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Under Discussion:Universal Protocol The 2009 JC standards include more specific language on Universal Protocol and site marking for percutaneous procedures. Are there any EP labs that have adopted site marking as a pre-procedure standard for ablation and device implants? — Lee Anne Hockey, RCIS, RCES (To reply to this question, please type “Universal Protocol” in your subject line.) Our labs have not "weighed" in on marking the site for percutaneous procedures. We perform the "time out" procedure, and of course the site is one of the mandated items that needs to be addressed. With so much concern over implant infections, magic marker over the incision site could be a risk factor. I have not seen any data supporting this, though. You have to be careful using a pair of clippers not to cut or damage the skin, so scrubbing off marker on patients with very friable skin could damage the skin. As an aside, any suggestions on the RCES [exam]? I am interested in taking it, and would appreciate any input. — Dana St. John, RN AF Ablations Two physician groups at our hospital have recently recruited atrial fibrillation (AF) docs. We do not currently have an AF program in our EP lab. Plans have been made to purchase an ESI (St. Jude Medical) mapping system, and we use EP MedSystems. Does anyone have suggestions or a guide on how we should go about training our staff? The biggest part of learning is the plan; any help would be appreciated, especially orientation timelines, classes that would be helpful and/or books that could be helpful for the beginner staff. We currently do more simple ablations (i.e., atrial flutter, SVT, WPW). Thanks! — anonymous (To reply to this question, please type “AF Ablations” in your subject line.)