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Heart, Lung and Circulation Abstracts S732008;17S:S1–S209

169Enhancement of a Child Friendly Echocardiography Lab-oratory Reduces Sedation Requirements

Karen M. Anderson Weller 1,2,∗, Sarah A. Hope 1,2

1 Monash University, Clayton, Victoria, Australia; 2 MonashMedical Centre, Clayton, Victoria, Australia

Introduction: Sedating infants and children to enable afull or clinically adequate echocardiographic examinationhas historically been accepted practice in many units. It iswidely believed that a child friendly environment reducesthe need for sedation. We aimed to evaluate the impact of asignificant enhancement of the child friendly environmentin our institution.Method: A retrospective review of prospectively main-tained data was performed. Data were acquired onall patients aged between 3 months and 3 years whounderwent echocardiography at Monash Medical Centrebetween January 2000 and December 2006. Environmentalimprovements occurred in November 2002. (Era 1 = pre-and Era 2 = post-improvements).Results: 564 studies were performed on 375 children, 52%male, average age of 19 ± 10 months. 33 studies wereclinically inadequate requiring repeat echocardiographicexaminations, 24 and 9 in Eras 1 and 2, respectively(p < 0.001). Of the 33 studies, 21 required sedation, morein Era 1 (13/157 (8.5%)) compared with Era 2 (8/407 (2%)pfaEcCecc

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prevention. The median follow-up was 797 days. Duringfollow-up five leads failed (0.6%) (excluding infection).Subclavian crush was the mechanism in three leads andexit block in 2.1 patient presented with inappropriateshocks. The failure rate in the 7F leads was 0.8% (3/364). Inthe 8F lead was 0.7% (2/286) and in the 9F leads 0% (0/127).The differences were not significant. The median time tofailure was 740 days. All three patients with lead failurehad physically active jobs, suggesting more than just leaddiameter played a role in the mechanism of lead failure.Conclusions: Long-term lead survival is acceptable. Sub-clavian crush was the main mode of failure. Small numberspreclude definite comment regarding lead size and fail-ure rate therefore larger studies with longer follow-up arerequired.

doi:10.1016/j.hlc.2008.05.171

CARDIOVASCULAR – NURSING

171Short Cardiac Educational Reading Improves KnowledgeBase in Both Cardiac and Non-Cardiac Nursing Staff

Natalie Simpson ∗, Daphne Perry, Rebecca Perry, Derek P.Chew

Flinders Medical Centre, Bedford Pk, SA, Australia

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< 0.001). There was no difference in the proportion ofull or clinically adequate studies between Eras. The agend gender proportion of children did not differ betweenras. 91% of sedated patients had previously diagnosedongenital or acquired heart disease.onclusion: Additional enhancement of a child friendlynvironment has reduced the need to sedate infants andhildren for echocardiography in our laboratory withoutompromising study quality.

oi:10.1016/j.hlc.2008.05.170

70echanism of Failure of Low-Profile ICD Leads Duringedium-Term Follow-up

effrey Wright ∗, Robert England, John Betts, Shawnolden, Daniel Wright, James Lindemann, Russell Den-an

The Prince Charles Hospital, Chermside, Brisbane, Queensland,ustralia

ackground: In recent months there has been con-iderable concern and debate regards the safety anderformance of low profile ICD leads.im: To review the mode of failure of transvenous ICD

eads over a 4-year period from a single institution.ethods: A retrospective analysis of the Paceart databaseas performed initially. Evidence of lead failure was con-rmed by a chart review to determine the mechanism.esults: 777 consecutive new ICD leads were implantedetween January 2003 and December 2007. Median ageas 66 years, EF = 34%. 62% were implanted for primary

ackground: Education of both cardiac and non-cardiacursing staff has been shown to improve patient outcomesith cardiac disease. For patients hospitalised with a non-

ardiac illness, the diagnosis of a cardiac event may beelayed. Therefore, the aim is to educate nurses from aaried background to identify and initiate early treatmenttrategies for patients experiencing myocardial ischemian the medical/surgical wards. Our objective in this pilottudy was to assess the change in knowledge level inardiac and non-cardiac nursing staff using a short edu-ational reading.

ethods: Thirty nursing staff—15 with a cardiac back-round and 15 from a medical background were randomlyhosen. A pre- and post-test was delivered to test the effec-iveness of targeted education.esults: In the non-cardiac/medical group the averagere test score was 13 ± 5 (out of a possible 25). After theducational reading this score significantly increased to1 ± 5 (p < 0.001). The pre-test results for the cardiac groupas higher than the pre-test results for the medical group

p < 0.001), however there was still a significant increase inost-test score for the cardiac group, though the changeas not as dramatic (21 ± 2–25 ± 1, p = 0.04).onclusion: This study demonstrates that even a sim-le 20 min education in the form of reading can improveardiac knowledge base in both cardiac and non-cardiacrained nursing staff. A more interactive and easily avail-ble education system, possibly computer based mayurther improve knowledge and perhaps lead to improvedatient outcomes.

oi:10.1016/j.hlc.2008.05.172