What is the size of your cath lab facility and number of staff members? We currently have three coronary intervention rooms, one pediatric bi-plane interventional room, one peripheral vascular suite, one interventional electrophysiology (EP) laboratory, and one implant room. In March of 2005, two new state-of-the-art flat-panel GE rooms (Waukesha, WI) were added, bringing our total labs to seven. The cath lab has over 40 employees: 17 RNs, 8 RCISs, 8 RTs, and 10 CVTs. To augment our service line, we have a clinical educator, inventory specialists, EP coordinator, cath lab aide, scheduler, and clerical support staff. Staff members have been with the cath lab for time periods ranging from one year to over thirty years. We also have a 28-bed recovery room that consists of approximately 35 staff members.

In November 2005, the American College of Cardiology (ACC), American Heart Association (AHA) and Society of Cardiovascular Angiography and Interventions (SCAI) released the 2005 update to the guidelines for percutaneous coronary intervention. This guideline statement offers the first update involving all types of percutaneous coronary interventions (PCI) since 2001. Interventional cardiology continues to be a rapidly changing field. A substantial body of newly published literature, as well as changes in practice patterns, has occurred since the release of the previous PCI guidelines. Given this background, many of the writing groups’ recommendations have changed. This brief review will summarize the key changes in the latest update to the PCI guidelines. The full text of the guideline document is available for download in PDF format on the American College of Cardiology website (www.acc.org) or the Society for Cardiovascular Angiography and Interventions website (www.scai.org).

Memorial Hospital of Colorado Springs (MHCS) is a 477-bed, non-teaching, community-owned, not-for-profit institution. The hospital serves the community of Colorado Springs and southern Colorado with a full range of outpatient and inpatient health care, including medical, surgical, pediatric and rehabilitation services. Memorial Hospital is the main provider of a complete array of specialty cardiology services to the community of southern Colorado, serving patients with a wide range of inpatient and outpatient cardiovascular services.

It is estimated that 5–10% of all minimally invasive procedures will result in a hematoma, infection, pseudoaneurysm or retroperitoneal bleed.¹ Despite the advancements achieved through the ever-changing treatment modalities and the increase in minimally invasive procedures, we still find that proper technique in accessing the artery is one of the most important aspects in a successful procedural outcome. This article is intended for those who are new to the cardiac catheterization lab and/or are currently learning some of the basic elements in acquiring femoral artery access.

The Heart Center at Columbus Children’s Hospital (CCH) is dedicated to meeting the complex cardiac needs of pediatric and adult patients with congenital heart disease and, as such, is one of the top ten pediatric research centers in the country. The challenges of offering treatment for such a wide variety of complex cardiac defects has required a new spirit of collaboration and unique equipment design, particularly in the area of interventional cardiology and cardiothoracic surgery.

What is Pay-for-Performance? Called “the provider payment methodology of the future,” Pay-for-Performance (also referred to as P4P) has become the latest “catch-phrase” for both healthcare administrators and clinical providers. The global strategy of all P4P methods is to raise the quality of healthcare, which in turn, should control costs while maximizing reimbursement. In today’s fee-for-service payment methodology, healthcare institutions and providers are reimbursed according to the level of service provided, which has been shown to decrease the length-of-stay (LOS) for in-patient episodes due to the case rates that are assigned by the Centers for Medicare & Medicaid (CMS) to the Diagnostic-Related-Groups (DRGs). Outpatient procedural costs have also changed with Ambulatory Payment Classifications (APCs), in an attempt to correct reimbursements based on actual procedural expenses.

This monthly column in Cath Lab Digest reviews important points of distinction in drug-eluting stents (DES), from characteristics to techniques, so that physicians and staff have valuable and relevant information about this revolutionary technology.

I am a native North Carolinian and have lived in the Charlotte (Mecklenburg) area for most of my life. My educational path includes graduating from North Mecklenburg High School, Gardner Webb College (now Gardner Webb University) in Boiling Springs, NC with an Associate Degree in Nursing, and finally University of North Carolina at Charlotte with a Baccalaureate and Master’s of Science degree in Nursing. At present, I am not currently working in the cardiac catheterization laboratory, but spent twelve years (1983-1995) working in cath labs. I have been in the North Carolina Air National Guard as a flight nurse since 1984 and am currently the commander for that squadron. I enjoy learning and never shy away from new experiences, am an animal lover, and have hobbies that include reading, fishing, bicycling, pottery and stained glass.

Technology advancements are occurring at an ever-increasing pace. Typically, each new advancement means the ability to diagnose and treat health conditions is improved. However, some new advancements only provide marginal improvement in the capability to diagnose and treat healthcare conditions. As technology moves forward, it also brings a need for enhanced education and training.

The Seventh Annual Conference of the National Society of Radiology Practitioners Assistants (NSRPA) was held at the Orleans Casino and Hotel, Las Vegas, Nevada on January 30–31, 2006. The meeting opened with an introduction from the President of the NSRPA, Eric Burd, RPA. Mr. Burd thanked the corporate sponsors, the planning committee, society members who volunteered their services to help and interested registered radiologic technologists who are current applicants in RPA programs. The program host was Chuck Williams, RPA.

NEW to the Cath Lab? Your questions are answered here! Submit your question to: Jason Wilson, RCIS Ellis Hospital Clinical Instructor Schenectady, New York -- hrtfixr7@yahoo.com

“It all came from that ironic song playing during those STEMI call-ins…”

Dear Colleagues, Members and Friends,