What is the size of your cath lab facility and number of staff members?

Holston Valley Medical Center (HVMC), a member of the Wellmont Health System, is a 544-bed facility located in Kingsport, Tennessee. In 2005, and again in 2007, Holston Valley was named one of the nation’s top 100 hospitals for cardiac care by an independent, nationally recognized healthcare information company. Holston Valley is just one of four Tennessee hospitals recognized in Thomson’s 2007 100 Top Hospitals: Cardiovascular Benchmarks for Success. Holston Valley also houses one of only six Level I trauma

How is a vulnerable plaque clinically defined?

Coronary plaque rupture with superimposed thrombus is the proximate cause of acute coronary syndromes (ACS). “Vulnerable plaque” is the atherosclerotic lesion defined as the precursor to coronary plaque rupture. A frankly unstable, disrupted atherosclerotic plaque is characterized pathologically as an inflamed, thin-capped fibroatheroma (TCFA). Thrombus forms upon this disrupted plaque, leading to an abrupt reduction in coronary blood flow, clinically manifested as ACS, with the patient presenting with chest pain or other symptoms, E

How did you come to use the transradial approach?

About fifteen years ago, I was invited to a transradial session in Amsterdam, taught by Ferdinand Kiemeneij. It was a live demonstration course and I was in the audience as a femoral interventionalist, surrounded by people that were very enthusiastic about the radial approach. I watched as a dockworker from Rotterdam walked into the lab and extended his wrist. Dr. Kiemeneij brilliantly used the transradial approach to perform coronary angiography followed by stenting of the right coronary artery. Within about 20 minutes, the patient

Why found PAMEAS?

I had worked in physician education training for a long time and felt that we needed an organization to represent patients and improve the patient experience. I wanted an organization that could do so, unlike typical patient advocacy groups, by working directly with physicians, other health care providers, industry, regulatory agencies and third-party payors. That is our focus and why we developed the Patient Medical Association, or PAMEAS.

I founded the organization back in 2005, and at the time, it was a division of another group I founded called the Endovascu

A new trend is emerging in cardiac services — the hybrid catheterization lab. There is some controversy over the specific definition (A cath lab where they will also do surgery? An OR where they have fixed imaging?), but hybrid cath labs combine the traditional diagnostic functions of a cath lab with the surgical functions of an operating room. Most existing cath labs are not large enough to convert into hybrid labs, so hybrid labs are typically placed in locations adjacent to surgical suites. Only a handful have been developed thus far, mostly focusing on pediatric procedures, but the appli

We explore four areas pertaining to peer evaluations. These areas include a look at potential problems in an evaluation performed solely by management, the positive and negative aspects of peer evaluations, suggestions on how to implement a peer evaluation and a brief look at change theory. This article will help those interested in implementing a form of peer evaluation for the cardiac catheterization laboratory, taking into consideration how employees may react to the plan.

Problems That May Occur With Management-Performed Evaluations

In most facilities, management is solely res

The world of medicine is fascinating. Each day presents itself with new opportunities to learn, invent, and most importantly, heal. In our years of working in cardiology, we have come across countless medical products and techniques, many of which we have chosen to incorporate in our practice at Rush University Medical Center. While patient safety will always be the primary concern, we cannot ignore the business aspects of financial and safety issues that exist in the acute setting. As medical professionals, we are all searching for products that will improve patient care while decreasing both

How did you move from the cath lab to creating a temporary staffing agency?

I started in diagnostic x-ray in 1994 and worked there for about 5 years, then moved to the cardiac cath lab after that. I left to work in industry for a number of closure device companies. I thought the glamour of sales was where I wanted to go. Yet, as I visited cath labs from Bakersfield all the way to San Diego, I saw one constant — a shortage of personnel, be it RNs, x-ray technologists or cardiovascular technologists for the cath lab.

I was having lunch one day at a cath lab as a staff tech and I

Mount Sinai Hospital cath lab accomplishes over 5,000 interventions annually, making it one of the busiest cath labs in the country. In 2008, the cath lab performed 5,254 interventions, a 7% increase over 2007 (4,908 interventions). The cath lab has also maintained a very low major complication rate (<0.5%) and mortality rate (0.22%) over the past five years, with both rates decreasing steadily from 2004 to 2008.

Tell us about the increase in volume at Mount Sinai over the past five years.

Our growth has been tremendous over the past five years, occuring in both coronary and non-

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“We have so many different ways that we administer nitroglycerine. Which one is best?”

— RCIS Online Class Student

Yes, it can be confusing sometimes. However, as I will explain, there isn’t a ‘best way,’ only a best way depending upon the situation.

Since we are discussing nitroglycerine (NTG), let’s refresh ourselves on how it works. When NTG is administered into the body, it is converted into nitric oxide at the cellular level. Nitric oxide is a natural vasodilator. NTG dilates veins more than arteries, and as a res