Peace, Terry J. DuBose
--
Hi Joan, Just to clarify my "3-5 years". I should have been more
specific. It will be that long before contrast agents are used
ROUTINELY by the "average" lab for perfusion. The holy grail of
perfusion has not been achieved yet by these agents even in the hands
of the researchers. One researcher at University of Virginia, Dr. Sanjiv
Kaul, puts it this way when it comes to contrast agents in
echocardiography:
*The Pharmaceutical companies are 80% of the way there with the
development of bubbles (contrast agents) *The Ultrasound companies are
40% of the way there with the development of systems and transducers to
interact with bubbles *End users (physicians and sonographers) are about
20% of the way there in knowledge using bubbles with ultrasound.
This is a rather graphic illustration of where the biggest hole is
in this picture. He stresses that there is ALOT of education that
needs to occur prior to contrast agents becoming mainstream. There is
also much training that needs to happen.
There certainly is a role for the SDMS in this new arena.
Looking forward to seeing you on Wednesday here in Andover.
Best,
Carolyn :)
______________________________ Reply Separator
Subject: Re: contrast agents
______________________________ Reply Separator
Author: Non-HP-jpbaker (jpbaker@uswest.net) at HP-ColSprings,mimegw3
Date: 8/8/98 12:20 AM
Thanks Carolyn there are many important points here. I also think that
your 3-5 year anticiapted time may be too generous. Most contrasts are
due to be approved this year or very early next, so I think the issue of
who can and who cannot inject these "drugs" will be less than 3 years
away.
We are working on the scope of practice with this issue in mind. The SDMS
should be prepared to lead the way in training in IV's. The question is
how to go about that? We need to get in touch with Nuc Med, which I
will do, to find out how this was implemented. I injected isotopes and
gave IM injections for B12 and other nuc med studies. I was never trained
per se I just did it!! a while ago before the nurses got to realizing
that this was an area they could invade. We need to find out wh at is
involved today. The ARDMS are going to have to get involved also because
testing of competency will be an issue. Another subject for the Summit
Sept 15th!! Contrast agents were originally going to be considered a
"devise" had that remained the situation it would have been easier. Some
companies that were not ready for approval fought this to give themselves
more time and got the FDA involved and made this a drug which slowed
everything down but also made a difference as far as who and how this
could be administered!!
CAROLYN_ALEXANDER@HP-Andover-om3.om.hp.com wrote:
> Hi Laura,
>
> The only contrast agent that has been approved in the US at this
time > is Optison. It is approved only for LV opacification, not
perfusion. >
> For now, if a lab is using the the contrast agent for perfusion,
they > would be a research lab and therefore an MD (the researcher)
would be > present. In our experience, either the researcher or a
Fellow is > doing the injections. In some cases, where Sonographers
are also > RN's, the Sonographers have done the injections.
>
> In my opinion, injecting contrast would be no different than
injecting > thalium for a thalium stress test. It is the Nuclear
Medicine tech > that does the injection because they have been
trained to start IV's.
>
> If Sonographers are to take on the role of the one who injects the
> contrast agents, they will need to be trained to start IV's. In
the > near-term, this probably could/would be done per hospital
policy and > proceedure. However, if contrast agents become
mainstream in routine > clinical practice for the echo lab (which
many predict will happen in > 3-5 years) there is ALOT of education
and training that will need to > take place for both Sonographers
and MD's. Training Sonographers to > start IV's will be one of the
many areas that will need to be > addressed. > > Hope this
helps! > Carolyn :) > > > >
______________________________ Reply Separator
Non-HP-laura (laura@sdms.org) at HP-ColSprings,uugw3 > Date: 8/6/98
______________________________ Reply Separator
12:44 PM > > Please help me out. Just wanted to know the liability or
legal issues > surrounding contrast agents and who they should be
administered by. I had > a gentleman call today inquiring whether or
not he could administer a new > contrast agent (Optison?). He is a
cardiac sonographer in Louisiana and is > an RDMS/RDCS. I was under the
impression that contrast agents needed to be > administered by an RN.
Is this correct? > > Thank you. > Laura
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