Published Jun 17, 2003
You are reading page 2 of Does your hospital do heart caths, but does not do CABG's?
CCL"Babe", BSN, RN
The cath lab I work in has OR back up. Thank God we don't need it very often, but in the years I've been there we have rushed patients to the OR, just from diagnostic procedures.
Cathlabrn is correct. We now are doing very risky procedures on patients we would have sent to the OR before. The equipment and technology is advancing rapidly.
I still wouldn't want to work in a lab that didn't have OR back up. Even though I miss the ER, I wouldn't want to work anywhere else.
moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS
Going rate for a heart cath is 10,000 dollars. At least that is what my grandmother was billed.
Our facility does have a cath lab, actually we have two. We have 3-4 Cardiologists that do caths and we have 2 Cardiac interventionalists. Since we are a trauma center the cath lab and the OR must be ready to roll within the 30 minutes. There is always a cardiothorasic surgeon on call as well.
The competing facility in town also provides caths. They do not offer intervention of any kind at this time. This is problematic for the patient because of the increased frequency that they have to move within the city and the facility. (Have the cath at Hospital B, then ambulanced over to Hospital A on a tele floor usually, then to Critical Care, then to Intermediate Care, then potentially back to tele). It is bad enough keeping it within the facility let alone to have all the hoopla of it all.
The other kicker is that we have only had one cardiothorasic surgeon for 7 months. There have been times when there have been 4-5 cases set for the day, and sometimes weekends. Great surgeon, but can only imagine how overworked he has been.
Our "mother hospital" does caths without cardiovascular backup. And they are in the process of getting approval to do PTCA and stents without the backup. That's a scary thing for me. I have worked in a large teaching facility that does CABG's and yes, things can go wrong very quickly. Our little hospital even had cardiologist that would bring a trailor and do caths in a mobile cath lab. When we joined a different hospital system that was stopped. Thank goodness. I was always worried on days that they were there. Always waiting for a code to be called in the cath lab trailor. If it were me or my family, I want them to be able to fix whatever if something does wrong. But I cardiologist are really pushing for caths and angio without surgical backup.
barefootlady, ADN, RN
I work at a facility that does heart caths and stents but not CABG. It can be very dangerous for some patients. We have had to ship many a patient to the "Big House" for a CABG on very short notice. I think it is a money thing and only money that drives some of these facilities to do things like this Our local major medical center is one of the top 5 cardiac centers in the East. Now why would anyone in their right mind come to our little facility to have a cath? The doctor tells them it will be ok and he wants to do it at our facility because he can get it done sooner or quicker. He never mentions the danger until they are practically on the table. Patients need to be advocates of their own care. If they choose to take the risk, then how can we do anything to protect them? I could loose my job, but I have councelled patients to go ama and check into the major center for more through care. Glad I did, one man's wife came back to tell me he almost died during the cath and had to go right into the OR.
Zee_RN, BSN, RN
My community hospital just installed a beautiful new cath lab. But we do not do open heart surgeries. We do screen our patients carefully also and don't really even DO that many caths. But I really don't understand why we spent the money on a new cath lab when there's so much else that needs done NOW that we can use to full effect NOW. Like renovate our outdated ICU that has 25-year-old beds that are just one step above crank-style beds. And semi-private rooms. And standard doors that you can barely fit a patient through let alone a patient in an OLD bed with four or five old Baxter pumps, an art line, etc.
When we have a high risk patient, they get sent off to our "mother ship." But they usually spend the night in our outdated ICU first. And if it is a Friday night that they come into the E.D. complaining about chest pain, they won't get "shipped out" until Monday morning! So....don't have your c/p on Friday night and go to a community hospital. Hie thee straight to a tertiary facility.
I do not think that you should do caths and especially NOT stents or angioplasties in hospitals which do not offer open heart surgery.
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