[SFRN]

Hey guys,

I have been working in the NICU for 2.5 years prior to starting a training program in the CV/thoracic (surgical) ICU at a large university hospital. My question for all you CV ICU nurses: What are some of the most common gtts. you use on the unit? medications? Lines? When did you start to feel comfortable, and any other recommendations would greatly be appreciated.

James

[rickard]

best site i've found is www.pacep.org

[ghillbert]

Common infusions:
- epi
- norepi
- milrinone
- dobutamine

Lines:
- CVC
- swan

It took me about a year to feel totally confident with any CVICU patient.

[Zookeeper3]

add Neosynephrine for us and plasma volume expanders.. hespan, hextend and albumin... volume, volume, volume (unlike the babies)

Any new nurse I promise 6 months at least for comfort. Our NICU doesn't swan so that may be new for you.

but you KNOW airway, abg's and treatments, vents sedation and weaning

ekg's acls/pals drugs... how to treat pressure and HR varies a bit but is similar.

you have assessment skills, our adult norms are a bit different.

You really have quite a good foundation, the doses will scare you at first. So will the volume but you should keep remembering the skills you have to keep up your confidence, moving to a novice is a difficult task.

hey, just as you never trust a 33 weeker.... never trust a post op day two, they'll go into afib as fast as you blink

[New2CVSICU]

Originally Posted by ghillbert

Common infusions:
- epi
- norepi
- milrinone
- dobutamine

Lines:
- CVC
- swan

It took me about a year to feel totally confident with any CVICU patient.

We use all these plus:

Sodium Nitropursside (Nipride)
Vasopressin

And lots of Albumin, RBCs, Platelets, FFP etc...

Also see:
inhaled nitric occasionally.

And lots of devices...VADs, Ballon pumps, ECMO

I've been on my unit for about 8 months. I'm feeling ok now. I've been on my own for the last 6 months. I feel pretty comfortable, but still a little nervous with the really sick patients.

Hope this helps.

[ghillbert]

We have devices too, but the OP asked about lines and infusions. They won't have to manage devices for quite some time, and definitely not without additional training.

[TX_ICU_RN]

I just stared in a general adult ICU that does lots of cardiac stuff. My ENTIRE background is in pedi (mostly outpatient). I had my first shift in the unit on Thursday and LOVED it. It is going to be a big change, but I am finding that my pedi skills are coming in handy. The change is going to be a lot easier than I thought. It is nothing like being a new grad!

[NoviceToExpert]

I'm surprised nobody has mentioned nitroglycerin or amiodarone yet... you'll see a lot of that... also be familiar with Labetolol, Cardene, Cardizem...know your A-line usage...go to Edwards.com for video tutorials on setup and management of A-lines, Swans, PA Catheters, etc... go to Atriummed.org for chest tube management tutorials... all above for free... go to Datascope.com for IABP counterpulsation information, they have some beautiful new animated videos...you'll see Integrilin and Heparin infusions for other cardiac patients and carotid stent patients if your unit takes those conditions as well...be familiar with your insulin gtt protocols and algorithms...electrolyte replacement parameters and infusion times...central line protocols, etc... How exciting for you... Congratulations on your new post... I love the CVU...check out Blaufuss.org too...

[SFRN]

Wow! you pretty much hit a lot of what I have already experienced on the unit! Thanks to everyone. I just started my third week of training and it is slowly coming together. Thanks for the tips, the links to the web sites.

james

Originally Posted by NoviceToExpert

I'm surprised nobody has mentioned nitroglycerin or amiodarone yet... you'll see a lot of that... also be familiar with Labetolol, Cardene, Cardizem...know your A-line usage...go to Edwards.com for video tutorials on setup and management of A-lines, Swans, PA Catheters, etc... go to Atriummed.org for chest tube management tutorials... all above for free... go to Datascope.com for IABP counterpulsation information, they have some beautiful new animated videos...you'll see Integrilin and Heparin infusions for other cardiac patients and carotid stent patients if your unit takes those conditions as well...be familiar with your insulin gtt protocols and algorithms...electrolyte replacement parameters and infusion times...central line protocols, etc... How exciting for you... Congratulations on your new post... I love the CVU...check out Blaufuss.org too...

[ICUCoOLWaTER]

u better get a clinical exposure for 2 months u will get along very fast easy do not worry pal.