747 thoughts on “Uncategorized”

  2. We also activate from the field! Patients who arrive by EMS during regular business hours are brought directly to the lab, if available, which reduces door-to balloon time significantly. I also requires extra RN staff to facilitate medication administration, lab draws, and basic patient information.
    How does your facility handle informed consent for the procedure? Are STEMI procedures considered “an emergency” procedure and documented as such?

  3. Sounds like a great place to work! I am curious about the number of RN’s compared to techs, is there a particular thought process behind that? Do the RN’s and techs’ have a strict division of their role in the cath lab?

    1. The invasive team is composed of 3 techs and 8 RNs.  This mix is due to the call rotation and my preference of having two RNs on the call team.  I strongly believe that the assessment skills that the RNs bring to the table, along with their critical care experience are one of the reasons that we have such a low mortality rate with our stemi patients.

      Job roles are pretty well defined.  RNs circulate all of the cases and the techs scrub all the cases.  The monitor position can be either, but numbers normally dictate an RN sitting in the captain’s chair. 

  4. Your process seems very similar to our own.   Out of our 3 person call team, I require that 2 of the members be RNs for the same reasons that you listed your second RN.

     

    Informed consent is obtained when possible, the MD describing the procedure to the patient as we go from ED to cath lab.  In cases where the patient cannot give consent however, we do document these as an emergency procedure.   We will send the nursing coordinator out to get consent from the family when they arrive, but the procedure is well under way by then.

  6. We allow the patient to have a say in the selection of the music. They are part of the “team” in our cath labs. If they say that they have no preference, then the staff picks the music. If a physician is dragging their feet in getting the cases done, I pick the music that I want. No body likes my choice of music so this ensures that the cases get done in a timely manner.

  7. An interesting thought with the “Stem Cell Factor” introduced to us. Always thought there might be a Genetic possibility of all the different things dealt with in the Cardiac Cath Lab every day. Will read the reference materials as stated above. I attended the Family Tree DNA 10th International Genetic Genealogy Conference last year in Houston, Texas and a lot of ideas popped into my mind in reference to Cardiology.

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  10. So much for the “team” concept explanation. In Washington, where I work, the CCI folks came to town and rammed legislation thru, tacked onto Rad tech legislation so they wouldn’t have to do it themselves, to allow RCIS techs to do what Rad tech have gone to school 2 yrs to do. The real problem is that the Cardiovascular Digest and cardiologists have pushed their credential as “The” credential for the Cath lab, which has resulted in Rad techs being replaced by RCIS techs in many hospitals. It seems Rad techs are being seen in Washington as another kind of Rad tech unfortunately. That leaves hospitals with little to no radiation protection supervision since neither the RCIS or Cardiologist has the amount of training (or cares about it) to protect themselves or their patients. I think the team concept they are talking about here is between RNs and RCIS techs. Who needs techs who have gone to school for 2yrs specializing in radiation to use radiation producing equipment? Certainly not the Cath lab.

    1. Thank you for your comment, Steve.

      In this particular case, the proposed motion is conditional: “provided a CRT is present in the room and is managing the radiation exposure and X-ray equipment…”

      “Team-based care,” here, is absolutely inclusive of the rad tech.

      All three typical cath lab team members—RNs, RTs and CVTs—bring specialized expertise and knowledge that contribute greatly to quality team-based care and excellent patient safety in the cath lab.

  13. The information presented was useful, and provided good discussion of some points of difference between lead-type and lead-less pacemakers, (Micra and Nanostim). The obvious omission is how health insurance companies view the big cost differential between lead-type ($2500) and lead-less pacemakers (around $10,000)?
    A head-to-head study between Nanostim and Micra may also be useful. But, that would probably take several years to produce.

  15. Regarding both “in production devices as the Nanostim and the Micra (as a potential recipient,) I am concerned about the problems associated within a “welding” environment. Also if both are OK for the CT and MRI environment what about the relationship to microwaves and the exposure to induction cooktops etc…..
    Any response would be greatly appreciated as I have some decisions to make…thank You

    1. Hi Norman,

      This blog was written without comment or direct contact with either manufacturer, but I have found some information in materials from both that can answer your question regarding household devices.

      It looks like either company’s guidance for physicians discussed CT and MRI environments, but not microwaves, etc. However, their patient guidance materials did have this information.

