Orientation to VA Cath Lab Rotation
We have decided to outline the responsibilities of the cath lab fellow at the
VA and put them on paper. They are not much different from what you have
been doing before, but we decided to (re)involve the fellows more in case
selection and pre-procedure assessment/obtaining consent as well as
post-procedure follow-up. We are introducing a change in that the cath
fellow will have to input the precath eval in CART CL. I must also
emphasize the importance of putting in the formal cath reports (using
CART CL) as soon as possible after the procedure in CPRS. Please
remember to also put the estimated blood loss in the brief postprocedure report or in the cath report. This is an important JACHO
requirement. Remember that fellows who make the cath lab run smoothly
and quickly are held in high regard not only by the cath lab staff but also
by the cath attendings. Moreover, working closely with the ACE team
fellow will make things a lot easier.
In return for fulfilling these responsibilities, the fellows have the opportunity
to ‘run the show’ and (especially in the case of senior fellows like you) to
act as a junior attendings, making decisions and speaking to patients and
their families. Also, they get hands-on experience and learn the technical
and theoretical aspects of cardiac catheterization/coronary angiography.
I am attaching the responsibilities as a MSWord document. Note that
actually doing the case is only a fraction of the total responsibilities.
We will see how things go and we are open to criticisms and suggestions.
Thanks for your help in making the cath lab rotation better for everybody.
Ion S Jovin
PS: Please also let Lorraine Russell and Debbie Nelson know as soon as
possible about your clinic dates and the dates when you will not come
because you are post-call.
ISJ
Diagnostic Cardiac Cath Fellows’ Responsibilities
Be in the cath lab before or at 7:30 am.
Round on 2E, evaluate and get to know the patients and obtain consent for the procedure.
Put in pre-procedure note (especially for inpatients, you will have to input precath data in
CART-CL).
Do the cases.
Review the films.
Put in the post-procedure orders and the cath consult note in CPRS and in CART-CL.
Round on post cath patients, explain results and evaluate pre-discharge.
Review the cases for the next day (including the indication for the procedure as well as
the pre-procedure labs) and consent the patients who are on 4B & 2E.
Triage the flow of non-CCU inpatients scheduled for cardiac cath and, if needed, review
the consults for outpatient caths and decide about the appropriateness and the urgency.
On weekends evaluate the inpatients and make sure they have the labs and consent for the
procedure next day (personally or by arrangement with CCU/Consults fellow).
On Tuesdays run the CT surgery/PCI conference and put brief notes in CPRS on the
decisions/opinions reached.
Also, it is expected of the fellows to set the table and/or to hold the groins and/or to
escort critically ill patients to the ICU after the cases as the need arises.
Using CART-­‐CL 1. Sign in to CPRS 2. Select a patient 3. Click on Tools 4. Click on CART-­‐CL 5. Close CART-­‐CL (File -­‐> Exit)