CARDIAC CATHETERIZATION LAB SKILLS INVENTORY

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Scrub Responsibilities
Accepting sterile supplies from non-sterile personnel.
Administer, or hand off to MD, table meds as ordered by MD.
Aseptic technique to set up & maintain sterile field. Uses latex-free products when indicated for allergies.
Aseptic technique, preps & drapes neck, groin), subclavian or brachial. Uses non-iodine prep with allergies.
Assist MD w/ wire/catheter placement.
Drape flouro Tube/Shield. Arranges foot pedal position.
Exchange catheters over a wire.
Label all meds on table.
Load catheter w/ wire.
Prepare manifold & flushing tubing.
Prepare/wipes all wires.
Preparing/flushing catheters, sheaths, tranducer.
Scrub Responsibilities - RHC
Assist w/ calibration & zeroing the transducer.
Draws blood samples from appropriate ports of catheter.
Obtain cardiac output using thermal dilution catheter.
Prepared thermodilution catheter.
Use of balloon tip catheter.
Scrub Responsibilities - LHC
Assist MD to cross AV w/ catheter &/or wire, as requested.
Knowledge of various coro catheters.
Knowledge of various wire.
Placement of wire during catheter insertion.
Still Wire technique during AS cases & other placements.
Wipe wire w/ heparinized.
Scrub Responsibilities - Interventional Cases
Apply occlusive dressing over site.
Apply sterile caps to all ports of A/V lines to ensure sterility.
Draw ACT samples.
Flush A/V lines w/ heparinized saline at end of procedure.
Knowledge of various interventional wires.
Prep of various balloons/stents/burrs/IVUS catheters.
Secure A/V lines to skin.
Use of indeflator.
Scrub Responsibilities - Peripheral Cases
Ability to assist with wire placement.
Prepping balloons and stents.
Apply occlusive dressing as indicated.
Assist MD w/ vascular closure device insertion.
Assist MD with table positioning if needed or requested by MD (Rad Tech only).
Disassemble table & appropriately disposes of sharps, contaminated equipment/solutions, linen.
Inject coros w/ contrast while MD pans (Licensed staff only).
Maintain & Communicate awareness of pt. Condition during procedure to MD/Circ RN/Monitor.
Review procedure & supplies w/ Monitor/circ to ensure accuracy of billing.
Save designated equipment for re-processing. Places in correct container.
Sheath Removal
RN gives report to receiving RN to include pt. Condition, tolerance of procedure, any complications or reactions.
Sheath Removal - Procedure for sheath removal & groin management
Angioseal.
Application of C-Clamp.
Application of Fem-O-Stop.
Manual hold.
Vasoseal.
Sheath Removal - Patient instructions post-procedure RE
Do not bend leg of puncture site.
Do not sit up.
Do not strain while voiding.
Head on pillow.
Notify nurse of suspected bleeding at site.
Contract Administration
Contrast needs w/ MD & selects correct contrast for specific case.
Differences between ionic vs. non-ionic contrast.
Knowledge of all contrast media used in CCL, including indications & precautions.
Physical characteristics & functions of current power injector.
Storage requirements including hand-time & when to discard contrast.
Understand major side effects of contrast administration & how to manage reactions, including allergic reactions.
Contract Administration - Ability To:
Arms injector
How to safely abort injection
Inject contrast
Insert syringe into barrel
Interpret messages/responses on console
Load contrast into syringe
Makes bubble-free fluid path between catheter connection & tubing
Set injection parameters after conferring w/ MD
Troubleshoots common problems
Circulating Responsibilities
Airway management.
Assessment & monitoring procedures per protocol & documents accordingly.
Assists scrub with gowning, table pre, needed supplies.
Correctly does pre-procedure teaching to ensure safety, privacy, and understanding of procedure.
Dosing & administration of common sedation meds during C.L. procedure.
Ensure appropriate shave/prep done, or performs.
Frequently offers reassurance to pt. &/or family to decrease anxiety.
Knowledge of S/S of complications & how to respond
Monitor pt. If monitor person out of room getting supplies.
Monitors patient sedation level throughout procedure.
Processes ACT/AVL & O2 saturation samples.
Use of emergency equipment & reversal agents.
Circulating Responsibilities - Assemble appropriate supplies for procedure:
ACT/AVL/ O2 sampling
ECG monitoring
Formalin from lab for biopsies
Medications per order
Oxygen
Pressurized transducer system for arterial line
Pulse Oximetry
Special catheters/balloons/stents
Syringes
Monitoring Role