      Micra’s website suggests that household appliances “that are properly maintained and in good working order are safe. This includes microwave ovens, major appliances, electric blankets, and heating pads.” Nanostim resources have a similar statement: “Most home appliances and office equipment in good working order are safe to use (microwave ovens, blenders, toasters, electric knives, televisions, electric blankets, stoves, garage door openers).” Though it also says: “The pacemaker will work properly with most medical equipment during x-rays, diagnostic ultrasound, CT scans, mammography, and fluoroscopy. It is also MRI conditional. You should do your best to avoid electromagnetic interferences (EMI) that could be caused by electrical appliances in poor conditions or not grounded correctly, industrial generators, arc-welders, specific medical equipment. Magnets, large heaters and radio transmitters also can cause EMI.”

      You can find this quotation in the “Nanostim Patient Education Handbook” or the Micra Transcatheter Pacing System “FAQs.”

      Of course, St. Jude recently announced battery issues with the Nanostim affecting 0.5% of patients, which might also affect your decision if time is of the essence.

      Let me know if I can be of any further assistance, and thank you for your comment—I’m glad you found ACVP’s blog.

    2. Hello.
      1. What is the patient charge for the Micra Pacer and the Nanostim Pacer?
      2. Regarding electronic interference in our environment: Cell Phones: Microwaves: Weather Lightning Bolts: Electrical Shocks from household current: Highway Traffic Control Electronics to name a few potential sources of electronic interference. Is there any data available?

  18. Please learn the correct terminology when referring to a medical field that you obviously know nothing about. I am a Registered Radiological Technologist. I am not a technician. If you want to be taken seriously learn about the profession you are attempting to discredit.

    1. Hi Steve,

      Thank you for your comment.

      1. I wanted to apologize for the typographical error on that page you pointed out. I can assure you that this typo was isolated – we always refer to Registered Radiologic Technologists elsewhere on the site. I also hope you understand that this was simply a mix-up, not an attempt to discredit Radiologic Technologists by referring to them as technicians.

      2. I also have to apologize for the tone of the article if you thought it was our intention to discredit Radiologic Technologists. Radiologic Technologists are an important part of our membership, an integral part of the inter-professional cardiac education the Alliance of Cardiovascular Professionals provides, and of course an essential member of the cath lab team. Our stance is in favor of team-based care, and we believe RNs, RTs and CVTs all bring important skills and knowledge bases to the cardiac care team.

      This particular issue was also clearly a compromise supporting team-based care. The issue was taken up directly with the Radiologic Technology Certification Committee, so Radiologic Technologists always had direct representation and input in the decisions being made. The recommendation resulting from the RTCC clearly stipulated that they would allow an assistant under direct supervision of the S&O only if a certified Radiologic Technologist is in the room.

      This issue only ever affected the scope of practice of the RCIS, not the RT, so our materials may have seemed to credit the RCIS over the RT. This was not our intention, rather, just the reality of the issue at hand.

      Of course, I’d love to hear more of your opinion. Again, we represent all cardiovascular professionals – RNs, RTs, and CVTs/RCISs – and we strive to represent and promote the point-of-view of all these groups.

      Best,
      Kurt Jensen
      Communications Director
      Alliance of Cardiovascular Professionals

  21. I have been very disappointed in the advocacy of the Invasive Cardiovascular Profession in recent years. Members of the CV profession have been increasingly replaced by members of non-cardiovascular disciplines, receiving higher rates of pay with far less Cardiovascular education and training. To make matters worse, the Cardiovascular professional is being asked to train those without a Cardiovascular background so that they might function in the Cardiovascular arena.
    Therefore I must ask, What efforts are being made to advance the Cardiovascular professionals position in the present environment?

  22. Walter, I have to ask what have you done to advance invasive cardiovascular professionals? For the past 25 years, it seems as if they have the only been 8 to 10 individuals such as myself could have been out there promoting the RCIS credential and profession of invasive cardiovascular technology. We volunteer sacrifice time away from our families and use their own money to promote the profession. Everyone complains yet no one wants to be involved and do the work. In fact no one wants to even do a simple thing such as belong to a Professional Organization to advance our practice. Nursing, radiographers, and respiratory professionals have professional groups numbering in the hundreds of thousands, yet we can only get a few hundred members.

    As one of the founding members of the Society of invasive cardiovascular professionals I’m saddened that it will no longer be an independent group. I am excited that this gives us a new opportunity to grow as profession.

