Cath lab staff

Ours have been given the option to work critical care as they all have CC backgrounds.

Ours have been doing severe and emergency cases only.

We have four labs available for use. Typically two get used for interventions, one for EP and one for devices or structural heart.

Currently we are running one intervention lab (for STEMIs and urgent/emergent caths both outpatient and inpatient at ours and other regional hospitals), occasional devices (ICD and PM generator changes, urgent initial implants).

The other day there was a TAVI on the slate (definitely urgent), and we are told that we will be doing occasional urgent EP cases. Probably rare, because we have no anesthesia support which limits EP abilities, and how often is it that someone needs an urgent ablation...Also we are still taking call but there is more happening in terms of doctor to doctor conversations before activating the call team to discuss COVID status and potential risk to staff.

Staffing wise, there are a lot of extra staff floating around! We haven't been hit hard (yet) at my hospital so are doing a lot of preparation, lots of changes coming down the pipes about how we manage codes among other things. One of our labs has been set to negative pressure and all the equipment (minus one set of all the basic equipment like sheaths, one set of usual diagnostic catheters, etc) has been taken out of the room - so this is the designated COVID lab. The other one is where we are doing all our cases, unless it's a COVID positive or high suspicion for COVID patient. We have also done a dry run to work out the kinks - like an earlier post mentioned having "clean" and "dirty" personnel, etc.

We are getting floated to CCU or the cardiac ward on occasion, but there are not as many cardiac patients in general right now. I anticipate we will all eventually get floated to ICU once the storm hits (critical care training is mandatory for us) but that hasn't happened yet. It's been a while since I last worked with a vented patient so I'm reviewing old notes and just trying to be prepared.

They moved the CCU patients/staff to a smaller area because we're only doing a few urgent/emergent surgeries and getting the occasional STEMI or cardiac arrest since all elective procedures are cancelled.

They converted our CCU into a COVID+ ICU, staffed by a combo platter of nurses and techs from CCU, MICU, Float pool, and are now pulling CRNAs to be ICU nurses and Cath Lab/procedural/PACU/ED/PICU and any nurse who has left ICU in the last few years to work anywhere else in the hospital system...back to staff COVID ICUs.

Demand a little orientation/training, even if it's just management emailing you 2 powerpoints about ARDS and getting an orientation shift on the COVID ICU (when one crops up. I feel certain it will. We have 2 now with talks of where they could open a third and fourth) before you're expected to just show up and start taking a bunch of proned ARDS patients when you've likely lived in CCU/Cath lab/Cardiac world for most of your career.