This year, we discussed such topics as EP policies, implant guidelines, AED access, anesthesia protocol, and outpatient care. We wrap up 2004 with other recent responses to our questions still under discussion. For a sneak peek at 2005’s email discussion section, please take a look at this month’s new questions for discussion. Readers, if you have information or tips that might be helpful, email us at eplabdigest@hotmail.com or go to www.eplabdigest.com and click on the email discussion group link. Our website is constantly being updated with new responses, so check back often!

Currently Under Discussion:

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

No. We place the chest pad on the right subclavian area close to the sternum and the second on the patient's back close to the left lateral. This works very well for us. When we prepare for an ICD implant we do not have to change the pad placement.
— R. Kidd, RN

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

Our lab regularly uses physician assistants (PAs) in both cath & EP. They put in sheaths, catheters, and generally do what fellows do. Nurses are used in some labs. In Warren "Sonny" Jackman's well-known lab at the U. of Oklahoma, the "ace" EP person is a nurse. His lab may have protocols etc.
— J. Fisher

Post Procedure
Does your lab transport patients back to their room post RFA procedure monitored or unmonitored? Also, do all of your RFA patients post procedure go directly back to their room, or are they monitored for a short period of time in a CCL/EP holding area/recovery room?
— M. Arenas

We transport all patients to the Cath Lab Care Unit unmonitored. They are then monitored during their stay and then either go to a monitored hospital room or are discharged home.
— Renee Shaffer, RN

New Questions for Discussion in 2005:

Radiation Protection Drapes
Do these drapes need to be sterile and body length? Because so many hospitals are cutting costs, would the drape be just as effective to place under the sterile drape from the neck to the groin?
— S. Smoker, RT

Readers, to reply to this question, please type “Radiation Protection Drapes” in your subject line.

Propofol for Moderate Sedation
Our lab is looking for policies/procedures/guidelines on using IV Propofol (bolus and/or drip) for our longer EP procedures. Does anyone have any information that can help?
— Randy Shaffer

Readers, to reply to this question, please type “Propofol for Moderate Sedation” in your subject line.