  24. They are so many great opportunities in all areas of the healthcare business and salaries are moving up so much! The hospitals with strong cardiovascular programs are having a tough time finding enough qualified candidates for all areas and finding candidates who have experience in the cardiac cath lab and interventional radiology labs are really hard to find. We are getting older and the future for this candidates is huge with a much bigger growing older population, which me much more patients in the future! Nurses, Radiology Tech’s, Ultrasound Tech’s, Nuclear Tech’s, RCVT, RCIS, Surgery Tech’s, etc: The abilities for future grow in their areas in huge!

  25. I could have joined the SICP 20+ years ago. I refused because of the politics it played in the state of Ohio to get Tracy King (then an ultrasound technologist) the unheard of legal ability to practice as one of the Radiology Technologists or as a Registered Nurse. Those roles were well defined by scope of practice laws and a non certified professional did not have the privilege to work in that setting. The SICP lobbied the state of Ohio strongly to pass laws to make it legal for her to do so. If she wanted to work in that setting then she should have credentialed herself by getting the proper education to do so. Imagine passing laws for anyone to practice medicine without the properly attained medical degree! Their would be an uproar by the medical community! Instead of supporting the RN’s and RT’s the SICP sold them out. Do you think I want to be a member of the SICP? HELL NO!!!!
    I have been a member of the ACP to show support and respect to my fellow RN and RT professionals. I hear the ACP wants its members to be more active? Not once has the ACP ever come to my place of employment to see how we work here in Pittsburgh. I doubt they ever leave Midlothian to see how its members function. To grow membership the ACP should visit its members and encourage chapters in various cities to start, build, and grow! I would be shocked to here their is an ACP branch office in Pittsburgh. If you ever want somone to help with one here in Pittsburgh let me know! You have my email address. I’d say call me but my phone number has changed and the ACP website does not give me a way to update! Not easily anyway.

  29. Hello! Please let me know if there are any openings available for the cardiology conference at ROPH on 10/14/17. The brochure states that you can attend the conference and become an ACP member for $65.00, which is what I would like to do if possible. In the meantime I will fax a registration for the conference, but please reply at your next earliest convenience. Your help is much appreciated, thank you!

    1. Good morning, Crystal – I received your message from Joyce yesterday and I can report that we have not received your registration as yet for the RUSH Cardio Conference. Did you FAX your registration form to (804) 639-9212?

      To answer your question, the $65 membership and registration is absolutely available to you. Both actions can be taken on the registration form. You can also register for both online at https://www.acp-online.org/events/chicago-cardio-conference-2017/. You can copy this address into your browser and you’ll be take there straight away.

      If you are having any issues with this, or if I can assist you with any other matter, please call me directly on (804) 245-9211. Thanks, and have a great day!

      Best,

      Sean McElgunn
      Director, Member Services
      ACVP

  34. I am just now learning of this particular issue involving members of our Cath Lab in Washington State. We do not have the fluoroscopy license requirement that exists in California, but many of the ARRT ceritfied techs have expressed concern over the States law that allows RCIS Techs to use ionizing radiation to patients. While I understand fully the points referenced in the above article I must express that very little seems to be known about the actual radiation safety training covered in RCIS curriculum. I am hoping that through this correspondence you might be able to help me and my members uncover specifically what training RCIS tech get. I believe that your goals would be well served to ensure that radiation safety training remains a significant aspect of RCIS training and that these details are made known to Cath Lab teams and managers. I thank you in advance for any assistance that you may be able to provide.

  35. TAVR is still a risky procedure and should be done in centers that have experience and appropriate means to handle complications. It does require skill/technique to have the best outcomes. Not only performing the procedure, but also the testing. Catastrophic complications can occur if the physician is not experienced. I think the point that should be addressed is getting people access to centers that have good outcomes and allotting those centers the resources to accommodate the increasing need.

  36. We have been radial first for many years now at Heart Hospital of New Mexico, in fact we are one of the training sites. We do probably 95 to 98 percent of our procedures radial. First, the interventionists had to be on board with it and next the staff. There was a short span of several months for the interventionists to be comfortable and efficient with radial access and engaging coronaries with this approach. Also, the staff had to be on board with the radial prep and we always have groin prep as a back up. There was definitely a learning curve, but not too long. Overall, it is a better less complications and easier on the patients.

