CLINICAL EVENTS CALENDAR
- StartOct 22,2008EndOct 23,2008The Joint Commission Presents Laboratories: Accreditation Essentials (Beginner: 10/22; Advanced 10/23)www.cathlabdigest.com
- StartOct 23,2008EndOct 23,2008Introduction To Cardiovascular Cath Labwww.socalmeded.com
- StartOct 25,2008EndOct 25,2008Cath Lab Basics ‘08 with Dr. Morton Kern and Dr. Michael Limwww.cathlabdigest.com/basics2008/
- StartOct 30,2008EndOct 30,2008Introduction To Cardiovascular Cath Labwww.socalmeded.com
Non-Accredited Education
 CLINICAL EXPERIENCE WITH A NEW HYBRID CORONARY WIRE On Demand Web Archive Non-Accredited Target Audience: Physicians, nurses, and technologists. This activity is supported by an educational grant from Terumo Medical Corporation. |
Clinical Editor's Corner
What’s Your Approach to New Technology? Early Adopter or Prisoner of Tribal Customs?
Technology and new information come to the cath lab nearly every month. The use of new stents and techniques in percutaneous coronary intervention (PCI) (for example, bifurcation management or thrombus aspiration methods) continues to evolve. Years of studies supporting various approaches encourage each one’s incorporation into the lab when associated with better outcomes. If such a straightforward application of technology is related to better patient outcomes and supported by excellent studies, why then are simple technologies like intravascular ultrasound (IVUS) and fractional flow reserve (FFR) not put into daily practice?
Hemodynamic Data Collection at Square 1: From transducer to recorder
Hemodynamic studies require accurate data collection technique. For complex cases we record simultaneous pressure waveforms, working with multiple transducers. I have had some questions from our staff as to what is the best and easiest way to collect hemodynamic data. As a caveat, I am sure most of you already know that there is more than one way to do nearly everything in the lab, and that includes setting up and recording hemodynamics. Let’s spend a few moments addressing how we record hemodynamics in our cath lab.
I tell our fellows, “if you’re going to do it (measure hemodynamics), spend the time to do it right. No data is better than wrong data.”
Step 1. Check the cables: Transducer connections to the recorder.
When Is It Safe to Cath Someone on Coumadin?
Your patient has atrial fibrillation, chest pain and a positive stress test with risk factors for coronary disease, and is planning to undergo cardiac catheterization. The international normalized ratio (INR) is 2.2. When is it safe to perform coronary angiography on this individual?
Do You Have a Weight Problem in the Cath Lab?
The issue of patient weight for performance of cardiac catheterization is no trivial matter. The excessive weight of the patient can damage the x-ray table, produce poor quality non-diagnostic images, expose the staff to excess radiation and work-related back injuries (from improper lifting), and is associated with increased procedure complications. We all face this problem at least on a quarterly basis. Obese patients coming to the cath lab have increased in the last decade, with patients weighing above 350 lbs increasing from 1% to nearly 2%, and those greater than 350 lbs from 0 to 0.5%. How should we best manage the morbidly obese patient who truly needs cardiac catheterization?
Equipment Weight Limits
What do you mean, you don’t have a 2.25 stent? Managing frustration with supplies in tight times.
Your diagnostic catheterization procedure turns into a PCI. The left anterior descending artery (LAD) is accessed with the 6F JL4 guide catheter. Your circulating nurse is drawing up the heparin. The operator then requests his equipment: “Please get a 0.014 XYZ guidewire, a 2.0x15 ABC balloon and a 2.25x12 OMG (aka, “oh my gosh”) stent. The staff then scramble to collect the needed PCI items. After lesion predilatation, the operator is ready for his OMG stent. “Let’s have it,” he says. The circulating nurse then informs him, “Sorry, we do not have this stent in stock. Dr. Jones just used up our last one this morning.” A small tableside explosion signals the frustration that all labs experience at one time or another related to managing inventory in tight times. This common scenario is managed in different ways, depending on the systems, personalities and budgets involved.
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CME Showcase
Diagnosing Coronary Artery Disease: Advanced Cardiovascular Imaging Solutions Complimentary accredited web archive This activity is intended for physicians, nurses, and technologists. Treatment Options for the AF Patient A-fib Ablation:  New Standards of Care for CRMD Antibiotic Protection Complimentary CME Accredited Webcast Dates: November 18, 2008 Time: 6:00 pm ET November 19, 2008 Time: 3:00 pm ET This activity is sponsored by the North American Center for Continuing Medical Education. |
 LUMEN 2009 - THE SYMPOSIUM ON OPTIMAL TREATMENTS FOR ACUTE MI Live Symposium Date: February 26-28 Location: Loews Miami Beach Hotel Miami Beach, Florida 33139 This activity is sponsored by the North American Center for Continuing Medical Education. |
 Hemostasis Management in Today’s Cath Lab Complimentary Accredited Web Archive Release Date: June 19, 2008 Expiration Date: June 19, 2009 Target Audience: This activity has been developed for physicians, nurses, and technologists. This activity is supported by an educational grant from Radi Medical Systems, Inc. |
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