rebelccrn 1,479 Views
Joined: Apr 2, '12;
Posts: 6 (33% Liked)
; Likes: 2
I would have to disagree with the statement that in all trauma pt's we should assume that they have cardiogenic shock. Unless with direct coronary injury, there should be no form of cardiogenic shock. Trauma patients experience distributive shock close in relation to septic shock with the overreaction of the immune response.
I agree with pretty much everything else that you said, though.
My SICU has had 2 CLABSIs in the past 12 months and both have been traced back to insertion.
We implement Curos caps and Bio-patch dressings. We use sterile technique when changing the dressings.
Also one thing to watch out for is the "hubbing out" of the lines, be sure to the remind the physician to leave you enough exposed catheter to place the bio-patch.
I wish I could say we change all lines q7days and all femoral lines after the initial 24h but we do not and we still have an almost 0% infection rate.
Why did you chose the TICU over the other ICU's? Was it because these patients may have been in less control of their fate vs a COPD pt? Do you like caring for the younger adult population? Were you involved in some sort of trauma and want to help others? Or did you just want an ICU job and TICU was the only one who took you? I am just curious to hear the various stories. Also include your favorite part and least favorite part about working on the unit.
Hello everyone! I'm a CCRN and I currently work in an SICU in a teaching hospital in my state. Starting on June 1st, our facilty will be going to be transitioning to the Epic computer system hospital-wide. I have no experience with Epic whatsoever and was wondering what to expect. We will be receiving training of course, but there's no better resource than a fellow nurse who went through the same process. Anyone have any experience with the Epic system and willing to share?
I work primarily in the SICU at my hospital and for trauma/surgery patients we usually start Levophed, then Vasopressin, and then Epi infusion. this is as far as we go
as well, i've gotten overflow pt's from other units and this is how it goes
MI: Dopamine, Levo, Epi
Neuro: Neo, levo, epi/vaso
CI: dopamine/dobutamine(arguably a pressor), then it depends on the physician.
Coming from an SICU where everything we give as far as blood products; PRBCs, FFP, and plasma, are all free-flowing. The only reason i've ever heard of putting blood on a pump was my previous experience in a smaller hospital. But, even there, only prbcs were transfused via pumps.
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