Exercise Testing

Thank you Dr Brawner!!

I second Amanda's comment. At Henry Ford Hospital we have standing orders that allow CEPs in Preventive Cardiology to give nitroglycerin, aspirin, and oxygen as indicated. These were approved by the health system's pharmacy committee. I could see that with appropriate training and annual competency assessment- and assuming it does not violate local regulations- CEPs could be empowered to push Regadenoson and aminophylline. I am also aware that many hospitals will not support this role.

Thanks so much!!

It depends on your hospital's policies and procedures. I have worked at two hospitals that say only nurses can give aminophylline because it is a drug, but I have also worked at hospitals that say in the policies since nuclear techs can administer lexiscan, they can give aminophylline. At my current employer, we do not have a nurse in the room, they are stationed down the hallway doing clerical work while we stress incase we need them.

Thanks so much! There might not be a nurse on sight which is my concern (office vs hospital). I didn’t know if the nuc techs would administer the aminophylline??

So typically you’ll need a nurse to administer the medication, and then the nuc tech will administer the radioactive tracer. The stress portion takes 5 minutes, the set up is literally longer than the test, and it’s one of my favorite tests to do. I do stress tests in a hospital so typically there are more resources so it all depends on where you work and what you have available. And the procedure is slightly different if you have a walker versus someone in a bed. But it’s a pretty simple test for the stress portion.

I work in NJ in cardiology stress testing with one other CEP. Currently we only perform testing for regular exercise stress tests however there may be an opportunity for us to do nuclear stresses. My question is for the pharmacological tests (we use regadenoson) - if aminophylline is necessary who administers the injection (as that is outside our scope of practice). I would greatly appreciate any insight in how you administer/run the nuclear pharmacological tests. Thank you!