RCES Flashcards
Pass the RCES exam
What is the ion responsible for cardiac depolarization?
Soidium (Na+)
What is the ion responsible for SA node and AV node depolarization?
Calcium (Ca+)
What Xray position shows halo catheter in clock face view?
LAO 30
What step is the sterile package flap opened towards you?
Last
Name 3 important handoff details.
History and physical
complications
patient mental status and procedure results
The doctor puts in RV lead which he suspects went through an ASD. What indications will appear on the EKG and what angle should the C-arm be in to check the lead?
RBBB, verified in LAO
Quinidine is part of what antiarrhythmic drug class?
Class Ia
Lidocaine is part of what antiarrhythmic drug class?
Class IV
Flacanide is part of what antiarrhythmic drug class?
Class Ic
What should the mapping person set the voltage for scar on the mapping system?
0.5 mV
What complication at the access site causes pain, swelling and bruit sounds?
Pseudoaneurysm
What complication at the access site causes pain, swelling and bruit sounds?
Pseudoaneurysm
What arrhythmia is induced by exercise and post exercise?
Brugadas syndrome
What is the best view for RV catheter?
RAO 30
What reverses benzodiazepines?
flumazil
What should we educate our patients’ about when they are discharged on coumadin?
INR needs to be checked
What is the range for the intraprocedure ACT ?
300 - 400 sec
When would we difibrillate a patient?
unstable polymorphic VT
When would we defibrillate a patient?
unstable polymorphic VT
What would cause an increase in lead impedence?
Conductor fracture
What would cause an increase in lead impedence?
Conductor fracture
What does ACT stand for?
Activated clotting time
What changes to the frames per second will reduce radiation dosage?
15 f/s
What is the optimal cryoablation temperature?
-65 degrees VS 4 min freeze
What should you look for when pulling an arterial sheath?
a faint distal pulse
Where would the transseptal needle be placed for transseptal access?
fossa ovalis
What is a contraindication to a transseptal puncture?
dilated ascending aorta
What kind of ventilation is it when you have pCO2=20 and a respiratory rate = 24?
hyperventilation
if H increases, what happens to the pH?
Increases
How would you convert BPM to msec?
60 000 / BPM
Define: ERP
longest coupling interval that fails to conduct
What kind of pathway is it if the VA interval increases with LBBB ?
Left sided accessory pathway
What would you use if the patient is allergic to iodine?
Chlorahexadine
What lab values would be checked if the patient is allergic to iodine?
Check BUN, creatinine and GFR, BUN/creatinine ratio
What type of access is non-pulsatile?
venous access
Where do you find the correct information of a patient’s device?
Physician’s orders
When should time out begin?
beginning of the procedure
What is Ohm’s law?
V(volts) = I(Amps) R(ohms)
What is a MSDS and what is it used for?
Material Safety Data sheet for chemical information in lab
What is the angioplasty term for stretch?
compliance
What balloon would be used for a rigid coronary sinus lesion?
non-compliant balloon
During timeout the joint commission requires we mention what three things?
verify patient
procedure
surgical site
What medication is given for SVT?
Adenosine
What medication is given for TTT?
Isoproternol
Other than pain what can morphine be given for?
vasodilation
What does flacainide do to cardiac thresholds?
increases
What is the most anterior chamber?
right ventricle
What location would be prepped for pericardiocentesis?
subxyphoid
What would be set the threshold for a pacemaker?
pacing threshold x2
To reduce the risk of retroparitoneal bleed getting arterial access should be below what ligament?
inguinal
What allows for RA to LA conduction?
Bachmann’s bundle
Who can sign consent if the patient is sedated?
family
If the LA pressure waveform is dampened, what do you do?
aspirate and flush the sheath
What electrode is positive?
Anode
What is the best defense against infection?
Handwashing
What trial established that a patient should consider an ICD post MI with an EF <30%?
MADIT II
When would we use DFT ?
patient taking amiodarone for new-onset AFib
When the P wave of a PAC is upright in II,III and AVF where is the focus located?
close to the SA node
What is the highest cSNRT?
550 msec
How long should an exchange guidewire be?
long enough to fit the length of the catheter
A woman with paroxysmal atrial fibrillation, chronotropic incompetence, 1:1 AV conduction @100BPM. What would you program her device to?
DDDR
What is the Wedensky effect?
lowered threshold of excitability induced
by a strong stimulus
What is the Wedensky effect when you increase the voltage of a pacing stimulus?
lowers the threshold of the myocardium
What equipment is used for a pericardiocentesis?
sterile table and echo tech
Where would you prep for a pericardiocentesis?
subxyphoid
When pacing in the HRA, a QRS of 210ms results indicate what?
high mA output
What would you do physically for the patient when the patient has pulmonary edema?
Raise PT’s head
What is the equation for pulse pressure?
pulse pressure = systolic-diastolic
ETCO2 measure what?
COs expelled
30 mins after removal of a right femoral venous and arterial sheath, patient complains of back pain. What should you do?
turn patient to side
After a PM is removed from the pocket with a bifurcated V. lead, 1 pin capped and 1 pin in the header; What should you look for?
Intrinsic Activity/Rhythm
What device would be implanted in a patient with an EF of 58%, Hx of VT and ischemia?
Dual chamber ICD
What view is used during an A. flutter ablation to view clock faced valves?
LAO 30
What returns oxygenated blood to the LA?
PV
Where does the CS return deoxygenated blood?
RA
What is the antagonist to heparin?
Protamine
What is the therapeutic INR?
2.1-4
What is the body’s normal pH?
7.35
What is the ACT range for a transseptal puncture?
250-350 sec
How tall in cm is a patient who is 6 feet tall?
6’= 72’’ * 2.54 = 189 cm
What is the length of an exchange wire?
300 cm
A holter monitor is used to assess what?
frequency and severity of arrhythmias
