Cardiac Cath Lab Checklist

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

1. EGRESS, ACCESS AND TRAFFIC PATTERNS

• Egress: Cardiac Cath Lab shall be designed and perform as Surgical OR as operative procedures are performed and egress to these rooms shall meet the following traffic patterns standards which should be designated to clearly define specific areas. Separation of “restricted”, “unrestricted”, and “semi-restricted” space is required.

• Semi-restricted Area: Includes peripheral support areas of the Lab, the corridors leading to the restricting area and is limited to personnel wearing surgical attire. Staff head and facial hair is covered (may wear jumpsuits designed to totally cover outside apparel).

  Compliant

  Non-Compliant

  N/A

• Restricted Area: Includes Lab where operative procedures will occur. Surgical attire, shoe covers, masks, and hair coverings are required.

  Compliant

  Non-Compliant

  N/A

• Staff Traffic: Ideally there are 2 approved patterns of traffic flow for staff. One pattern is from the staff lockers/lounge through the semi-restricted corridor to the Scrub Stations and then into the individual Lab with exit through the semi-restricted corridor. The second pattern of staff traffic is from the staff lockers/lounge directly into the clean core area to the Scrub Stations and then into the individual Laboratories. Possible exceptions to the flow are the “circulators”, who retrieve supplies and equipment from the clean core.

  Compliant

  Non-Compliant

  N/A

• Patient Traffic: Patients are brought into the Lab from the Prep Area on a gurney. Patients entering the Lab should have a clean gown, clean linens, and their hair covered. After the procedure the patient are transported through the semi-restricted corridor and taken to Recovery.

  Compliant

  Non-Compliant

  N/A

• Traffic Patterns: Traffic pattern policies and procedures shall be clearly defined and traffic control practices enforced. The Lab should be made secure. Movement of personnel should be kept at a minimum during the invasive procedure. Clean and sterile supplies should be separated from contaminated supplies, equipment, and waste. Staff must have a clear understanding of equipment range of motion and possible collision points.

  Yes

  No

  N/A

2. THE BUILT ENVIRONMENT

• Design Criteria Guidelines followed: 1. New Construction: OR Room Guidelines shall comply with & follow<br> FGI Guidelines for vSurgery and CATHEP Labs. For Transfemoral <br> Aortic Valve Replacement (TAVR) procedures in Cardiac Cath Lab, <br> Cardiothoracic Surgery Room specifications are required. 2. Renovation Projects: Labs will be evaluated on an individual case<br> by case basis. 3. MEP and Electrical requirements shall be pursuant to the NEC and AHJ 4. Minimum 25 air changes per hour with 4 low returns preferable, 3 <br> absolute minimum

  Yes

  No

  N/A

• Provide laminar flow to extend beyond the sterile surgical field

  Yes

  No

  N/A

undefined

• Specific Architectural Requirements:

• 1. Cardiac Procedure Hybrid Room: <br> • Absolute Min for Existing Facilities: 750 net sq ft (65.11 net sq meters) <br> (26’ x 29’), 24’ min dimension <br> • New & Existing Facilities: 900net sq ft (83.61net sq meters) (29’ x 31’), <br> 24’ min dimension. <br> • Interstitial space above finished ceiling line is a must to adequately <br> install and distribute MEP infrastructure. <br> • Reconstructed sites will be evaluated on an individual basis

  Yes

  No

  N/A

• 2. Control Room: 190 net sq ft preferred, 120 NSF min <br> 3. Equip. Room: Min 120 net sq ft & accessible from Control Room or the <br> restricted corridor and not accessible from procedure room. <br> 4. Lead-lined walls, doors, and window frames including leaded glass <br> vision view panels.

  Yes

  No

  N/A

• 5. A Scrub station located adjacent to the entry door of the Lab.

  Yes

  No

  N/A

• 6. A clean section (supply space) is available for supplies, equip, case carts, etc.

