considering working in Echocardiology Lab

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I presently work in the ED and I'm thinking of switching to the Echocardiology Lab. I feel its time to make a change.... anyway.... just wondering what the duties are and would love to hear of some worse cases they may have seen. Also... are you glad you made the change to the echo lab?

Thanks...

K

1
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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

I'd ask the manager of the Echo lab just what they do: how many rooms are there, what would the RN be needed for [what skills do you need to work there, and what skills would you acquire there], etc.

I work in the Cardiology Dept, and we all rotate between Cath Lab/EP and Stress Lab.

We don't have an RN assigned to the Echo Lab per se, just free one up prn.

The only time our Echo Lab (with four techs and four machines running) needs an RN is the occasional IV start for a contrast study or moderate sedation administration and monitoring for a TEE.

Yours may have more rooms and be doing dobutamine stress echos, more IV starts and more TEEs than we do.

Ask them! :) Good luck!

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Yes, they do the dobutmanine stress tests too. just hate going and interviewing for a area that I might not have the knowledge for. I would imagine that a physician is present for the tests and you always have other nurses for back up.

Thanks for your reply!

K

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

You have the requisite background and can be taught the department-specific extras!

In our Echo lab a physician is present to help interpret the echo results (real-time), and mainly what we do is administer the dobutamine (per protocol) and monitor the pt.

Do they use Definity for contrast injections, or just saline bubbles?

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I believe they use the contrast..... could you recommend a site so I can read up on some of the specifics. Have you had any "worse case scenrious"...ie...codes...etc

Thanks...

K

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Not many, really (knock on wood!).

Most risk would be during the TEE. Pts are usually awake-ish, NOT DEEPLY SEDATED (the MDs just have to put up with an occ. arm moving -- they usually want to scratch their nose, w/the Versed :D -- or with the pts watching the screen). They are still sedated, just not deeply.

Watch 'em like a hawk!

An article r/t ischemia and dobutamine stress echo:

http://eurheartj.oxfordjournals.org/cgi/content/full/25/17/1477

A simple video (for pt teaching) that might be a good introduction:

http://www.cardiosmart.org/HeartDisease/CTTVideo.aspx?id=2010

Article about Definity:

http://www.medicalnewstoday.com/articles/140259.php

More info about Definity:

http://www.rxlist.com/definity-drug.htm

You might want to watch one or two dobutamine stress echos in that dept, just for info. sake.

Might not be as exciting an area as ED, but it's fascinating in its own way. :)

Good luck!

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Thanks for the info.... I have administered conscious sedation a few times... fentanyal (sp) and versed. And do watch them like a hawk... until fully awake!

I'm tired of the ED..... time to move on.... don't want the EXCITEMENT anymore.... looking for a slower place...tired of adrenaline rushes....

Just worried about my EKG skills.... never been one of my strong points!

Well see.....

Thanks again!

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Worst case, to me, would be

* perforation of esophagus by probe (check coags and WBCs and platelets pre-exam)

* oversedation requiring resuscitation/reversal agent administration

* other prob r/t sedation, i.e., adverse response to Fentanyl or Fentanyl admin. too fast; O2 sat instability, etc.

Had one of our Cardiologists insist we do a TEE on a pt whose baseline BP was 70/50. :eek: :eek: We proceeded with MUCH caution, me reporting VS CONSTANTLY to her!

Best thing is, the Cardiologist is present throughout the whole exam (= good support, IMO).

:)

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Your skills will grow ("she CAN be taught!") with exposure.

We have a weekly conference (we all attend) in which our Fellows are shown ECGs and quizzed about them.

I know more now than I used to, ust from watching and listening, but there's SO much to learn!

Main thing that our Cards stress is, have a systematic way of examining all the parts of the ECG, so you don't miss anything.

Let me know what happens! :)

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I'll let you know...

Thanks again...

K

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