? about coding the post Open Heart pt???

[rickard]

this question is only concerning the first 24 hour period. do you deviate from ACLS protocols or do you give 1 mg epi q3-5 mins? anyone use calcium chloride ?

[jmgrn65, RN]

you still use acls protocol.

[nurselizk]

No chest compressions on a patient with a sternotomy. The chest gets opened up for cardiac massage, if necessary. We've just started doing minimally invasive open hearts, haven't had any of them code but chest compressions should be acceptable in that case.

[Dinith88]

No chest compressions on a patient with a sternotomy. The chest gets opened up for cardiac massage, if necessary. We've just started doing minimally invasive open hearts, haven't had any of them code but chest compressions should be acceptable in that case.

I hope thats not a policy at your place.

Time is brain. Dont twiddle your thumbs. Do compressions.

Unless you have a surgeon standiong at the bedside 24/7 with a bottle of betadine and a razor...

It's unfortunate (and kinda gross) compressing a fresh sternotomy but in the event of cardiac arrest you have no other choice. (or...if you choose to wait until someone comes and cracks the chest you'll likely just be watching the patient die...)

[sirI, MSN, APRN, NP]

I hope thats not a policy at your place.

Time is brain. Dont twiddle your thumbs. Do compressions.

Unless you have a surgeon standiong at the bedside 24/7 with a bottle of betadine and a razor...

It's unfortunate (and kinda gross) compressing a fresh sternotomy but in the event of cardiac arrest you have no other choice. (or...if you choose to wait until someone comes and cracks the chest you'll likely just be watching the patient die...)

:yeahthat:

[nurseabc123]

No chest compressions on a patient with a sternotomy. The chest gets opened up for cardiac massage, if necessary. We've just started doing minimally invasive open hearts, haven't had any of them code but chest compressions should be acceptable in that case.

Compressions (push hard, push fast!) for patients with closed chests. You're not going to open the chest at the bedside every time.

No compressions for patients whose chests are already open.

[utahliz]

You may call compressions on a sternotomy patient unfortunate and gross and do it because your policy does not prohibit it, but ours does.

[nurseabc123]

You may call compressions on a sternotomy patient unfortunate and gross and do it because your policy does not prohibit it, but ours does.

huh? your does prohibit it? that was hard to follow.

[kirbybunny]

You may call compressions on a sternotomy patient unfortunate and gross and do it because your policy does not prohibit it, but ours does.

So if a post CABG patient goes asystolic, what do you do? Prep for an open chest, but no compressions in the meantime? I understand if it is your policy, but it makes no sense to me!

~ Jen

[krzysiu]

I hope thats not a policy at your place.

Time is brain. Dont twiddle your thumbs. Do compressions.

Unless you have a surgeon standiong at the bedside 24/7 with a bottle of betadine and a razor...

It's unfortunate (and kinda gross) compressing a fresh sternotomy but in the event of cardiac arrest you have no other choice. (or...if you choose to wait until someone comes and cracks the chest you'll likely just be watching the patient die...)

Dont forget the pacer wires.

[Dinith88]

Dont forget the pacer wires.

Very Good point.

Unfortunately, pacers wont help in certain situations/arrests.

Do you mean you withhold compressions in all patients with wires??

[krzysiu]

Very Good point.

Unfortunately, pacers wont help in certain situations/arrests.

Do you mean you withhold compressions in all patients with wires??

Just the ones where the surgeon tells me to withhold compressions.