"Pump Head" post OHS

HappyNurse2005, RN · Nov 14, 2005

I'm in the cardiac surgery stepdown, and honestly, I don't see it that much at all. I can remember once. The guy was combative (not his normal), thought it was 1984 and he was in the basement (???), tried to hit people, etc. Turns out he'd had a small CVA. Afterwards, he wasn't delirious, but was very emotionally labile. We all sang him happy birthday and he cried.

lee1 · Nov 14, 2005

Hello everyone...the cardiac thread is getting stale..I was trying to think of something we could discuss/share..when I thought of this...
How many of you nurses who work in CVICU/Cardiac Surgery Stepdown Units experience their pts with postop delirium. I have seen it resolve before the pt is discharge..others go home that way.
Does anyone have protocols for postop delirium? The service I work in uses a Loxapine/Delirium protocol. For those who never heard of Loxapine...it's an antipsychotic med used many years ago.

Have personally had it happen to both my father and my uncle post bypass.

They also have had mild to severe postop cognitive disorders. Now, these cases were done "onpump". Surgery done approx 4 years ago for both. This has been the dilema of modern medicine and the risk of OHS>

hrtprncss · Nov 14, 2005

Haven't seen much post op delirium on CV patients. Had a few over the ten years suffered CVA. One thing I don't want to see again. I get nervous when patients don't wake up after 3 hours. I remember one time one patient suffered CVA, pt was vented, IABP, multiplexmultiple gtt's. Then we had to take them to CT! This was within the first 6 hours post op. That was back breaking at the least. Pushing balloon/vent/multiple drips is soooo difficult. At least the CV surgeon went with us and he was nice enough to help transfer the pt to the CT table. Almost as bad as the patient tamponading and having to crack the chest open in CVICU and having the CV fellow on top of the patient pumping the heart with his hands while we pushed the bed and rush the pt back to OR. My adrenaline was running so high I couldn't sleep the whole night and I was so tired the next day, only to come back and to see I have the same patient again, and yes crashing again LOL.

babynursewannab · Nov 16, 2005

Hmmmm... On my unit, we are often able to look around and pick out the "On pump" patients. It is not unusual to get "pump head" in report. Honestly, we have so many OHS cases where I work that there is an enormous population to witness in this regard so it isn't a flippant statement. It is very obvious...shown by numbers. Sometimes assignments are made such that nurses will get one "on pump" and one "off pump" just because of this.