I C N/A CKD In patients undergoing PCI, the glomerular filtration rate should be estimated and the dosage of renally cleared medications should be adjusted. I B 298 300 Aspirin Patients already on daily aspirin therapy should take 81 mg to 325 mg before PCI. I B 301 304 Patients not on aspirin therapy should be given nonenteric aspirin 325 mg before PCI. I B 301,303,304 AKI indicates acute kidney injury; CKD, chronic kidney disease; COR, class of recommendation; LOE, level of evidence; MI, myocardial infarction; N/A, not applicable; and PCI, percutaneous coronary intervention. Levine et al 2011 ACCF/AHA/SCAI PCI Guideline e591 procedure outcome. Nursing and technical personnel are also required to be present in the catheterization laboratory, with specific staffing dependent on state requirements and labora- tory caseload and mix. Catheterization laboratory technical staff may include nurse practitioners, registered nurses, li- censed vocational or practical nurses, physician assistants, nursing assistants, radiology technicians, or catheterization laboratory technicians. All catheterization laboratory staff are usually certified in basic life support, advanced cardiovascu- lar life support, and, where appropriate, pediatric advanced life support. Catheterization laboratory personnel have a nursing degree/certification or invasive cardiovascular cre- dentials such as registered cardiovascular invasive specialist or American Society of Radiation technologists.305 4.1.3. Time-Out Procedures In 2003, The Joint Commission mandated a universal proto- col requiring proper preoperative identification of the patient by the members of the catheterization laboratory team, marking of the operative site, and a final time-out just before the procedure.306 Although initially intended to prevent wrong-site surgery, this has been expanded to include all invasive procedures despite limited scientific evidence of its effectiveness.307 The intent of the time-out is for all members of the team to improve patient care by collectively discussing the case. 