Cardioversions

Cardioversions usually come to my tele unit afterwards. They are done in PACU and recovered and then we just monitor the patient afterwards for several hours to days depending on diagnosis. Typical staff ratio 1:5 days, 1:5-6 evenings, and 1:8-10 on nocs. Hardly any cardioversions go to the step down unit. Only those with severe complications related to the cardioversion, like, now they need a temp pacer, they will go to the CCU.

I'm a student, but spent a better portion of the semester on a Telemetry floor. I saw 2 cardioversion done. In both instances an anethesiologist came to the floor and it was done at the bedside...

At my facility,when they need done on an inpatient in critical care, we do them right in the room, and the anesthesiologist just comes over for sedation. typically the nurse to patient ratio is 1:2 with these types of patients. Scheduled cardioversions will often go through same day surgery.

Pete495

When I did Stepdown, we did them there, but not often. Ratio on days was 3:1. Loaded them up on Versed. Did one on Tele for a Dig toxic guy, but even still ratio was 1:5, but I think I gave up a patient when that happened.

I work on a medical intermediate unit and we do cardioversions in the room under conscious sedation. The pt's doctor is at the bedside not an anesthesiologist. Our ratio is 1:4 always.

Our floor is set up in "pods"...one desk with computer and 4 rooms and central monitor over desk for the 4 patients.

Our cardioversions are done in ICU.

I don't rightfully knowhat a cardioversion is, admittedly.

When I floated to the cardio recovery unit, my eyes gaze with wide wonder at how people recover. Recently, a wonderful nurse took 10 minutes and communicated to me the way the telelmetry unit the PT wears can be sycned with the bedside EAGLE unit, which shows 4 lines of streaming cardio output. I don't know how those techs snare at those screens and know all the alarms and spikes and pacemakers. That must throw a serioous strain on the retinas.

I used to didn't know what all those scrollable numbers meant, but thanks to a sup wonderful nurse who knew, and could give excellent answers to my questions, I see the heart technology better.

On my old tele floor (I left for another unit a few mos ago) we did cardioversions. The staffing ratio never changed, whether you had a cardioversion or not. It was a very high acuity floor, with cardiac drips, lots of central lines & TPN, pre-op/post ops, lots of isolation pts, etc. Usually 1 RN:4 pts days, 1:5 pm, 1:6 nocs. There were LVNs also, and each RN would "cover" 2-4 pts of an LVN. So, if you were taking care of your cardioversion pt, the rest of the staff would have to watch your other patients for you during the procedure, which as you know can be 1-3 hrs including set up & recovery.

We did most cardioversions on dayshift. The float nurse would do conscious sedation... if they were available, if not...then one of our RN staff had to do it (which was really a bad idea~ since you have to monitor 1:1 for at least 1 hr, sometimes two hours after).

We started trying to get docs to schedule cardioversions in another outpt procedure dept & then send em back to us, but the docs got VERY upset b/c we "always did on the floor before!" It caused quite a stir.

You know, I got tired of the high acuity on that floor & lack of support. It just was another example of unsafe cutting of corners & expecting the RN to do "just a little extra work" in a day already spread way too thin. Cardioversions are usually planned hours in advance (if not a day in advance), so why not staff extra for it?!!!!

We do cardioversions on our cardiac step down, but now often thank goodness. It's usually done on days when we have a ratio of 1:3, but another nurse will cover your other patients during the procedure. No anasthesiologist at bedside, just the cardiologist. Haven't had a problem yet, but like I said, we don't do it often. :)

We do cardioversions on our tele floor. An anesthesiologiest is present (they use diprivan) and the cardiologist is present and one nurse. I work in the cath lab and if the tele floor nurse is not able to get away from her other patients, we will do it. In fact, we use to do them exclusively in the cath lab and I wish we still did because I like to do them. The diprivan is great because they wake up fast and -- my personal experience here -- have less side effects than with versed.

Sherri