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No More Empty Beds - Outpatient Surgery Magazine - February 2020

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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• Start-up capital. The main piece of equipment you'll need is a fixed C-arm designed specifically for cardiac procedures that mounts to the floor or the ceiling. The operating table for cardiac procedures has a radiolucent surface and is designed to allow for 360-degree views of the coronary vessels when the C-arm rotates around the patient. You'll also want to consider purchasing an ultra- sound machine, micro-puncture needles and an assortment of sheaths, guidewires and stents. In total, these items could cost upward of $1 million. Pacemakers and defibrillators typically are delivered to facilities on consignment by the manufacturers, so there are no upfront costs to maintain an inventory of those devices. • Big footprint. An interventional cardiovascular suite consists of a procedure room, an equipment room and a control room. The proce- dural space must be larger than a traditional OR — large enough to comfortably house the C-arm, the radiolucent table and ancillary equipment. Although square footage varies from facility to facility, you basically need the space of two standard operating rooms to make one fixed interventional suite. • Emergency equipment. While emergent events are rare, they do occur and you must be prepared to manage them. Be sure to have a dedicated crash cart that will be kept in the cardiovascular inter- ventional suite. You should also have available an intra-aortic bal- loon pump (IABP), pericardiocentesis kit, temporary pacemaker and, if possible, covered coronary stents. An IABP is a therapeutic device used to reduce the workload of the heart. For instance, if there is a critical blockage, the IABP can be used to augment blood flow to the extremities as well as to coronary arteries. Pericardiocentesis kits are used to treat symptomatic pericar- dial effusion or cardiac tamponade by aspirating fluid from the peri- cardial space. This can occur during angioplasty, or during pacemaker F E B R U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 1 7

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