[SoccerMomNC]

Our hospital has recently started doing heart scans. Since I am new to radiology, I would like to hear from nurses with experience in this test. We currently give 100mg Lopressor po 2 hours prior to scan to lower HR. If this does not lower HR to less than 65, we give IV Lopressor 5 mg Q5 minutes X3 doses. Recently, we had a patient with known cardiac prob's (MI and stents 5 years ago), who was already on a beta blocker, so he did not take the po Lopressor we normally give. We ended up giving him 3 doses of IV (15 mg total). The problem is, his HR was still in the high 60's, although it REALLY dropped his BP (80/50) post procedure!! We do not have a "recovery room" so I monitored him in our treatment room for 45 minutes. Of course his BP was better, and he went home. I have 2 questions: Does anyone use anti-anxiety meds(Ativan, Valium, etc) po prior to scan to lower HR? 2nd question: Does anyone use po Calcium channel blockers for someone with asthma instead of a beta blockers? When I asked one of our cardiologists, he said he would still use a beta blocker on someone with asthma because it "is in and out so quickly". By the way, when we scan, I am the only nurse and I have a radiologist with me and the tech. Our radiologist reads the heart scan. Is this common practice else where? Thanks in advance!

[DutchgirlRN]

Originally Posted by SoccerMomNC

We currently give 100mg Lopressor po 2 hours prior to scan to lower HR. If this does not lower HR to less than 65, we give IV Lopressor 5 mg Q5 minutes X3 doses. I have 2 questions: Does anyone use anti-anxiety meds(Ativan, Valium, etc) po prior to scan to lower HR? 2nd question: Does anyone use po Calcium channel blockers for someone with asthma instead of a beta blockers? By the way, when we scan, I am the only nurse and I have a radiologist with me and the tech. Our radiologist reads the heart scan. Is this common practice else where? Thanks in advance!

We give Lopressor 15mg IVP over 5 minutes, wait 15 minutes, if the HR is not down, and BP ok, we push 35mg of Lopressor in 7 minutes. 99.9% of the time if the first 15mg doesn't bring it down the additional 35mg won't do it either. It's just me and the CT tech. No radiologist, no cardiologist. Our cardiologists read the heart scans. I also push Versed & Sublimaze for conscious sedation. The interventional radiologist is present for sedations. I personally think IV anti-anxiety meds would work much better for the heart scans.

http://tickers.tickerfactory.com/ezt...rqV/weight.png

[SoccerMomNC]

WOW That's alot of Lopressor at once! What are your standards re: BP too low to give? How long do you monitor these pt's post procedure? Thanks for your prompt reply!

[DutchgirlRN]

Originally Posted by SoccerMomNC

WOW That's alot of Lopressor at once! What are your standards re: BP too low to give? How long do you monitor these pt's post procedure? Thanks for your prompt reply!

If the systolic goes 90 or lower we stop the Lopressor. I stop it when it gets close and I see a downward trend. The cardiologists have a fit if the entire 50 mg is not given and want documentation as to exactly why it wasn't given.

We monitor the patient for one hour post procedure unless they are an ER patient then we take them back to the ER.