ablation — Edmund J. Donovan, Clinical Nurse II, We are newly starting to do atriNew York Presbyterian Hospital-Columbia al fibrillation ablations, and I was wondering if anyone could give We are going to use the Medtronic ACT me examples of their instituplus, and some of our doctors have tion’s policy on AF ablations? expressed concern regarding the “real time — anonymous ACT” — that it may delay therapy during (To reply to this question, please type “AF ablations. Our current thought is a therapeuAblations” in your subject line.) tic ACT = 250, that’s a four-minute wait. — name withheld by request Service for the EP-3i Stimulator EP Exams At our hospital (E. Wolfson Has anyone used the online Medical Center), there is an EPtutorial from HRS and taken 3i Stimulator that needs technithe Cardiac Pacing and cal service (we need to buy a Defibrillation Exam in the same key pad). Is there a distributor in year? What are your thoughts Israel? about the tutorial with regard to — S. Hanan passing the exam? How do you (To reply to this question, please type “EPfeel about the new RCES certi- 3i Stimulator” in your subject line.) fication from SICP that was unveiled this year? Has anyone CT Scanner Integration taken this exam? Did the SICP I am currently working with a exam appear more difficult than Toshiba 64-slice CT scanner, and the HRS’ EP exam, and which would like more knowledge on exam do you feel is perceived as the integration with CartoSync. the more state of the art and Where can I find more informarespected more by peers and tion about CartoSync? employers? — Michael J. Moore BSRT, CT — Dana St. John, RN (To reply to this question, please type (To reply to this question, please type “EP “CartoSync” in your subject line.) Exams” in your subject line.) EP Protocols/Procedure Antibiotics Lists Our electrophysiologist wants to We are expanding into EP proknow what is the standard prac- cedures (i.e., ablations, EP studtice for antibiotics post PM and ies, mapping) when our electroICD implants. He currently physiology lab opens soon. We gives a second dose of IV antibi- would very much appreciate some otics, and no oral antibiotic is help with protocols/procedure EMAIL DISCUSSION GROUP Continued from page 29 checklists for EPS, ablations (right atrial and AV nodal), and CRT-D procedures. We are very experienced with caths, interventions, pacer and ICD insertions, but are starting an EP service from scratch. Thanks for your help! — Cindy Muto, RN (To reply to this question, please type “EP Protocols” in your subject line.) NIPS, Cardioversions, Tilt Table Testing How many labs perform NIPS, DCCVs and TTTs? — anonymous (To reply to this question, please type “NIPS/DCCV/TTT” in your subject line.) 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.) Readers, we need your help! These questions have yet to be answered: Roles in EP Lab I have two questions. We are Readers, want to join EP Lab Digest’s Email Discussion Group, but don’t know how? It’s easy! • In each issue of EP Lab Digest, find a listing of the latest questions and responses from our readers. Then email your EP-related questions and/or responses to “eplabdigest@hotmail.com”. • You can also go to “www.eplabdigest.com” and click on the “Email Discussion” link. Here you can reply with your answers and/or ask new questions. • To find previous discussions on a specific topic, click on the “Archives” link on “www.eplabdigest.com”. Choose any issue from any year, and click on the email discussion section for that month. To search a particular topic, you can also click on the “Article Search” link. • Remember to inform us if you would like your name, location, and email address published, or if you prefer to be listed as “name withheld by request.” Your question or response could appear in an upcoming issue of EP Lab Digest! http://www.eplabdigest.com http://www.eplabdigest.com

Table of Contents Feed for the Digital Edition of EP Lab Digest - December 2007

EP Lab Digest - December 2007 Improved Anatomical Orientation During AF Catheter Ablation: Experience from Leipzig Heart Center One EP Lab’s Solution to the Administration of Deep Sedation Contents Letter from the Editor Spotlight Interview: Northeast Georgia Medical Center Emerging Technologies for the Electrophysiology Lab The Western Atrial Fibrillation Symposium About the PRECEDE-HF Trial: Interview with William T. Abraham, MD, FACP, FACC, FAHA Overview on Shire and the Discontinuation of Ethmozine®: After the Heart Rhythm Society Intervenes, the Company Changes its Decision Minimizing the Risk of Infection at Children’s Sibley Heart Center: Interview with Nicole Jarrell, RNC, MSN, and J. Renee Watson, RN, CIC Is There a Link Between Gasoline Vapors and Brugada Syndrome? Interview with Darko Kranjcec, MD and Hugues Abriel, MD, PhD New Feature! Pacemaker/ICD Puzzle Email Discussion Group Events Calendar Industry News and Products

EP Lab Digest - December 2007

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