Email Discussion Group: AHA Roundup

New Questions: Antibiotics Our electrophysiologist wants to know what is the standard practice for antibiotics post PM and ICD implants. He currently gives a second dose of IV antibiotics, and no oral antibiotic is given at home. Is it common to send patients home on oral antibiotics? Janice Christian, RN, CCRN (To reply to this question, please type Antibiotics in your subject line.) Wearing Hats and Masks / Bringing Food and Drinks Inside the EP Lab Help! We have been having major discussions about allowing food and drinks into the EP lab. Also, what is the protocol for wearing hats and masks during ablations? We would like to know what other facilities practices are. What does the policies and procedures read, and what is the actual compliance based on the policies and procedures? Janice Christian, RN, CCRN (To reply to this question, please type Inside the EP Lab in your subject line.) Atrial Fibrillation Ablation We are newly starting to do atrial fibrillation ablations, and I was wondering if anyone could give me examples of their institution s policy on AF ablations? anonymous (To reply to this question, please type AF Ablations in your subject line.) Service for the EP-3i Stimulator At our hospital (E. Wolfson Medical Center), there is an EP-3i Stimulator that needs technical service (we need to buy a key pad). Is there a distributor in Israel? S. Hanan (To reply to this question, please type EP-3i Stimulator in your subject line.) CT Scanner Integration I am currently working with a Toshiba 64-slice CT scanner, and would like more knowledge on the integration with CartoSync. Where can I find more information about CartoSync? Michael J. Moore BSRT, CT (To reply to this question, please type CartoSync in your subject line.) Under Discussion: EP Protocols/Procedure Lists We are expanding into EP procedures (i.e., ablations, EP studies, mapping) when our electrophysiology lab opens soon. We would very much appreciate some help with protocols/procedure checklists for EPS, ablations (right atrial and AV nodal), and CRT-D procedures. We are very experienced with caths, interventions, pacer and ICD insertions, but are starting an EP service from scratch. Thanks for your help! Cindy Muto, RN (To reply to this question, please type EP Protocols in your subject line.) Here is the tilt table test protocol from Mid-America Cardiology (HUT Clinical Resource Guide.pdf). name withheld by request *Editor s Note: For a copy of this PDF, please email the editor at I ve been away for awhile. If you are still interested in EP protocols, contact me and I will be glad to assist you with any needs you may have. Dana St. John, RN ACT Guidelines I was just wondering what people are using for ACT guidelines during pulmonary vein isolations. I am also curious as to what ACT machine they are using. Heidi Helmer, RN, BSN (To reply to this question, please type ACT Guidelines in your subject line.) We use Signature Elite ACT monitoring meters. Our PVIs are bolused with 5000-7000 units of heparin, then we check ACTs q 30 minutes and try to maintain ACTs greater than 300. Kelly Williams NIPS, Cardioversions, Tilt Table Testing How many labs perform NIPS, DCCVs and TTTs? anonymous (To reply to this question, please type NIPS/DCCV/TTT in your subject line.) We do NIPS in the EP lab, tilts in the EP lab or the tilt room depending on the need for art line access, and cardioversions are done in the Cath lab recovery area. Hope this helps! Alison Swarens, RN, BSN, CCRN, Electrophysiology Program Coordinator Our lab does perform NIPS. We do not do cardioversions or tilt tables. The defining issue is EP lab availability. The EP docs do not want the EP/Implant labs being utilized by other non-EP docs for cardioversions and tilt table studies. Only EP docs perform NIPS, so we do them in the lab or if another room is available, the EP staff will assist. Dana St. John, RN More Questions: Roles in EP Lab I have two questions. We are having trouble in our lab hopefully you can help me out. We have three labs, and will be getting our fourth. One of our three labs is an EP lab. We have 3 RTs, 1 RN and an EP coordinator, who is also an RN. How do you handle call time, and what is the role of the coordinator? anonymous (To reply to this question, please type Roles in EP Lab in your subject line.) 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.) Alcohol Septal Ablation Does anyone have, or are they willing to share, established written procedures for this procedure? In addition, if performing this procedure, do you use ECHO contrast? If so, how is it administered? name withheld by request (To reply to this question, please type Alcohol Septal Ablation in your subject line.) Loop Implant/Explant I was just wondering what some protocols are for loop procedures, particularly explants. I have recently been told that loop explants should take place in a positive pressure room. Any comments on this matter would be appreciated. Edward Muxlow (To reply to this question, please type Loop Implant/Explant in your subject line.) 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.)