CARDIAC CATHETERIZATION
GOALS AND OBJECTIVES – ORGANIZED BY CORE COMPETENCIES
Background:
Fellow education in the cardiac catheterization lab includes learning the technical aspects of performing a
cardiac catheterization including achieving appropriate anesthesia, obtaining access to blood vessels,
manipulating the catheters to obtain hemodynamic information and using the catheters and imaging
equipment to perform angiography. Other important aspects of the experience include pre-cath
assessment of the patient and obtaining consent as well as post cath reporting of data and data
interpretation for use in clinical decision making. Because of the complex nature of the catheterization
procedure as well as the acuity level of the patients, the care team in the cath lab includes nurses and
technicians as well as the physician staff (which includes cardiologists and anesthesiologists.) For safe
and effective patient care, it is essential that this care team works together in a coordinated and efficient
manner.
The following goals and objectives are applicable for all fellows rotating through the cardiac cath lab:
Goals:
Know how to safely and professionally perform a cardiac catheterization, which includes the ability to:
 Acquire the appropriate hemodynamic data
 Interpret these data
 Communicate these data and the patient’s clinical state and needs to other health care
professionals
 Coordinate the care for patients who have undergone cardiac catheterization.
 Participate in at least 100 cardiac catheterizations during fellowship
The fellow should expect one-on-one teaching from the attending after each study or at the end of each
day. The fellow will receive informal feedback on a daily basis and formal feedback twice a month.
Systems Based
Practice
Professionalism
Interpersonal
Communication
Skills
Practice Based
Learning
Medical
Knowledge
Patient Care
Year of Training
The YEAR of Training is listed for clinical training in Pediatric Cardiology. In other words, YEAR 1 of
clinical training in Pediatric Cardiology and YEAR 2 of clinical training in Pediatric Cardiology. The
specific objectives for the cath rotation are as listed below:
Cardiac Catheterization:
Goal: Know how to safely and professionally perform a cardiac catheterization, which includes the ability
to achieve the following objectives:
Compose a plan for the procedure by
performing pre-procedure evaluation
consisting of history and physical
examination and review of all past
1
X
X
X
medical data and past procedure data
(cines, catheterization reports, ECHO,
Holter, Treadmill, EKG’s, etc)
Relate this plan to the catheterization
laboratory attending prior to the
1
X
X
X
X
X
procedure
Safely conduct the procedure by
1
X
X
X
X
X
making sure that all pre-procedure
1
Systems Based
Practice
Professionalism
Interpersonal
Communication
Skills
Practice Based
Learning
Medical
Knowledge
Patient Care
Year of Training
preparations are in place (e.g., blood
set-up, general anesthesia notified,
PICU/PCICU or recovery room notified,
etc.)
Recognize radiation safety concerns
and cite a basic understanding of
radiation physics and radiology
Discuss catheterization techniques,
devices, and instrumentation
Communicate and provide appropriate
post-procedure care; achieved in part
by:
o Writing preliminary procedure note
o Writing post-procedure orders
o Relating the results of the study and
status of the patient to those to whom
care will be transferred, which will
include other fellows and the
residents
o Monitoring patient recovery
o Writing follow-up notes in patient
chart, and formulating discharge
plans
Recognize the basis of function of the
catheterization laboratory equipment
and apply this knowledge to the
performance of the procedure
Perform vessel cannulation and
insertion and removal of catheters
successfully. By the end of the first
three rotations, the fellow will
successfully perform cannulation in
over 50% of the patients and by the
end of all the rotations, successfully
cannulate and insert catheters in over
75% of the patients
Relate an understanding of normal and
abnormal physiology and normal and
abnormal anatomy
Characterize the cardiovascular
anatomy of each patient for whom the
fellow participates in their
catheterization
Obtain and begin to synthesize
angiographic and hemodynamic data
Obtain and synthesize all angiographic
and hemodynamic data
Relate pathophysiologic states to the
X
X
2
X
X
X
X
X
1
X
X
X
X
X
X
X
X
X
X
X
1
2
X
X
X
1
X
X
X
1
X
X
X
1
X
X
X
2
X
X
X
1
X
X
X
X
X
Professionalism
Systems Based
Practice
Interpersonal
Communication
Skills
X
X
X
X
X
1
X
X
X
X
X
X
Complete procedure reports within
three days without being reminded
1
X
X
X
X
X
X
Be punctual, courteous and polite at all
times
1
X
X
X
X
X
X
Utilize medical literature and apply to
patient care
1
X
X
X
X
X
X
Utilize health system to optimize
patient care
1
X
X
X
X
X
X
1
X
X
X
X
X
1
X
X
X
X
X
Coordinate care of patients
Communicate effectively with parents
and patients
X
Practice Based
Learning
Patient Care
X
Medical
Knowledge
Year of Training
1
angiographic and hemodynamic data
Communicate important findings and
management changes to other health
care providers, including referring
physician.
Collaborate effectively with all coworkers