[Morettia2]

Originally Posted by richard1980

shocking the pt at 200 joules b/c I looked at the defib. machine and said Hey we might wanna shock him at 360 joules

Don't you guys use biphasic defibs?

yes we do which is a pain in the but I have asked many times for a monophasic defib for this reason!

[Morettia2]

Originally Posted by TopherSRN

You 'coded' a person for 5 hours and 25 min s/p code they wer AAOx3?

And 10 tries to get a fem cvl? No wonder it took 5 hours.

when the pt went to the CCU pt had just had the baloon pump inserted aboiut 30 min before on my floor. That's how fast the heart took the the baloon. It just needed to open up the arteries a little bit, just enough so the pt. would stop going into pulseless v-tach and have the blood pumping ..we wuod have put one on earlier but it was saturday the cath lab is closed it was 8:30pm, only MD's are house MD and some tele residents..so that's part of the reson it took soooo long. Cath lab had to be activated on call md's, Rn's ect...I am sure if it was a monday our cath lab is open till 11pm M-F..so but pt survived and was extuabated today! talking dosen't remember a thing of course..

[Morettia2]

Originally Posted by rn/writer

This code started at 8:30 and ended at 1:30? That's five hours, not four. Amazing. Simply amazing. Glad you stuck to your guns. Enjoy the high while it lasts. Think back on this little miracle on those nights you want to walk out the door and not come back. Remember the life you helped to save.

You did a great job!

thanks..actually the entire process stopped at 1:30AM, we coded till 12:30AM, when the Interventional MD arrived and placed the baloon. The EPS MD said that the code ended when the Interventional mD showed up and the pt became stable...I was like Ok...but pt was extuabated today

[Morettia2]

Originally Posted by Morettia2

yes we do which is a pain in the but I have asked many times for a monophasic defib for this reason!

Sorry was not paying attn when I answered..no we use monophasic at my hospital, which is an inner-city hospital that has alot of money, a Physio-control from like 1980..I asked my director a million times for a new one..we don't have a pacing button only a sync on the machine. and our transport defib is a 1979 hewlett packard that's bright yellow, and the leads don't even stay connected to the machine...but you would think that we would be more updated, funny how things fall thrpugh the cracks..oh I know I am going to walk into work tomorrow and we will have a new machine b/c the EPS MD freaked about how old our machine was and how we should have been shocking the pt at 360.

[TopherSRN]

Originally Posted by Morettia2

yes we do which is a pain in the but I have asked many times for a monophasic defib for this reason!

Why would you want a monophasic? Biphasic has been proven more effective and you can crank a biphasic to 360. We do it very often.

[TopherSRN]

I don't think the balloon 'solved' your VT, as it doesn't 'open' the coronaries, rather it facilitates their filling. An IABP isn't a substitute for PTCA. There was some other etiology, and Im sure the amiodarone gtt you started solved your arrhythmias.

[Morettia2]

Originally Posted by TopherSRN

Why would you want a monophasic? Biphasic has been proven more effective and you can crank a biphasic to 360. We do it very often.

i don't know if you saw my corrected my self. I am sorry for any confusion

[Morettia2]

[quote=TopherSRN;2747828]I don't think the balloon 'solved' your VT, as it doesn't 'open' the coronaries, rather it facilitates their filling. An IABP isn't a substitute for PTCA. There was some other etiology, and Im sure the amiodarone gtt you started solved your arrhythmias.[/quot

I know a IABP isn't a substitue for a PTCA. I deal with PTCA's all night long. But untill the Cath Lab was able to do a PTCA and a full staff was able to work on the pt he recieved a baloon, which again was inserted at the bedside b/c the pt was so unstable..why do you feel the need to belittle me..I have only 9 months experience out of school and like I have said I have been in codes before but nothing like this Mega Code. I work with about 3 nurses at night including my self, and little to no staff available. So I am sorry if my terminology is off, I am still learning. Calm Down, I am just sharing what happened the other night.

[TopherSRN]

I apologize if you're confusing a teaching opportunity with belittling. I was trying to offer insight as to why he turned the corner(the amio) and the advantage of biphasic defibs and discuss those issues.

If you'd rather me just say 'gj on flogging the guy for 4 hrs and letting the IABP fix everything'. I can, but that does neither of us any good, and its not why I read this board.

[Morettia2]

Originally Posted by TopherSRN

I apologize if you're confusing a teaching opportunity with belittling. I was trying to offer insight as to why he turned the corner(the amio) and the advantage of biphasic defibs and discuss those issues.

If you'd rather me just say 'gj on flogging the guy for 4 hrs and letting the IABP fix everything'. I can, but that does neither of us any good, and its not why I read this board.

Let's call it a truce. I am still learning about what to do in a mega code.