[cdn-nucl-l] Nuclear lab recognized for diagnostic testing

["Adam McLean" <adam.mclean@utoronto.ca>]

Posted on the Kansas City Nursing News on January 11, 2002 and at:
http://www.zwire.com/site/news.cfm?newsid=2962556&BRD=1441&PAG=461&dept_
id=155395&rfi=6

Adam

----------------

Nuclear lab recognized for diagnostic testing
 
By:Lisa Waterman Gray, Contributing Writer January 11, 2002 
 
The nuclear medicine laboratory of Midwest Cardiology Associates, P.C.,
recently received accreditation from the Intersocietal Commission for
the Accreditation of Nuclear Medicine Laboratories.
 
This accreditation program evaluates quality and care, as well as
critical elements of the nuclear cardiology laboratory. Accreditation
signifies the facility has been reviewed by an independent agency that
recognizes the laboratory's commitment to quality testing for diagnosis
of heart disease.
Midwest Cardiology Associates' nuclear laboratory is one of the first in
the United States, Canada and Puerto Rico to be recognized for its
commitment to high quality patient care in its provision of quality
diagnostic testing. It is also the first accredited laboratory in the
Kansas City/Johnson County and Independence, Mo., area.

Each year approximately 5.5 million stress nuclear cardiology studies
take place in the United States.

Florence Morris, RN, ACLS, BLS instructor and TNCC certified, has worked
in the Quivira Road office of Midwest Cardiology - which received the
accreditation - for approximately three months. After working in acute
care nursing, she has found her new position very fulfilling.

"I get to know these patients better and become more involved in their
care," Morris said. "I get to know them and their families and learn
their personal and emotional as well as their physical needs."

Both left ventricular function and blood perfusion of the heart are
assessed during nuclear cardiology testing procedures. Physicians can
detect the presence of cardiovascular disease and may also discover
important information regarding the possible occurrence of future heart
attacks.

Patients who will undergo a nuclear scan receive an IV, which allows the
nuclear scanning technologist to inject a radioisotope using an IV push.
The body recognizes the radioisotope as one of its own proteins,
minimizing the possibility of an allergic reaction.

The first set of pictures taken is similar to a CAT scan of the heart.
After the first set of pictures, the patient's heart is stressed through
one of several methods.

Some patients use the treadmill, which provides them with an extremely
hard workout. Others receive an adenosine infusion, paired with walking.
Still others, for whom walking would be difficult, receive Dobutamine to
temporarily stress the heart. Atropine may be added if Dobutamine does
not increase the heart rate sufficiently.

"During the stress portion of testing we monitor blood pressure every
minute," Morris said. "We do continuous EKG monitoring, with a printout
each minute. Our infusions are based on a patient's weight, and our
target heart rate is based on age. After the stress portion of testing
patients receive a second dose of radioisotopes.

"During the recovery phase we stop all exercise and medications, with an
RN monitoring the patient for approximately 10 minutes, or longer, if
needed. Following recovery (to normal rhythm) we do a second nuclear
scan. It's noninvasive, other than the IV site, has less side effects
than cardiac catheterization and is very reliable. The entire process
takes about three hours versus cardiac catheterization, which takes a
full day."

Morris prescreens and interviews patients before procedures; makes sure
patients fill out consent forms, and questionnaires regarding medical
history and medications; and conducts a short physical assessment before
stress testing begins.

She also provides phone reminders to patients on the day before a
procedure that they should wear comfortable clothing and good walking
shoes, eat a light breakfast and ingest no caffeine for 24 hours before
arriving at the office.

The office has done nuclear scans for patients ranging in age from the
30s to the 90s.

"We're seeing an increase in females coming in, which is good because
women tend to ignore health problems until they become too hard to
handle," Morris said.