Noninterventional Cath Labs

Angie O'Plasty · Oct 3, 2005

I agree, why go in there twice and subject the patient to the potential risks one more time than is really necessary? I don't understand it either. Makes much more sense to be able to do the intervention right then and there when the problem is found.

hrtprncss · Oct 3, 2005

I've always worked at places equipped with interventional cardiology. Perhaps that's why I don't see fibrinolytics used as much as the other hospitals in rural areas where they would need emergent trip to the cath lab but would take a longer time to bring them to a place where they can do the plasty's. I think in my 8 years of cardiology experience, I've had less than five patients who just had TPA's.

Editorial Team / Admin · Oct 4, 2005

OK, here's the other side of the coin: I've worked at two facilities that were diagnostic only. We were gearing up for intervention at the one facility - had lists of supplies, worked out vendors, consignments, etc. . . but we had no cardiac surgery program, so the negotiations w/the ambulance co and the receiving facility took a LOOOOOOOOOONG time. Also, I just remembered: there were some heavy-duty area politics involving neighboring facilities that did intervention, that delayed us starting by at least five years before that.

At the second facility, our promising interventionalist was wooed away by his training facility (don't blame him, really). So we are ready to order the supplies he organized, but without an interventionalist ------ ???? no can do. We don't have a cardiac surgery program here either, have to rely on transport.

Sister facility in Las Vegas forwards their pts in need of diagnostics to us, (in the VA system) as the VA facility that does interventions is BOOKED, BOOKED, BOOKED!!! Pts have to wait months before getting an appt. So, the reasoning is, at LEAST we can do the diagnostic cath earlier, and it is turning out most of those pts don't require intervention. If they need something urgent, we transport a mile away, sheath intact, and they receive it the same day.

We are anxious to provide "one-stop shopping" experience for our (deserving!) patients, but have been hindered doing so. It's coming, just slower than molasses in winter, it seems!

rookreck · Dec 30, 2005

I work at a rural community hospital in Pa. A little over 3 years ago the state of Pa required that interventional cardiac caths be done in a facility that had open heart surgery programs. But for a little more than 2 years now,they are doing a pilot program and facilities without open heart programs are now doing interventional cardiac caths. We are doing interventional cardiac caths with great success. If a patient needs to go for surgery they are transferred by air to another facility. The program was only to be a trial for 2 years but the state of Pa. extended the trial. Our facility is hoping that the state will go ahead and approve the program. We are a 40 minute drive to the open heart program. When we get an acute MI , it is a great feeling to help the patient right away. After all time is muscle.

nekhismom · Feb 10, 2006

We do interventions in my lab, and we have surgical backup available 24/7. We also have a diagnostic only lab in the house, but they have the same backup. If a pt is cathed in the diagnostic lab and needs an urgent or emergent intervention, then they are transferred to our lab. If an intervention is needed but it can wait, we schedule them for PCI in our lab.

We get a LOT of our caseload done in the diagnostic lab that we would otherwise NEVER get done. We would pretty much be a 24/7 operation without the diagnostic lab.

All that being said, I would not feel comfortable having a cath in a place that did not have surgical backup immediately available. I have seen too many things go bad even with the best of cardiologists-- dissected aorta's, plaques broken off and arteries blocking off during cath, etc. I would not feel safe, but that's just my humble opinion.

zacarias, ASN, RN · Feb 10, 2006

Well if 64-slice CT scanners become the norm, interventional cath labs will be on their way out....no?

nekhismom · Feb 11, 2006

I don't think interventional labs will be out, because there will still be plenty to repair. I think non-interventional is going to be out of a lot of cases, though.

Our MD's are expecting the 64 slice scanner to "catch" a lot more disease than we currently see under angiography. We have ordered at least one 64 slice CT scanner for our lab, or so I'm told. I'm also told that the techs will be running the machine. In my lab, everyone is a tech, whether you're a nurse, resp. therapist, rad tech, cv tech, surgical tech, scrub tech, whatever. We all do the same job and have all the same training. So I'm looking forward to learning how to do some CT scanning!

SEOBowhntr · Feb 12, 2006

Well if 64-slice CT scanners become the norm, interventional cath labs will be on their way out....no?

Jury is still out on this one, but I think you mean "non" interventional Cath labs, not interventional.

As far as "Is it a money maker??" question goes, well sure it's a money maker, and if you can have a cardiac cath as a diagnostic in your local hospital rather than travel 2-3 hours to the "big city hospital" and have one, lots of people will still opt for the local place. Diagnostic caths still have a place, to make sure that pts. are clear for surgical procedures, etc. and decreasing stress by not making a pt. and their family travel. Read Dutchgirl's thread about her mother, and her results of her scans.

Doug

EricTAMUCC-BSN, BSN, RN · Feb 12, 2006

Thats retarted. no intervention, no cath

zacarias, ASN, RN · Feb 13, 2006

You're right, I messed up. I meant "diagnostic" caths, not "internventional." Sorry about that.

Whisper · Feb 14, 2006

Where i work we do emergency and elective interventions, our sister hospital only does diagnostic procedures and elective interventions only. We accept patients from five other trusts that do diagnostic procedures only... However if something were to go wrong it is our sister hospital 4 miles away that has the Cardiothoracic surgeons!

I can't see diagnostic procedures being on there way out as it is quicker for our lab to do the PCI in known areas of occlusion that doing an diagnositc angiogram then proceeeding... they still do a quick check but it is about half an hour quicker!