I work in a diagnostic-only cath lab. We pre-op our patients one hour before their cath with Valium 5mg, Benadryl 50 mg, and Tagamet 300mg. Once in the lab, if they are still anxious, we usually give 1-2mg of Versed. One cardiologist routinely orders a bolus of Heparin 2500U given during the cath. Nitro spray sl is given for spasm or c/o CP. If we do the cath radially, after the sheath is in the docs inject a "verapmil cocktail" which is Heparin 5000U, verapamil 4mg, and Nitro 400mcg (then we have to watch out for drops in BP and HR which seems to happen often -- grab the atropine!) These are the drugs we use most commonly in our lab.
Although we are diagnostic only, we still take call -- not for emergency diagnostic caths! but for temp pacers, IABPs. We also put in permanent pacemakers, do TEEs, cardioversions, place Swans, DSEs. Recently we started putting in PICCs for the floors. (Our manager volunteered us - the few people certified to do them were never available or had left over the last few years.)
We recently were told that they are bringing open-heart to our hospital within 18 mos. We will be expanding by one cath lab (for a total of 2) and will start doing interventions. We are all very excited!
I just want to add that after years of working short staffed and frustrated in ICU, I LOVE the cath lab. The regular hours, not having to worry about staffing. I have been in the lab for two years now (and I am still the "new girl") and the teamwork and comfort level we have with each other and with the docs is wonderful.
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