  Yes

  No

  N/A

• 7. Area under procedure table (restricted space) cannot be used to store equipment. 8. Area at end of table is restricted space due to table movement.

  Compliant

  Non-Compliant

  N/A

• 9. Ceiling Access Panels: Min 2' x 2' for installation and maintenance of <br> medical gases, electrical and data utilities to ceiling mounted booms, <br> except in facilities having interstitial floor construction. 10. Finished ceiling height min of 9’6” feet clear. Ceiling shall be <br> sealed, washable and homogeneous.

  Yes

  No

  N/A

• 11.VAC ductwork shall be fabricated of stainless steel 12.Flooring: Seamless membrane with minimum six inch high flash coving, sealed at intersection with wall surface. 13.Imaging equipment, ceiling booms, ceiling mounted lights, ceiling mounted utilities, hanging lead facial shield must be coordinated to prevent collision 14.Minimum 25 air changes per hour with four low returns preferable, three absolute minimum

  Yes

  No

  N/A

• Surgical Lighting: Lighting should be in working order and adequate for illumination of the invasive field. General lighting and specialty lighting should be on separate circuits. Surgical lights must have a critical feature of reaching across the procedure table. General room lighting can be incandescent or fluorescent and must have the ability to dim

  Yes

  No

  N/A

• Anesthetic Gases: Potential hazards associated with the use of anesthetic gases in the Laboratories should be identified and safe practices should be established. Anesthesia gases should be located at the head of the patient with enough swing to accommodate a room switch

  Yes

  No

  N/A

• Booms: (Preferred) Anesthesia Boom, (preferred) Utilities Boom, (required) Documentation Boom, (required) Display Monitor Boom. Booms must be either electromagnetic (preferred) or pneumatically operated. If pneumatic, provide air compressor and air storage tank in proximal sound proof room

  Yes

  No

  N/A

• Medical Gas and Electrical Outlets: Minimum of Oxygen (2), Vacuum (5), Nitrous Oxide (1), Nitrogen (1) Electrical Receptacles (24) must be present in each Hybrid Cardiac OR Cath Lab Procedure Room

  Yes

  No

  N/A

• HVAC Criteria: Proper air quality, air volume changes and air flow direction in the Lab must meet AORN Standards and HVAC Guidelines for Operative Surgical Suites. Ideally this includes: <br> - Visual monitoring of temperature, humidity, and positivity in the Lab. <br> - Room readiness should be documented prior to case start.

  Yes

  No

  N/A

• Yes

  No

  N/A

The following are required for operative procedures to be performed:

• 1. Laminar Flow Ceiling with Laminar Flow Diffusers (clear of ceiling <br> equip.)

  Yes

  No

  N/A

• 2. Low Return Air (3 minimum, 4 preferred)

  Yes

  No

  N/A

• 3. Room Pressure (+)

  Yes

  No

  N/A

• 4. Noise Criteria (35-45) <br>5. RH Heading (30-60%) 6. RH Cooling (20-60%)

  Yes

  No

  N/A

• 7. Total Air Exchanged (20L/minute minimum 25 L/minute preferred)

  Yes

  No

  N/A

• 8. During operative procedures, all space from the floor to a distance of 15” (380 mm) above is considered contaminated. Therefore, all exhaust & return grills positioned low on the wall approximately 18” (460 mm) above the floor. The Lab room exhaust system should include a min of 3 (4 is best) low exhaust/return air grills located in opposite corners to minimize recirculation of contaminated air within the room.

  Yes

  No

  N/A

• Power Systems:

• 1. Minimum One 208volt outlet is required

  Yes

  No

  N/A

• 2. “Code Blue” system is required in the event of a cardiac arrest summoning designated staff

  Yes

  No

  N/A

• Procedural Table: Capable to swing 90 degrees (preferred) radiotranslucent with “Slopesaddle” column design that allows for a maximum Trendelenburg/Reverse Trendelenburg of ≤80 degrees and simultaneous lateral tilt of ≤45 degrees in positioning support on the surgical table top.

Courtesy of