What is the size of your cath lab facility and number of staff members? University Health System (UHS) Cath Labs have 3 lab suites supported by 29 staff members, consisting of full-time and part-time clinical and non-clinical personnel. We have 14 registered nurses (RNs), 5 cardiovascular technologists (CVTs, 2 of whom carry the Registered Cardiovascular Invasive Specialist [RCIS] certification), 2 of whom carry the Registered Cardiovascular Invasive Specialist [RCIS] certification), 2 case manager RNs, 1 critical care technician, 1 administrative assistant, 1 operations manager, 1 inventory specialist, 1 data entry specialist and 1 data systems coordinator. University Hospital CCL staff range from 3 to 20-plus years of employment.

Abstract. The end-organ consequences of arteriosclerosis, namely heart attack, stroke and renal failure, are the leading cause of mortality and morbidity in the western world. Advances in percutaneous interventional techniques have meant that a fair proportion of this disease burden can be dealt with by percutaneous and nonsurgical options. Coronary angioplasty is an established way of dealing with simple and increasingly complex coronary disease. Carotid and renal stenting are also gaining favor as the preferred treatment options, compared to either medical therapy or surgical treatment. Overall, the endovascular approach to treating increasingly complex arterial atherosclerosis is increasing. As the use of stenting increases, so the drive to reduce potential complications and improve success rates intensifies. Although embolization from local atheroma has long been recognized as a potential complication in vascular surgery, direct evidence of this phenomenon was also observed

Any time a manager is updating or adding charges for a new procedure or product is also a good time to consider the impact on procedure time and staffing skills.

Breaking new ground with an existing cath lab remodel at Children’s Hospital Omaha

This monthly column in Cath Lab Digest reviews important points of distinction in drug-eluting stents, from characteristics to techniques, to provide valuable and relevant information about this technology. This article, the second of a two-part series on drug-eluting stent (DES) outcomes, focuses on the use of proper technique during an angioplasty procedure.

If you’ve worked in the cath lab for any period of time, chances are you have been to a large clinical meeting or two. Let’s face it, we’ve been to ones in which we’ve left with valuable information, and well, we’ve been to “other” meetings, when we’ve just left. When you work in a cath lab, there are rules you follow. The same applies for public presentations. There are rules to follow and they make a difference as to whether or not you are successful. For more than 25 years, I’ve attended and watched public presentations. Throughout that time, I have seen many common mistakes.

I have been a cardiovascular nurse for 20 years. I started out as a licensed practical nurse (LPN) and became burned out on bedside patient care. Next, I worked in a centralized telemetry monitoring station for 5 years and then landed in the cardiac catheterization laboratory. As soon as I had my two years of cath lab experience, I took the registered cardiovascular technologist (RCVT, the original version of the RCIS credential) exam. I became a registered nurse (RN) in 1999, and in 2003, when I became the clinical educator, I took the registered cardiovascular invasive specialist (RCIS) test again, so I could be a good resource to those wanting to take it in the future.

I have been a registered nurse (RN) for 26 years and have worked in the cath lab for the past 14 years. During this time, I have had the opportunity to wear a lot of different shoes and be on all sides of the fence. I have been a patient, a parent, a spouse and a nurse. It has been quite an eye-opening experience, and lately I have been thinking about how each role feels and how, as a professional, my responses affect others.

Multiple new and ongoing questions from readers. Your responses are welcome! Answer or pose a question at cathlabdigest@aol.com.

Ask your question, or any question you and your co-workers have had in your cath lab, to: tginapp @ rcisreview.com

Case Report A 48-year-old woman was transferred for cardiac catheterization and coronary intervention one day after thrombolytic therapy for an acute infero-lateral myocardial infarction. Catheterization revealed 90% stenosis of the mid-circumflex artery with possible spontaneous dissection (Figure 1); the ejection fraction was 45% with infero-apical akinesis.

Not all angiographic narrowings are atherosclerotic lesions. Coronary arteries have vascular tone and change caliber depending on the patient’s presentation, environment and the level of circulating neurohumoral mediators producing vessel tone.

SICP Editor’s note: Shirly is an active member of the Oregon Chapter of the SICP (Society of Invasive Cardiovascular Professionals) and will be writing a series of articles about teamwork. We hope you enjoy her work.