Admitting an open chest pt

Specialties CCU

Published

I am a newbie in the CT-ICU and part of my orientation is admitting all the fresh hearts. Yesterday, the case scheduled was CABG x3; but ended up needing an AVR and IABP in OR. and when receiving report they stated he was going to have an open chest. They ended up keeping him in OR til the next shift, so I never got to admit my open chest pt :(

I wanted to know your thoughts on these pts, differences in admit and care, tips in managing these pts so I get an idea of what to expect for next time. Thanks!

This thread is so cool. I know ICU nursing is definitely not for me, as I like my ER patient care length of a couple hours and getting the codes in through the door, but oh how I'd love to see something like this and all of the little toys we have to play with regarding it.

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Specializes in CVICU.

Iv been in the CV/CICU for over 5 years now and seen 4 patients with open chest and only two make it. The last one was an AVR with endocarditis, came out with an IABP and immediately started on CVVHD. He was on Epi, Levo, Vaso, Dopa, and primacor. Couldn't raise his arm without his BP tanking. We had to go back in twice at bedside within 18 hrs post-op because of tamponade. 4 weeks later the pt is in rehab walking and doing just fine. Just goes to show us that our hard work does pay off and there could be good outcomes in the end.

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Specializes in Emergency Dept, ICU.

Sounds like a patient with this type of post-op condition should be in the SICU or CVICU only. Not the CCU or the MICU.

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Specializes in CT-ICU.

FYI... you know it's July when a open chest patient codes and the resident is trying to jump on the chest and do compressions, while we are all yelling at him to step away so we can get in. hahaha for real, true story a few weeks ago.

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FYI... you know it's July when a open chest patient codes and the resident is trying to jump on the chest and do compressions, while we are all yelling at him to step away so we can get in. hahaha for real, true story a few weeks ago.

Thank god for NO residents in my CICU - teaching hospital yes, but residents do not do any rotations in my unit (not that first year fellows are any better but its a few months before they get to be on the unit by themselves)

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