This month, we are including a recent response to our question under discussion. In addition, please take a look at this month’s new question under discussion.

Currently Under Discussion:

Femoral Sheaths
Our EP nurses are going to start putting the femoral venous sheaths in for the electrophysiology cases. There does not seem to be any other centre in the United Kingdom that is doing this; could anyone help with information/protocols/policies, etc.?
— J. Mudd

I am an EP Lab supervisor; we allow our techs as well as trained nurses to insert sheaths. We follow a certain procedure and protocols in order for them to be certified:
1) Must be able to pull sheaths (arterial/venous). No Hematoma
2) A quick review of the anatomy
3) They must observe 25 patients insertion (not just 25 sheaths insertion)
4) They will try to insert sheaths under my supervision (10 patients)
5) They must do the follow up with those 10 patients that they do same day or the day after if there are no complication or hematoma.
6) After the completion of the 10 patients, they will insert sheaths under the supervision of the physician. Only with the approval of their techniques from the physicians will they be allowed to do them by themselves.
I hope this helps!
— Alex Gonzaga, Washington, DC


New Question for Discussion:

R2 Pads
Does anyone routinely position the R2 pads under fluroscopy so that they are placed exactly over the heart?
— R. Sparrow, RN

Readers, to reply to this question, please type “R2 Pads” in your subject line.