ghmccart

ghmccart has 3 years experience and specializes in ICU/CVICU.

Latest Activity

1. IV Methylene blue post OHS vasoplegia

   ghmccart replied to RN12345656's topic in CCU

   sounds like a protamine reaction that i have seen in the past, interesting that the epi was at just 0.2 mcg/ min, could have gone up to 10 eh>? and the vasso could be at 0.4.. interesting though

2. Lopressor drip

   ghmccart replied to traumagirll99's topic in CCU

   I wonder about using nicardipine for vasodilation, never used metop gtt, wouldn't, that night RN let it fly way to long, but good job dealing w it. thats why good thorough saftey checks always pay off!

3. Pulling Sheaths on a Cardiac Stepdown

   ghmccart replied to ItalianRN's topic in CCU

   it sounds like you are at one of those crossroads in life where you will be making a choice which will take you down two different paths. If you take the ethical stance in the sake of pt safety and safe practice for you it could mean your job at wor...

4. Primacor drip

   ghmccart replied to Genista's topic in CCU

   this positive inotrope is also a prodysrhthmic so watch for that! it vasodilates especially in the pulmonary vasculature, and is often used for folks who have pulmonary hypertension and are in need of a medication to help with contractility, lots of...

5. Transvenous Pacemaker

   ghmccart replied to juraviel's topic in CCU

   we turn our patient with TVP's per policy q2 hrs, just make sure that their line is secure and locked, watch it close, and you know you dont have to turn them too much, just a little but to shift the weight of the pt, I learned that from our wound/sk...

6. Mediastinal Bleeding and Turning

   ghmccart replied to SH18D's topic in CCU

   if we have MT bleeding > 100 ml/hr x2 hr or >200 ml/hr x1 we call, then most likely check serial coags/cbc, consider underlying cause medical or surgical, then consider tight BP control, consider adding 10 of peep, focused med management etc. ...

7. chest tube removal

   ghmccart replied to corkyrn's topic in CCU

   I pull mediastinal tubes in my OHS patients, not pleural tubes however. Try to pay attention to the difference on XR or communicate with doc.

8. Book for CV-ICU

   ghmccart replied to CoCo612's topic in CCU

   I was A new grad into ICU two years ago, and have since trained into the CVICU, I use Bojar's manual of perioperative care in adult cardiac surgery, fouth addition. If you are looking for a complete cardiac ref. this is it. it is detailed enough fo...

9. where did i go wrong? please comment

   ghmccart replied to BandEmom's topic in CCU

   what an experience, First off, if you still like being a nurse, and you want to, then dont let one experience where you DID advocate for the pt get you too down, but I too would have felt bad about that situation. All of the instict advice you got...

10. CHF question

    ghmccart replied to haji's topic in CCU

    in one word optimize this pt maybe has an ef of 23 lets say, bad pump=all the things you listed. diuretic would be good as a part of the therapy, but this pt could possible benefit from an inotropic medication like dobutamine or milrinone. incre...

11. iabp

    ghmccart replied to Feldner's topic in CCU

    just like most things in real critical care, it depends on the situation. could be 1:1 if unstable, or 1:2, I would not do more than that

12. What do you never leave home without?

    ghmccart replied to RNCRNA2BE's topic in CCU

    one bag w/three ring binder for educational stuff, couple crit care refs, chapstick etc, gum for bad breath, other things work in and out of the rotation. on my person I carry crit care ref. and very important to me is my little not pad that I write ...

13. Any new grads that went into the ICU?

    ghmccart replied to KR's topic in MICU

    hi, I graduated in may 06 and went into a rural hospital icu new grad program. included critical care course, 12L, hemodynamic course/test, IABP classes. I was with another nurse for around 6 months and let on my own only as I felt it was time. I ...

14. Milranone and B/P

    ghmccart replied to MacNurse's topic in CCU

    my concern is that you did not look up the medication and anticipate that before you gave it, it is a serious cardiac medication and should be given by knowledgable hands. asking us hear on this forum is ok, but man you need to empower your self.

15. Right Ventricular Infarct--thing I thought I knew...

    ghmccart replied to papawjohn's topic in CCU

    msybe the pts MI allthough inferior maybe stable and not in need of so many fluids, and with the mitral regurg. preload and pacing are still good for RV MI's