Carotid Endarterectomies

[susanmary]

Do you receive carotid endarterectomies straight from PACU to your floor? Floor, step-down, or ICU? How frequent are your vital signs? When do they usually go home.

My patients do come straight from PACU (evening shift) to my unit -- a vascular-thoracic telemetry floor, VS q1x4, q2x4, q4 -- usually do very well & go home the next morning. Keep them on tele until d/c.

[hoolahan, ASN, RN]

Everywhere I have worked, CAE's go to ICU. They have VS and neuro checks q15 x 4, then q 30 min x 4 then q 1 x 4, then q 2h until transfer to the floor.

[bestblondRN]

I have also seen CAEs go directly to a neuro unit (non-ICU) from PACU with frequent vital signs and neuro checks, but most often, they spend the night in the ICU or stepdown in most places.

[BadBird, BSN, RN]

CEA go to the icu because patients have arterial lines and you need to titrate nipride or neo for BP control. VS q15 x4, Q30 x4, Q1hr x 4, then q2hr until dc'd. Most do well and go home the next day.

[NurseDennie, BSN, RN]

I worked on a neuro floor, and just before I left, we started getting the CEA's direct from PACU. Made me very, VERY nervous, because they had been going to ICU overnight. I started thrashing around because I *Really* thought they needed more than what we were capable of doing on the floor. How reasonable is it when you have 6-8 patients and you've got people coming back from arteriograms and other stuff that ALSO requires frequent vitals? And those CEA patients, when they go bad, they go spectacularly bad, spectacularly quickly.

So what? They go direct from PACU to either vascular floor or neuro floor now. I left, so I don't know how it's working. I didn't leave over *this* but it certainly didn't help.

Love

Dennie

[Doey, BSN, RN]

I work on a cardiac telemetry unit and CEA's do come to us straight from PACU. q1-2hr VS & neuro checks w/parameters for starting neo/nipride if needed. They do very well and are usually d/c the next day.

[pauls-gal]

Our patients go to a med-surg floor that handles most of the vascular surgeries. Vitals are usually q 15 min x4, q 30 x 4 q hour x 4 then q 4 hours. 99% of the patients go home the next day.

[Zee_RN, BSN, RN]

They go to ICU overnight with arterial lines. Some have neo or nipride running; some don't. Parameters for maintaining Mean Arterial Pressure dictate start/stop of vasoactive meds.

We had one doc who used to send his CEAs to the floor but he has since retired.

Most do fine but when they are bad, they are very bad. I hate getting that fresh carotid who presents with vomiting and headache...ewww, just waiting for something nasty to happen! And they are MISERABLE! Then you get the ones that are fine, just fine, when can I get out of bed, I'm hungry, etc. etc. Discharged next day. CEAs are either very boring patients or very miserable patients...there's no inbetween.

[Fgr8Out]

"Stable" endartarectomies come straight to our Med-Surg unit. VS q 15 min x4, q 30 min x4, q 1 hr x4 and then q 4 hrs. Most go home the next day. All of them used to go to ICU, but now that's reserved for "at risk" patients.