+My first patient on a ballooon pump...

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Specializes in Critical Care.

I had my first. Of course my precepter was with me the whole time, but by the end of the shift I was reading my own strips and all that jazz:D

I really think I'm gonna love icu!

Noney

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Good job... sounds like fun! I am still waiting for my first IABP. It is overwhelming but so cool to be in the CCU. I can't wait for the day when I get my first grain of confidence (it won't be for quite a while)! Best of luck! :D

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Specializes in Critical Care.
Originally posted by NsgTiger

Good job... sounds like fun! I am still waiting for my first IABP. It is overwhelming but so cool to be in the CCU. I can't wait for the day when I get my first grain of confidence (it won't be for quite a while)! Best of luck! :D

Thanks. Let me know when you get your first.

Noney

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Specializes in DNAP Student.

Noney, great job. I remember my first. Anyway, once you know the concept of aortic counterpulsation, you will surely be confident in caring for these types of patients.

Just some tidbits and tricks on the care of IABP.

1. Make sure proper timing ( inflation and deflation ) is maintained. I see most of the time inaccurate timing. There are two worst timing you can encounter and when you see one, make sure to coorect it. One way to remember these two types of fatal timing is comparing this to attending a party. You don't want to come early to the party and you don't want to leave late because if you come early you have to wait for the food and when you leave late you have to help clean. comparing this with IAP, EARLY INFLATION AND LATE DEFLATION are two worst timing you can have. Both can cause fatal consequences to your patients. Early inflation will cause elevated filling pressure and late deflation can cause increase afterload.

2. Analayze waveforms correctly. If you have taken care of one, you must have seen the IABP waveform. Diastolic augmentation is supposed to be higher ( but not all the time in some cases ) than your unassisted systole and the assisted diastole should be V shaped. If you can't remember this tryholding your RIGHT hand up and make the VULCAN sign popularized by STAR TREK. The palm of your right hand facing you. ( I wish I could show this to you personnaly but man this works. ) By making a VULCAN sign with your right palm facing you you will see the same resemblance of an accurate IABP waveform.

3. Remember we are always taught to monitor pulses at the affected limb because of possible limb ischemia as a bad complication? Well, there is another pulse that you have to check and this is most of the time forgotten. Check the patient's Radial Pulse at the LEFT hand. It should be present or bounding. If it is absent then the tip of your IABP cath is way too far in the descending aorta.

4. You might know this but I just have to include it here. When coding a patient with IABP, change the trigger to pressure trigger. This way when compression is done the balloon senses your compression as the R wave thus making the pump functional instead of just being still or "quivering" which is bad and may cause PE.

Ok thats it. Good luck to you and keep up the good work. I am sure you will like ICU as many of us do.

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Specializes in Critical Care.

XIGRIS

Thanks for the tips. I'm taking a 4 hour class next month about the balloon pump. I didn't know to pay extra attn to the L radial pulse. I do we we have to watch urinary output closely anf abd girth. I can't wait to learn more. I had a preceptor watching over my shoulder. I'm happy that our unit believes in a long orientation.

Noney

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gotta love that xigris!!!!

glad to hear you had a positive experience with a preceptor and a pump. It's a very simple concept, time it right and decrease afterload and filling pressures and your AOK, as my czech. peer used to say... "This is not science rocket".

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Hi Noney - you might want to look at http://www.icufaqs.org - nice article we put up there on IABP, timing strips, timing errors, all like that.

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Specializes in Critical Care.

Thanks Mark.

I had another IABP last night! Yeah me:D Seriously this was the sickest pt I've ever taken care of. My preceptor is trying to give patients that I can learn as much as possible while she is holding my hand.

noney

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I'm not sure which balloon's everyone is using, but here in the Southeast, datascope runs the monopoly. It's an excellent machine with great backup support. Those of you that have used it know what I mean. I just wanted to add a website for anyone's viewing pleasure ... http://www.datascope.com/ca/cardiacassist.html

There are links to CME credits and intersting articles to help the novice and expert increase their knowledge base. Hope this helps! :)

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Thanks for the link, versatile kat. We'll be "installing" IABPs soon in our cath lab - probably Datascope - and I'm glad to get a little education before it all happens. Last time I cared for a pt on a balloon pump was over 20 years ago, and with the technology then, the pt was a 2:1! One nurse for the pt and one nurse for the pump, to make the adjustments! Gotta love technological advancements . . . :)

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Specializes in CCU (Coronary Care); Clinical Research.

Just out of curiosity...we have been using datascope but are trialing the new arrow pumps right now (they are so pretty!). More importantly, the fiberoptics, set up, and general use of it are quite neat and easy...I am pretty sure that we will be switching over to these...does anyone have any experiences with the new arrow?

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