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I think we're getting at the same idea from different sides.It's impossible to predict the result of one intervention (say, volume loading/increased SV) when the other variables are not fixed. It...

It is really difficult to say that volume loading will have any absolute effect on SVR. Resistance results from the interplay of flow (CO) and vascular tone. With fixed tone and CO the SVR would...

The main reason they require volume is due to the massive third spacing from cardiopulmonary bypass/inflammatory response, and the use of vasodilating agents for anesthesia and postoperative...

why was the pt unresposive w/ a SBP 180? 300 amio IVP is usually given w/ VF/unstable VT. This sounds like hemodynamically stable VT if I'm reading you right.

The pacer will protect the pt from bradycardia caused by dual therapy, but NOT from potential ventricular arrhythmia 2/2 dig toxicity. Levels should be monitored.

Here's the latest comparison, PA-NP head to head per specialty In some the difference is marginal, in others, significant. National Salary Report 2011 on ADVANCE for NPs & PAs

noncardiac chest pain- musculoskeletal pain esophageal spasm pneumonia/pleuritis PTX abd source etc

I've never seen it happen. A central line would be essentially impossible since the line material is nonconductive. There is a theory that exposed temp pacer leads can deliver static discharge. ...

Bengin in spectrum of postoperative complications, overall arrhythmias, and epidemiologic data on liklihood of acute decompensation. Numbers are numbers.

certainly- just sharing my clinical experience. My Masters specialization was in AF and I have taken care of easily >1000 AF pts. Most tolerate it, FWIW. Instability is rare and the most common...

AF in and of itself is benign. Having dealt with easily >1000 pts with AF, most tolerate it very well. I have had to cardiovert pts for instability but it is rare. As I said above the greater risks...

There will typically be some shift after pneumonectomy. The concern for shift is with a tension situation- pneumo or hemo. Tension effects re assessed with echo, invasive monitoring numbers (swan)...

Cardiac Surgical ICU acute control, target < 150 SBP IVP- hydralazine, metoprolol/labetalol gtt- NTG, nicardipine, fenoldopam, esmolol

I'm thinking you meant A fib, not V fib? Your initial rhythm was likely AF, flutter, or an SVT. AF is extremely common after thoracic procedures- cardiac, pulmonary, esophageal. The numbers for...

I appreciate that- my point is that it's not a blanket statement. The OP posits a specific scenario- a pt with initial ECG changes and unreleived CP, refractory to initial medical therapy. The...

the OP was discussing patients admitted to a coronary care unit...which means they have made it there on the basis of CP PLUS one of the following- ECG changes, enzymes, angina hx, family hx, or risk...

Not everyone with CP. But patients with unremitting CP despite NTG and antiplatelet/anticoagulation, yes. Unless they are not a PCI/CABG candidate.

Unremitting CP gets a NTG gtt and intermittent MS. And a trip to the cath lab.

-I've had one anesthesiologist give lasix in the OR but it is not common in my experience. BUT....every practice differs. Cardiac pts suck up volume so it would be an odd choice to diurese during...

Keep in mind that for now, you still have the option for the masters NP but you will need the BSN first. Also, NP education is structured such that you can work as an RN during the schooling,...

That's my point. Most are ready on POD#0. Perfunctory "rest time" is a thing of the past and has proven worse outcomes. All stable pts with adequate gas exchange should get a breathing trial on the...

thanks good to hear....

Your hospital should look into fast track extubation. Negative outcomes with prolonged ventilation and sedation. ~75% of my pts are extubated within 6 hrs.

1. If it's true than it is worth getting riled up, on both sides 2. It may seem silly but for some specialties it is a strong turf war in which there are no real winners. If each profession could...

She has significant risk factors, but all things considered she should still be able to get through with a strong recovery. The general mortality for isolated CABG is ~1-3%, and her risk profile is...