Adjust ECG wave size, HR and pressure alarm settings based on patient physiologic parameters.
Arterial pressure zeroing and transducer placement.
Assist in attaching patient to pulse Ox, NIBPcuff and adjusts frequency time/alarms as requested.
Assist w/ positioning patient on table.
Assure patient is hooked up to ECG monitor.
Calibrate ACT Machine daily and documents.
Calibrate AVL Machine daily and documents.
Catheter placement for accurate thermodilution curves & time delay between trials.
Generating valve areas, gradients, shunts, etc. & where to enter data to ensure accurate results.
Identify an accurate thermodilution curve vs. low cardiac output.
Logging on/admitting and re-admitting patient to hemodynamic system.
Method of setting up & performing emergency defibrillation per ACLS, including paddle & lead mode.
Proficiency in dysrrhythmia recognition vs. artifact.
Proficiency in use of defibrillator used in the CCL.
Recording pressures & cardiac output. Accurately reports data to MD during procedure.
Set up and arrangement of the tram on hemodynamic system.
Set up and calibrate equipment needed for case.
Turning on the cardiac output screen where injectate sensor probe & power cables are attached.
Where & when to change the injectate volume or catheter size.
Monitoring Role - Setup Troubleshooting & use of the AVOX oximeter to include:
Correct method for setting oximeter path length, retrieving results, verifying correct operation
Demo correct response to "error" message
Proper technique for filling cuvette & inserting into machine
Turn on & verify passing of self-tests
Monitoring Role - Perform common functions
Apply processing functions to optimize image
Calculate automated & manual ejection
Calculate vessel diameter & length
Display selected images on viewing monitors
Flag & de-flags images & runs
Review exam/select runs or images from exam
Store currently displayed image in photo file
Other Procedures - IABP Scrub Role
Ability to scrub, prepare patient and assist MD with IABP insertion
Catheter secured
Sterile dressing applied to insertion site
Other Procedures - IVUS Monitoring Role
Identify intima, advantitia, and media by ultrasound
Identify lipid, fibrous, & calcific plaque by ultrasound
Initiate, records, and annotates images
Make & erases measurements
Use of system including entering patient & operator information
IVUS Scrub role set up including:
Confirming helium levels
Correct connections
Correct inflation & timing
Correct transport of patient & set up of console at destination site
Establishing proper trigger sources
Proper power source
Verbalizes & demo correct ability to troubleshoot common problems
Verification of systems self-test
Handle IVUS catheter per IVUS procedure
Prepare and assists MD w/ IVUS procedure
Other Procedures - Rotorblade procedure
Ability to correctly monitor & report pressure/changes to MD
Ability to handle catheters/burrs & assist MD with procedure
Procedure for Rotoblator
Other Procedures - Temporary Pacemaker insertion - Scrub Role
Ability to scrub, set up & prepare patient and assist MD with T.P. insertion
Pacing capture has not been lost after moving patient
Technique for moving patient from table to ensure integrity of catheter placement
Other Procedures - Temporary Pacemaker insertion: monitoring role set-up & use of the pulse generator including:
Adjustment of MA to 5
Adjustment of rate to 70
Adjustment of sensitivity to "demand"
Battery check &/or placement
Additional Information
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CARDIAC CATHETERIZATION LAB SKILLS INVENTORY

CARDIAC CATHETERIZATION LAB SKILLS INVENTORY

Personal Information

Scrub Responsibilities

Scrub Responsibilities - RHC

Scrub Responsibilities - LHC

Scrub Responsibilities - Interventional Cases

Scrub Responsibilities - Peripheral Cases

Sheath Removal

Sheath Removal - Procedure for sheath removal & groin management

Sheath Removal - Patient instructions post-procedure RE

Contract Administration

Contract Administration - Ability To:

Circulating Responsibilities

Circulating Responsibilities - Assemble appropriate supplies for procedure:

Monitoring Role

Monitoring Role - Setup Troubleshooting & use of the AVOX oximeter to include:

Monitoring Role - Perform common functions

Other Procedures - IABP Scrub Role

Other Procedures - IVUS Monitoring Role

IVUS Scrub role set up including:

Other Procedures - Rotorblade procedure

Other Procedures - Temporary Pacemaker insertion - Scrub Role

Other Procedures - Temporary Pacemaker insertion: monitoring role set-up & use of the pulse generator including:

Additional Information