  46. You make an awesome point when you said that genetic testing has the potential to change the way we treat cardiac issues. Working with a cardiologist is a great way to prevent heart-related diseases in the future. If I come across anyone that suffered from cardiac issues, I would make sure to help them find a cardiologist that stays up to date with medical advances.

  49. That’s interesting that not only does the electrocardiographer need to become oriented in the cath lab, but the cath team needs to understand their work as well. This would be smart as both parties can then work together to help work on people’s hearts. Plus, it would give the patient more comfort to know that the entire team knows how to understand the readings and care for them.

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  66. The AORN made their recommendations without any scientific evidence. The scientific evidence that has been collected since then shows they are wrong — not only by the lack of evidence to support their push, but evidence that even shows they are backwards in their recommendation.

  70. Only 51 registered RT’s in CA? Wow ? sounds like a real shortage. Not check your facts and numbers before you sensationalize and exaggerate the true picture.

    I worked with a Grossmont CVT graduate whom had the X-Ray Tube against the patient and the II/FD as far away as possible. I quietly asked him prior to shooting the cross table lateral to move the table (patient) as far away from the tube as possible, and for the II/FD to be as close to the patient as possible. After the case. I asked him where he learned that. He said that was safe practice as far as Grossmont College, CVT School was concerned. I just finished my CEU course on Radiation Protection to maintain my CRT Fluoro License and showed him the picture in the book and the corresponding paragraph. I asked him if the instructor was an RT, he relayed that the instructor was an RCIS.

    With that said, I’d have to say that I question the validity of the claim that RCIS’s or CVT’s are competent in their foundations of radiation protection. Do they take classes in Radiation Production, Radiation Biology, Biological Effects of Radiation, Radiation Protection, is their initial reaction to collimate, and use soft filters, and minimize the amount of secondary and scatter radiation that adversely affect the patient, Medical Staff, RN’s and Technical Staff in the room? I’ve never seen a CVT do any. Not saying that none of them do, just never seen it.

    So I’ve worked in other states as well as CA and have given drugs, sedation, started IV’s, first line ACLS drugs and shocked patients in life threatening rhythms. Now the CA state law has changed so that only RN’s can do the stated above. Why don’t the CVT’s and RCIS’s fight to be able to do that as well?

    Because RN’s have the schooling and competency. If CVT’s and RCIS’s can pass the CA Fluoro test let them try. Keep in mind that you have to attend a semester at a Community College or University on Fundamentals of Fluoroscopy prior to sitting for the CA Fluoro Test. So it’s not like you can study the study guide and pass the exam.

    It boils down to this, see what the requirements are to be able to gain employment in the field you want to start your career, obtain that level of education.

    So this argument that CVT school is good enough to pass the Fluoro test especially because there are only 51 Registered RT’s in the State of CA, is erroneous in more ways than one.

    Nice way to paint a picture to compel your readers to advocate on your behalf. Where I’m from that would be lying. But in the political arena that is a tactic to plant the seed as truth, then let the opposing side present and see if the voters educate themselves enough to consider the other side.

    Great article!!!!

    Let’s see if you change your stats to show how many RT’s actually have their CA Fluoro License. My bet, you won’t because your not necessarily interested in the truth nor do you have an understanding of what RT’s go through in their schooling to become and RT in CA.

    BTW CVT’s and RCIS’s can participate all day long in labs that the MD’s pan. So why don’t the CVT’s and RCIS’s have the support from the MD’s to gain employment? All they have to do is pan and let the CVT’s and RCIS’s inject.

    I have taken my ARRT, CRT, CA Fluoro and my CV-CardioVascular Interventional Technologist (through the ARRT) to show that I’m qualified to work in my profession. Keep in mind that the ARRT is governed by the American College of Radiology. Why not approach the ARRT to meet their standards to do a joint venture nationally? Wow there is a concept!!!! Unification to have safe and successful outcomes nationally, not just in CA!!!!!

    I have heard in some states they only have RN’s in their CCL’s with no RT’s, CVT’s or RCIS’s. Why are they not banging on those doors? Because that is is in Mississippi and Arkansas and you don’t make as much money as you would in CA.

    So my question is, is this about wanting to make CA money or parent care? Just asking.

