What Do You Think?

Can you help your fellow professionals with the following NEW question?

Groin Prep I would like to know what other cath labs’ procedure is for prepping the groin area. Do you place a towel between the legs and prep, or do you prep the entire genital area without a towel down the center for patient privacy? Anonymous by request Email: cathlabdigest@aol.com _____________________________________ RCIS Acceptance I am currently a traveler and I am running into more job openings across the country that are only accepting RTs/ARRTs for tech positions in their labs. I have an AS degree in Cardiopulmonary Technology and my RCIS. Is there some way to improve the job opportunities for the RCIS people? RCIS credentialing is SPECIFIC to the cardiac cath lab. We have to gain better control over the cath lab tech market. How can this be done? Is there some way to promote the RCIS techs? How can we better educate cath labs on our skills/education abilities and improve our job market? Frances Sutera CPT, RCIS Email: fjs412@yahoo.com Cc: cathlabdigest@aol.com Frances, we as Cardiovascular Invasive Specialists are a unique breed. It is true that our talents are specific to the cardiac cath lab. We must draw attention to that fact. I do believe there is a change that must take place. The first change needs to be to stop calling ourselves TECHS when we are Invasive Specialists. Most people equate the word TECH to a nursing aide on the floor or basic EKG techs. We must start using our proper name and title. We need to take the next step in demanding that hospitals have all staff working in the cardiac cath lab become registered. We have different job fields that have all come in and replaced a dying breed (large shortage) of Invasive Specialists. A lot of the other job fields have done on-the-job training without attending an invasive cardiovascular course. I’m not saying we haven’t acquired some talented staff in this manner, but you do lose some of the theory behind our job knowledge when it is passed down this way. We must build a stronger platform of support by joining the likes of the SICP (Society of Invasive Cardiovascular Professionals) and ACVP (Alliance of Cardiovascular Professionals). All of the other modalities have a strong support organization. I used to view professional organizations as another way to waste money, but over time I came to realize that these are our support organizations. They are there for us to provide education, a lobbying platform and to help write guidelines for our job field. CCI (Cardiovascular Credentialing International) has been a big support organization that could be used as a sounding platform. They have taken an aggressive stance in what they will allow as CEU credits. This helps to gauge our legitimacy on an educational level. It is time for us to come together and make people stand up and recognize that we are a true profession with legitimate skills, quality education standards and true professionals in a job field that requires dedicated and talented personnel. At our hospital, we met with HR and have made new guidelines for staff working or wanting to work in the cardiac cath lab. You must be registered or registry eligible for new graduates (a strict timeline). This is the only way we can protect our job security. We have to take things to the next level and lobby for licensure. I know there are a few states that already recognize licensure, so why is it we can’t get that for all states and the Invasive Specialist? Kevin M. Collier, RCIS, Clinical Supervisor Cardiac Cath Lab Email: Kevin.Collier@ carolinashealthcare.org Cervical and Lumbar Damage from Lead Aprons Do you as a cath lab professional suffer from cervical and/or lumbar disc damage? My suspicion is that wearing the lead as often and for as long as we do, that the weight is causing a significant percent of our professionals’ to suffer lifetime damage! Bob Basile Email: bobstero@ptd.net Cc: cathlabdigest@aol.com Although we do tend to minimize by alternating the days in the lab, often, after a full day in the lab, we feel exhausted and really rather sweaty having worn lead all day. William Shankly I believe that Mr. Bastile is absolutely right. I suffer from lumbar damage, which I attribute to the amount of time spent in the cath lab wearing lead aprons. Two things I propose which may help cath lab professionals with cervical and lumbar damage are: 1) With new flat plate image intensifier technology, maybe more research could be performed to analyze how much lead is truly necessary to protect human organs from radiation exposure; 2) Change the amount of lead necessary for certain jobs in relation to distance from the tube/image intensifier. I.e., Scrub tech - 1.0 mm lead, Rad. tech - .75 mm lead, RN - .5 mm lead. Via the inverse square law of radiation, RNs would not need to wear lead over .5 mms for proper protection. Joey Bergeron, MS(R)(CV) I have worked in the cath lab for over 3 years, and working in an aggressive and busy lab, the only problem I really had was a sore back after wearing lead for a long case. I hope that I don't get any cervical or lumbar disc damage. I try to use proper body mechanics even when I'm leaning over to assist the physician. I can also say that I've been lucky to have physicians help the techs so we don't have to lean as much. Our hospital is really into back safety. Our lab purchased the lead aprons that have the shoulder inserts, which helps out immensely. Eldrick Hall, CVT Christus St. John Hospital Nassau Bay, Texas JCAHO and Temperature Charting With point-of-care testing (ACT) how is everyone dealing with the refrigerator temperature monitor over the weekends? In our lab, we check the temperature of the refrigerator every day and chart, but no one is in the lab over the weekend. Can we just put lab closed and have that be acceptable for JCAHO? We also have meds and our ACT controls in the same refrigerator, but they are separated. Has anyone with the same situation been surveyed by JCAHO, and was there any problems? Thanks! Larry Sneed, BS, RCP Manager, Cath Lab Alamance Regional Medical Center Email: sneelarr@armc.com Cc: cathlabdigest@aol.com We found that temperature probes that have a digital read-out with minimum and maximum alarms. Whenever the temperature goes out of range, the read-out flashes and lets you know what the temperature was. Sources of Min/Max Thermometer: Fisher Scientific 1-800-640-0640 Catalog Number 15-077-17B (degrees C) Cost is $28.76 Catalog Number (don't have catalog no.) (degrees F) Cost is $32.57 Traceable Memory Monitoring Thermometers from Health Care Logistics, Catalog #10368. Julia E. Davis Brackenridge Hospital Cath Lab/ EP/ Special Procedures To track refrigerator temperatures over weekends and holidays, we purchased Traceable Memory Monitoring Thermometers for about $60.00 from Health Care Logistics, 1-800-848-1633. It works by the first setting the acceptable temperature range on the device. If over the weekend the actual temperature goes out of range, this is noted on the LCD. Don Williams, RN Springhill Memorial Hospital Email: dwilliams@springhill.org In reference to the weekend medication refrigerator dilemma, we surveyed the medications that were in the refrigerator and found that we actually did not need the unit in the department. The use of abciximab had dropped off to the point that we had not used it for 6 months. Integrilin is the 2B3A of choice in our lab. According to the package insert Integrilin has a 60-day shelf life at room temperature. We tightened our par level of the drug to assure non-expiration and stocked our medication carts appropriately. In regard to the ACT controls, it was not an issue in past surveys and we were surveyed within the past 6 months. However, I partnered with the lab and asked them to store our controls. They agreed after it was discussed that the cath lab would take responsibility for reorder and expiration checks. I was told by the pharmacy that the lab being closed was a problem unless we could verify that the temperature had not fallen out of range over the weekend. They suggested an alarm or a thermometer that had memory capability. We are currently investigating electric remote monitoring hospital-wide. Raymond L. Stroup Jr., RN Director, Vascular Services Lake Hospital System Email: Chip.Stroup@LHS.Net

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