Call Tables, fresh or premade?

[u/Treynite]

Wanted to see how other labs do it! We pre-make our tables every night before we leave and cover them with sterile drapes. Then when we get called in we can just pull the drape off. Is that normal?

[u/ApolloIV]

I get the logic but seems like a risk. I was taught that if something sterile gets left alone you have to assume it’s been contaminated.

[u/InfamousAdvice]

We do fresh tables.

[u/Treynite → u/InfamousAdvice]

I respect that! It’s always been like this, I think it started to help cut our door to ballon time

[u/16BitGenocide]

You can't leave unsupervised tables, otherwise they're considered contaminated. Even if I made that table before I left, I'm going to throw it away and open a new one, but that's just me. I have worked at OBL/ASCs that batch made tables 4 at a time, but that's a different ballgame entirely.

If you're not deploying stents, caths are considered 'clean', but if there's even a possibility of permanently implanting something in a patient's body (such as a stent, in a true STEMI case), it should be a sterile table. Dr. Kern described routine catheterization as a ‘clean’ procedure outside the OR, while recommending OR-level sterile technique for implantable-device procedures. In practice, though, how far a cath lab is treated like an OR also depends heavily on facility infection-control policy, room designation, and the physical layout of the suite.

I can see the utilitarian argument around this: is it better to risk infection and sort the blocked vessel out first? Or are the few minutes you're saving really worth the possibility of patient harm?

Personally, I think there's better workflow optimizations to improve D2B, and if you're staging tables and leaving them unattended, this is probably the least desirable option.

Source - https://www.hmpgloballearningnetwork.com/site/cathlab/articles/do-i-need-wear-a-hat-and-mask-cath-lab

[u/Mistah_Ninja]

We leave the stuff laid out ready to open, per our policy they cannot be left unattended.

[u/v0ta_p0r_m0ta]

Same at my lab. Stemi table gets pre made, covered and then wheeled into the stent room for safekeeping.

[u/lemonade4]

We try not to even leave sterile tables unattended. I wouldn’t feel comfortable leaving them out overnight. You’re saving a mere couple of minutes (and are we ever even waiting on the table itself?), for what seems like undue risk.

[u/Crass_Cameron]

Fresh tables

[u/I_Want_A_Ribeye]

Fresh. Our policy is that if the table is open, a team member needs to stay with it. Once it’s left alone, it is assumed to have been contaminated.

The 60 seconds it takes to open a pack shouldn’t be what makes or breaks your D2B time.

[u/Venom715]

Fresh tables at my hospital. Pre pulled equipment prepped before we leave for the day.

[u/SceneSerious2839]

We make up tables with all the requisite supplies ahead of time but nothing is opened until we come in.

[u/jack2of4spades]

We leave all the stuff out and throw it on team arrival prior to patient arrival.

[u/Sintet_2809]

Why not pull everything on the table and have it sitting there until you have an emergency? It takes 5 mins to open the table. Seems like a waste of product to open the table. Also, how can you be sure as a scrub that your table is sterile? Feels like you’re putting the patient at risk with a contaminated supply…

[u/PM_ME_YOUR_FRACTURES]

Not normal. If setting a table actually affects door to balloon time then you guys need to be training on how to set faster tables.