considering working in Echocardiology Lab

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!

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?

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 -- 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!

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: 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).

:)

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! :)