Current Questions Under Discussion:

Catheter Placement Competency Check-Offs
I would like a job description and/or competency check-off list for placement of EP catheters during diagnostic studies by allied health professionals. Does any facility out there have a policy or procedure regarding this? If so, I would like a copy!
Vicki Maestas, ARRT R.T.(R)(T)(CV), CVRT/EP, Banner Baywood Heart Hospital
(To reply to this question, please type Catheter Placement Check-Off in your subject line.)

    I have been in hospitals where techs do place catheters and even start baseline procedures. I never have a "check-off" per se it was just the trust of the physicians that you have to gain. Some of the management team even tried to put a stop into this practice; it goes away but somehow manages to come back.
    Let s face it, there are some techs who can place catheters a lot better and safer (and faster!) than other doctors or fellows. If we don't keep the good techs challenged, they'll get bored and look somewhere else.
name withheld by request

Back-up Defibrillator for EP Lab (Second Defibrillator)
A question that continues to be brought up in our lab is that a second defibrillator is required in case of failure of the primary defibrillator. We have tried to find if this is a standard recommendation, etc. Do you have any insight as to where this information can be located, if it in fact exists?
Mary Hosler, RN, BSN, Bay Regional Medical Center, Bay City, MI
(To reply to this question, please type Back-up Defibrillator in your subject line.)

    We have back-up defibrillators in all of our EP rooms: invasive, device, and non-invasive.
Shawn Heffernan, RN

Billing for Transseptal Punctures
I have a question regarding billing for transseptal punctures. Our billing department at New York Hospital states that we cannot bill for a transseptal puncture during an atrial fibrillation (AF) ablation because it falls under the category of access. This is confusing to me as the cath side can bill for the same procedure under a valvuloplasty. How do other institutions, or do you, bill for this portion of the AF procedure? Thanks.
Edmund Donovan, RN, CN II, New York Presbyterian Hospital, New York, NY
(To reply to this question, please type Billing in your subject line.)

Check-Off List for Non-Medical Staff
I would love an outline for non-medical staff skills competency check-off list. More and more across the EP world, line access and catheter placement are being performed by non-medical staff. We have been doing this for 2+ years without one.
Peter Uluave, RN/EP tech, Salt Lake Regional Medical Center, Salt Lake City, UT
(To reply to this question, please type Check-Off List in your subject line.)