rcpals

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1. Name that rhythm...

   rcpals replied to *LadyNurse*'s topic in CCU

   Second degree type II. Fixed p-r, then drops a beat.

2. CPR question

   rcpals replied to Sand_Dollar's topic in CCU

   Several recent studies, document rates between 150 and 200 chest compressions. Survival starts to drop as compression rates get greater than 120. So 100-120 is optimal.

3. do you mask/bag during DNI

   rcpals replied to SarahT1974's topic in CCU

   According to multiple studies, there is no improvement in neurologically intact survival to hospital discharge, if you intubate during a code. Many hospitals no longer routinely intubate until the patient gets ROSC or they are having difficulty venti...

4. Amiodarone help!

   rcpals replied to Brama28's topic in CCU

   Hi Brama, One of the reasons we don't like to push amiodarone, if the patient is alive, is the high rate of hypotension and bradycardia. Generally this is an infusion related issue occuring in up to 25% of patients. Per your scenario, it doesnt seem...

5. why we can't give IV Atropine for 2nd degree heart block type 2?

   rcpals replied to erintiong's topic in CCU

   Hey all, Atropine works by blocking areas of the heart that are innervated by the vagus nerve. We know the vagus nerve only connects to the SA and AV node directly. The reason atropine is contraindicated in High level blocks (2nd type II and 3rd/C...

6. Yes. another ECG question

   rcpals replied to poohbear1968's topic in CCU

   ok, here's a basic method. there are three discinct areas of the heart; atrial, junctional and ventricular. each area has specific markers of origin. the atria. the identifiers are an upright p-wave. generally all atrial beats must have an uprigh...

7. Yes. another ECG question

   rcpals replied to poohbear1968's topic in General Nursing

   ok, here's a basic method. there are three discinct areas of the heart; atrial, junctional and ventricular. each area has specific markers of origin. the atria. the identifiers are an upright p-wave. generally all atrial beats must have an uprigh...

8. CPR question

   rcpals replied to poohbear1968's topic in CCU

   Hey Guys, Generally the best way to determine adequate perfusion during compressions is with a A-line. It displays actual pressure numbers and you can see a difference in compressed BP depending on your compression technique. Recently I was pushing...

9. Atrial Fib. Noninvasive Treatment

   rcpals replied to thatoneguy's topic in CCU

   Hey happy nurse, Very interesting. Is that all preop cabg patients? Could you kindly ask the doc on the specifics off why you use nasal bactroban for afib? I would love to learn a new technique. See if he can give you info on the study/author/jou...

10. Innapropriate comment at CODE?

    rcpals replied to Dinith88's topic in CCU

    Hi All, This is a cool thread. First let me say I am a totally open to all opinion's. I don't necessarily agree but thats cool. I have laughed at many,many things in code blues. I am not against a little levity in just about any situation. To me...

11. Question about SvO2, VSD, PCW Sat

    rcpals replied to HillaryC's topic in CCU

    Hi Hilary, This is how I believe it works. If you have a Ventricular Septal Defect (VSD) / rupture, the high pressure in the LV will push a little (or alot depending on the size of the VSD / Rupture) oxygenated blood into the RV through the VSD. Th...

12. Innapropriate comment at CODE?

    rcpals replied to Dinith88's topic in CCU

    I would politely ask if you feel other sexual inuendo (SP?) are also acceptable. What about a reference to a large or small phallus? or Breasts. Is that also appropriate . How would legal and administration look at your statement? Would they tell...

13. Atrial fib. with PVC's?

    rcpals replied to MrsSandman's topic in CCU

    The lawyers are the best part and I did read the other posts. In medicine today we have to be as accurate as possible. Picture this, you document PVCs with afib and something went wrong with your pt. The lawyer gets you up on the stand and asks a...

14. Atrial Fib. Noninvasive Treatment

    rcpals replied to thatoneguy's topic in CCU

    Hi Dinith and thanks for the post. First lets understand one basic thing. The AHA algorythms are community standards and we should be using it on most patients. This is not to say we can't deviate from AHA guidelines and try a new technique or dr...

15. Question about SvO2, VSD, PCW Sat

    rcpals replied to HillaryC's topic in CCU

    The reason PAC blood is different than RA blood is this. RA blood just represents the sum of all venous blood returning to the heart. Blood from the pulmonary artery is "mixed Venous". In order to be mixed venous it must go through 2 heart valves ...