Memorial
Medical Center

Right now, Memorial Medical Center is in the process of getting a third lab. We currently have two single plane cath labs. The new addition is a dual Shimadzu Cath/Angio lab (Torrence, CA). It houses a 9 inch and a 16 inch II, both ceiling-suspended. We currently have 16 people on staff. The staffing mix consists of 8 RNs, 1 Respirator Tech/CVT, and 7 RTs, including myself (RT, CCL Supervisor). We rotate 3 cardiology groups through our labs for a total of 25 cardiologists. Why ACIST? Originally, we purchased two ACIST systems in late 1999. We purchased a third ACIST system because we have been pleased with our two existing ACIST systems. We found that there is a learning curve, but once you get used to the machine and follow the required steps, it works perfectly. I ask for the entire lab™s input or feedback on decisions that we make concerning the lab equipment. We have a staff meeting once a month. At that time, we discuss anything that™s going to affect staff and get feedback. We chose to order a third ACIST CMS because it reduces set-up times and is mechanically easier on the body. We are no longer in awkward positions while injecting for the cardiologist in long PCI cases. Since we implemented the CMS, I™ve found that we have fewer staff members complaining of back problems. I have not been to a cath lab where someone does not have issues with their back. We have noticed a contrast savings. Some cases have been done with as low as 4 cc (RCA) and 5 cc (LCA) of contrast. It really depends on how comfortable the physician is with the system and how open he is to team members™ input. Additional Advantages Overall, our staff prefers using the ACIST CMS. Our cardiologists really like the fact that the CMS is easier on their hands while they are performing injections. The ACIST CMS also has an air detection system which reduces the risk of air emboli. Our doctors feel more comfortable because of this safety mechanism in place to detect any air in the lines. Our technologists prefer the CMS because it is easier on their backs. Along with the system, we have been able to use smaller catheters, which helps reduce hemostasis times. We mostly use 5“6F diagnostic catheters and 6“7F guide catheters, which are visualized very well. The Isovue 370 Multipack The CMS also helps us reduce procedure times because we use Multipack 500mL bottles of Isovue 370. We save time in not having to wait on the circulator to change out the contrast bottles. In keeping with our tradition of whole-lab feedback on the purchase of new products, all staff members contributed to the decision to purchase the Isovue Multipack. Our primary reason for switching to use of the Multipack was our purchase of the ACIST CMS. We knew that the Multipack would help us further in conserving contrast and saving time. It helps reduce procedure times and hemostasis times, allowing us to increase our throughput and get more patients through the daily schedule. We™ve found that image quality is as good or better than as any other contrast media we™ve used in the past. We feel that our patient care has definitely improved, since less contrast and great image visualization equals fewer patient complications and less need for medications. A Cost Savings Estimate To date, our lab has not done a cost savings analysis, but it would be an excellent opportunity to see how much savings we are providing to the lab. Both the CMS and the Multipack have definitely reduced set up times. I would estimate that the combination of the ACIST CMS and the Isovue Multipack has eliminated about 15“25% of contrast wastage in our lab. Overall, I would say that three most noticeable advantages of using the ACIST are:  The safety mechanisms inherent to the system that help us avoid patient complications; Alleviates improper body positioning;  Helps reduce procedure times and saves contrast.

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