CV experience

kmchugh · Sep 27, 2002

Experience with post op open heart patients is helpful, but not necessary. The key is learning about titration of vasoactive meds, and just learning about your "sixth sense" with patients.

Kevin McHugh, CRNA

g8rlimey · Sep 27, 2002

I am now in a med/surg ICU as a traveler, and I wish I had stayed in CVICU. I did 2.5 years in a teaching hospital CVICU and it was wonderful experience.

I was challenged EVERYday, and the drip titration experience was one that I hope I can get to feel again as a CRNA.

There is nothing like optimizing someone's cardiac index with Nipride and Epi, or making a DTAA's toes warm and pink with Nipride. Additionally, the experience with heart/lung transplants is worth it alone. We often used Ventricular Assist Devices as a bridge to transplant, and the connections made with those patients will last a lifetime. Seeing a 16-year old on deaths front step on a BiVad, epi, SNP, NTG, Lido, milrinone---getting fluid and blood constantly and then to see them going home after getting a great heart. If that's not enough, the cool equipment you get to use is great---Ventricular Assist Devices, Balloons, CVVHD (my least favorite). :clown:

AL bug · Sep 27, 2002

I agree that CV experience is good, but it's not necessary. I worked 18 months in MICU...had Swans,CVVHD,pressors,etc. If you are in a big enough hospital with sick patients, you should get more than adequate ICU experience in a MICU or STICU. just MHO.

g8rlimey · Sep 27, 2002

I agree the experience isn't necessary...just wanted to relate my love for the patient population...surgery pt.'s (in MHO) are alot more fun. Don't get me wrong, I do like the medicine side, but a post-op admit is where it's at!! :)

braden74 · Sep 28, 2002

Boy you sure make CVICU sound like fun. I was told that it isn't that interesting with the aggressive weaning parameters now. Our RN's are expected to have them extubated and off their drips in 24 hours for post-open hearts. Didn't sound that interesting until now.

thanks

g8rlimey · Sep 28, 2002

I suppose it depends on what sort of hospital it is and what kinds of patients the CV service takes. We had several surgeons that were known for taking the patients that know one else wanted. We rarely ever had fast-track bread and butter cabg/valves but it was a nice change when we did.

SunDevilRN · Jan 15, 2003

I realize that there hasn't been anything posted here in a while but I am new and wanted to give my 2 cents on working in the CVICU. I LOVE IT!! I started in the CVICU straight out of college and love every minute of it. There is nothing I love more than a fresh open heart pt on 6 gtts an IABP and strict blood presure parameters. I am also lucky enough to work in a large hospital with a highly acute population so I also see a lot of overflow.

g8rlimey · Jan 15, 2003

Hey SunDevil,

You'll be suprised to learn you and Brad work in the same hospital, he works on 11. Hope your nite is going well. I'm at home!:)

yodakelly · Jan 15, 2003

hey braden74-

just my $0.02: i've interviewed and been accepted to 2 crna programs, and both times someone has mentioned to me during the interview process their feeling that CTICU/ CVICU is the best preparation for CRNA school. Obviously, this isn't the only way to go, but I have gotten the message that caring for the post cardiac surgery patient straight from the OR is about as close to anesthesia care as you can get.

Plus, g8rlimey is right: it's fun and not often boring in bigger hospitals.

braden74 · Jan 15, 2003

Good to know. I think I'm headed there after I get my full year in in my Med/Surg ICU.

Thanks for the input

megmermaid · Jan 15, 2003

Wow...my hospital is a bit different.

Our CVICU is mainly for post heart cath and CICU overflow. The SICU (where I work) gets all the post open hearts (CABG's, valves), any transplants, and AAA's. It sounds like these patients would go to your CVICU. My unit also gets all the level 1 traumas, including head injuries or whatever else (ie GSW, multi system, etc), acute abdomens (because they'll probably have surgery sooner or later), and we also have pretty much all the organ donors too. My hospital recently opened a new Neuro ICU but guess what the neuro docs aren't used to it yet so we also get crani's and other neurosurgeries.

I personally love my unit because of the diversity. I've had experience with CVVHD, intra-aortic balloon pumps, and ventricular assist devices as well as gtt titrating.

Most of our open hearts get extubated about 6 hours after surgery...try that when you still have those strict BP parameters :)