    1. Hi Rob,

      We do not make any money from advocating on behalf of our members and quality patient care. We do not make any money from RCIS education or the RCIS credential. We do not control the RCIS curriculum or the credentialing assessment, which is administered by Cardiovascular Credentialing International (CCI). Here is that information, by the way: http://www.cci-online.org/docs/CCI_RCIS_Exam_Overview_122018.pdf

      We DO advocate on behalf of our members, a large group of which were being prevented from working in the cath lab – AT ALL – due to a widespread misinterpretation of existing regulations. A big part of what we argued was that RCIS professionals were simply not allowed to sit for the fluoroscopy exam. We agree with you – “let them try!” MDs do, in fact, support RCIS professionals – another crucial part of this issue was that MDs were being prevented from choosing the makeup of their own teams, even though their license is the only one that matters, in terms of liability, in the cath lab.

      We maintain that RNs, RTs and RCIS professionals all bring unique knowledge to the cath lab which improves patient safety and the quality of care. We also hear, anecdotally, an equal number of stories about experienced RCIS professionals being required to train RT or RN professionals with no cath lab experience in issues crucial to patient safety in the cath lab. I personally think a lot of these anecdotal issues come, simply, from inexperience in the environment. Does four years of med school fully prepare doctors for their work? I’d imagine you might have to explain a few things about the cath lab to someone fresh out of med school!

      I also want to remind you that the scope of practice of Radiologic Technologists was never threatened or in question. We advocated exclusively through the RTCC in California which was controlled by vast majority by RT professionals! This was simply a compromise to ensure that a misinterpretation was not preventing a wide swath of professionals qualified to work in the cath lab from working – again, AT ALL – in the cath lab.

      We also represent members who are RTs – if a misinterpretation of a law (Title 22, for example) were to prevent you from working in the cath lab for which you’ve been educated and trained, we would be there to support you. Please let us know if anything arises threatening your ability to work!

      With regards to the 51 RTs statement, I agree it was misleading, and I removed it. I believe it was only 51 RTs educated and credentialed through ARRT to work specifically in the cath lab via the RT(CV) credential. That should have been made more clear, originally. But those numbers have also changed since 2015 when this was written.

      Best,
      Kurt Jensen
      Communications Director
      Alliance of Cardiovascular Professionals

  71. That’s great to hear how genetic programs are developing enough to make it easier to have improved screening for cardiac care. My dad likes to run every morning, but talking to him today he mentioned that his heart is starting to hurt when he runs. I’ll tell him to visit a doctor so he can get his heart checked out and see if there are any forms of cardiac care that can help him out.

  72. There has consistently been only ONE credential that has sought to limit/eliminate other credentials from the cath lab. I’m not going to say which one because we all know the answer. That should be enough to give everyone some insight into what’s really going on here.

  73. I’ve been in the cath lab for more than twenty years dealing with this same argument. I have been in and out of the “red line” and have seen no difference in SSI rates. I’ve always heard that cath procedures were not really surgical procedure, that they were more clean than sterile. Pace maker implant are however a little different, I would lean on the more sterile side. With the cost of healthcare so high in this country already do we really need more expense to be added on something that is not even fact one way or the other.

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  79. The major problem with cardiac cath based doctors, nurses, cardiovascular technologists, radiologic technologists, surgical technologists and nursing assistants working in the environment is that they are not educated on radiation physics, biology and safety at the levels the doctors and support staff were taught years ago.

    I have always been a CV Radiologic Technologist who has always focused on radiation safety of peers and patients. Even with modern digital imaging devices, patients develop radiation burns because the imaging equipment is not used properly and are subjected to lengthy radiation dosages during prolonged procedures.

    One question I ask doctors and support staff members what is the least distance a team member should stand from the radiation source during fluoroscopy and cineangiography. 99% of the persons asked have not answered the question with a valid answer. What area of the body of attending doctor, scrub assistant and circulating support staff is heavily radiated during procedures? The answer for 1st question is 1 meter from the radiation tube filter area. Answer to #2 is lower legs which are not covered completely with lead aprons.

  80. The EP labs have been pioneers in no fluro procedures. It is a step in the right direction for Cath labs. Glad to see the push for overall patient and staff safety

  81. Cardiac biomarkers have evolved as essential tools in cardiology over the last 50 years, that is, for primary and secondary prevention, the diagnosis and management of acute myocardial infarction, and the diagnosis and risk stratification of heart failure. Now it’s a great achievement to discovered a new lipid biomarker panel to detect heart failure with reduced ejection fraction.

