MAP=60? Why wait to treat?

[sewnew]

I am currently working as a student nurse/tech on a SICU at a busy teaching hospital. Was told that patients on the unit should maintain a MAP of at least 60 or above in order to maintain optimal organ perfusion. Wondering why nurses have to wait until the MAP falls to 60 before treating the patient. Doesn't it make sense to start bolusing the patient with fluids as soon as the MAP starts trending down? Is this standard practice or unit specific?

[fiveofpeep]

I'm a nursing student, but

Tip: Stop beginning your posts with "I'm a student." I would never know otherwise and I know it's bad, but I automatically don't want to keep reading because of it.

Edit: I forced myself to read your gigantic post and it sounds like you will be a great ICU nurse. You're on the right track with asking a lot of smart questions about the situation and being prepared.

[NCRNMDM, ASN, RN]

Thanks for the advice. I just don't want to pass myself off as a skilled nurse when I'm not. I'm interested in critical care, I hope to land a critical care residency out of school, but I am not experienced, and do not want to give anyone the impression that I am. I do like posting to this board because of the advice, input, and educational opportunities that it offers. I hope it doesn't seem too forward on my part. I don't post because I want to showcase my knowledge, but simply because I want to be corrected when I'm wrong and learn all that I can. I will remove the, "I'm a student" advertisement from future posts, as I think it's evident by now.

Also, thank you for your kind words.

[fiveofpeep]

Thanks for the advice. I just don't want to pass myself off as a skilled nurse when I'm not. I'm interested in critical care, I hope to land a critical care residency out of school, but I am not experienced, and do not want to give anyone the impression that I am. I do like posting to this board because of the advice, input, and educational opportunities that it offers. I hope it doesn't seem too forward on my part. I don't post because I want to showcase my knowledge, but simply because I want to be corrected when I'm wrong and learn all that I can. I will remove the, "I'm a student" advertisement from future posts, as I think it's evident by now.

Also, thank you for your kind words.

I think it's great. I'm sure you reinforce a lot just by typing it all out and looking up details to confirm. I know I do. It's part of why I like to respond to academic posts. I don't think you are misrepresenting yourself, but to me at least, it's as if you are apologizing for being a student. I learn so much from students and nurses alike :)

[NCRNMDM, ASN, RN]

Thank you. I did sort of feel guilty when I first started posting to this board because I was posting with all these experienced ICU nurses who knew so much more than me. I guess it was kind of a way for me to apologize for posting here. The more I post here, the more I feel like I know more than I give myself credit for. I don't know anywhere close to enough, but I feel like I have more knowledge than I originally thought. I love posting here and learning from other, more experienced, nurses. Thanks for not running me off the board, for reading my posts and providing information, and for giving me constructive criticism.

[fiveofpeep]

No problem. We're all learning here. Wish you all the best. Now I feel guilty for hijacking this thread. Carry on OP

[esie]

We generally run with a guideline of MAP >65mmHg, unless specifically indicated. When considering chatting to the docs about a fluid bolus, I consider the trends over the last 2-3 hours. What has the pt's urine output been, where is the MAP hovering, where is the CVP? What is the patient's condition, and what is the general aim of the day? What was their general baseline before becoming sick enough to be admitted to ICU? So, it's not a matter of waiting to treat a tending downward MAP, it's considering all of the trends.