  82. Has anyone involved with SCAI and ACVP ever been educated and trained in procedural cost analyses that invokes sound revenue reimbursements from Medicare, Medicaid and Medical Insurance Entities? I have automated forms that I developed from hardcopies that have been in my personal hardcopy files for 35 years. With my first involvement to straighten out a CCL system in 1981, the previous year the CCL only did 600 patients in the year and generated $240,000 with $238,000 in expenses. In 1984, the annual caseload was 1600 with an annual revenue of $ 3,700,000. In 1983 I was asked by a president of another hospital to design a cath lab system for his facility. The task was done with the help of a team of 25. I trained several of the members in cost analyses. The CCL lab system open in 1985. By 1987 the lab was averaging 35 patients per room of which there were only 2 CCLs. The rooms were averaging 3.2 patients per hour. The revenue was legitimately gained. I left the system in 1990. I returned to visit in April 1994. The same manager debriefed me on the revenue. The 1984 fiscal year finished with 6500 patients (which included diagnostic and interventional) and 47% of the total revenue of the hospital was coming from the cath labs. EP studies were done in two other detached rooms from the main cath lab. Patients who had 80% percent coverage from insurers were having their bills paid 100%. The same had already happened at the previous system. Medicare was paying 100% too. The operation was averaging a 20% cost containment. The other factors were working with vendors based on volume along with working with assigned representatives from Medicare annually before the new fiscal year began. Same experiences with private insurance companies and HMO’s.

  85. I’m so blessed to be part of an organization
    ACVP, that fully and legitimately supports our best interest in this highly technical demanding profession.

  100. Our busy Cardiovascular Lab that normally does 20-25 patients each day is now doing 1-6, depending on how many transplant patients need their biopsy that day. Elective procedures have been eliminated unless the physician decides they have unstable angina, and we’re being sent home early when there are no cases (without pay unless we want to burn our PTO just to fill our paycheck). We’re also noticing an increase in the number of STEMI and NSTEMI patients, some of whom had elective procedures cancelled. Even though the physicians heavily consider thrombolytics when possible, many are coming in too unstable to try it. Unless we know for certain the patient is COVID-negative, we gown up in full PPE and N95 respirators for the STEMIs. We’ve had to bump up to a 4-person call team and revamp our process to make things run smoothly.

  104. As an instructor in a college-based CVT program the Covid-19 crisis has deeply impacted both myself and my two groups of students. Collectively, we have had to become very innovative and flexible in our approach to learning, studying and accepting what hand we’ve been dealt.

    My soon-to-be graduates had their last semester (which is primarily clinicals) completely disrupted as a result of the pandemic because the clinical sites either stopped allowing student participation all together or they greatly curtailed participation just at the point in time where the students were becoming proficient in the lab with interventions. Fortunately, they were a fairly advanced group with regards to their skills although I know each one of them is wondering what the 3+ month lay-off will do to their skill set once they do start working. The good news is that since testing centers have begum opening up again, my 2nd year students have begun passing their RCIS exams, and all but one has a job lined up two weeks before they graduate.

    The first year students were in their first semester of clinicals and it’s got pretty minimal contact and expectations so they were not as greatly affected as the 2nd year students, but they immediately had to switch to online classes with little or nor preparation and in some cases, no desire to attend online courses. Lab skills sign-offs are going to be completed over the summer break but overall, they made the switch with relative grace and composure, and remained very flexible when it seemed like everything else was crashing around them.

    I was also greatly affected by the pandemic in that I had to determine how students were going to finish clinicals and labs without being allowed to meet as a group or go to the clinical sites, while simultaneously transitioning four classes from a face-to-face format into an online format two days after having had knee surgery during my Spring Break! Fortunately, my Masters Degree is in Distance Education (University of Maryland) so I had the principles, practices and technological background to quickly set up courses, adapt assignments and construct new study aids and tools. Although not an ideal time frame, my students have voiced positive feedback.

    As a result of this experience, I have decided to make one of my four courses next semester a fully online course and I am currently adapting the other three courses offered next semester for online delivery just in case there is a need to switch to a virtual learning model again. Once this is complete I will be able to deliver all eight of my annual classes either face-to-face or virtually, enabling me to offer high quality education under a variety of circumstances. Although I don’t want to experience this environment again, at least I will be better prepared if I ever do.

    Thanks, Covid-19

  105. Great course! Having only worked within EP, my exposure to balloon dilation and stenting is VERY Minimal, but this was very informative!

  117. This was a very interesting course. I was able to expand my knowledge and understand more about the renal system. Thank You!

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