TopherSRN

TopherSRN

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All Content by TopherSRN

  1. 4 hour code blue

    TopherSRN replied to Morettia2's topic in CCU, Coronary, Cardiac

    I apologize if you're confusing a teaching opportunity with belittling. I was trying to offer insight as to why he turned the corner(the amio) and the advantage of biphasic defibs and discuss those...

  2. 4 hour code blue

    TopherSRN replied to Morettia2's topic in General Nursing

    I apologize if you're confusing a teaching opportunity with belittling. I was trying to offer insight as to why he turned the corner(the amio) and the advantage of biphasic defibs and discuss those...

  3. 4 hour code blue

    TopherSRN replied to Morettia2's topic in CCU, Coronary, Cardiac

    I don't think the balloon 'solved' your VT, as it doesn't 'open' the coronaries, rather it facilitates their filling. An IABP isn't a substitute for PTCA. There was some other etiology, and Im sure...

  4. 4 hour code blue

    TopherSRN replied to Morettia2's topic in General Nursing

    I don't think the balloon 'solved' your VT, as it doesn't 'open' the coronaries, rather it facilitates their filling. An IABP isn't a substitute for PTCA. There was some other etiology, and Im sure...

  5. 4 hour code blue

    TopherSRN replied to Morettia2's topic in CCU, Coronary, Cardiac

    Why would you want a monophasic? Biphasic has been proven more effective and you can crank a biphasic to 360. We do it very

  6. 4 hour code blue

    TopherSRN replied to Morettia2's topic in General Nursing

    Why would you want a monophasic? Biphasic has been proven more effective and you can crank a biphasic to 360. We do it very

  7. Insulin during cardiac arrest?

    TopherSRN replied to kimmie518's topic in General Nursing

    "Calcium (chloride) is indicated for hyperkalemia during a code. And, it is indicated first line for severe hyperkalemia." Why do you keep repeating this? Its cookbook medicine and not even the point...

  8. Insulin during cardiac arrest?

    TopherSRN replied to kimmie518's topic in MICU, SICU

    "Calcium (chloride) is indicated for hyperkalemia during a code. And, it is indicated first line for severe hyperkalemia." Why do you keep repeating this? Its cookbook medicine and not even the point...

  9. How To Determine ET Tube Placement

    TopherSRN replied to Kwest70's topic in CCU, Coronary, Cardiac

    So a Sa02, Abgs, ETCO2, EBBS and a PCXR (ALL done in a pt Why not just go for a CT to check ETT placement? Thats just as pragmatic as your bronch

  10. Insulin during cardiac arrest?

    TopherSRN replied to kimmie518's topic in MICU, SICU

    Your 2 quotes are contradictory. Ca has absolutely 0 effect on the potassium level. It only acts to normalize the normal resting membrane potential thereby rturning myocyte excitability to a more...

  11. Insulin during cardiac arrest?

    TopherSRN replied to kimmie518's topic in General Nursing

    Your 2 quotes are contradictory. Ca has absolutely 0 effect on the potassium level. It only acts to normalize the normal resting membrane potential thereby rturning myocyte excitability to a more...

  12. 4 hour code blue

    TopherSRN replied to Morettia2's topic in General Nursing

    You 'coded' a person for 5 hours and 25 min s/p code they wer AAOx3? And 10 tries to get a fem cvl? No wonder it took 5

  13. 4 hour code blue

    TopherSRN replied to Morettia2's topic in CCU, Coronary, Cardiac

    You 'coded' a person for 5 hours and 25 min s/p code they wer AAOx3? And 10 tries to get a fem cvl? No wonder it took 5

  14. does anyone use swans anymore?

    TopherSRN replied to squirlkeeperCCRN's topic in MICU, SICU

    The decline of PACs probably has more to do with MDs than

  15. does anyone use swans anymore?

    TopherSRN replied to squirlkeeperCCRN's topic in MICU, SICU

    I don't think it necessary for me to go browsing pubmed to 'prove' that PAd approximates PAWP in a NORMAL heart. That is common knowledge and I am far too busy. This text was handy so on pg. 211 of...

  16. does anyone use swans anymore?

    TopherSRN replied to squirlkeeperCCRN's topic in MICU, SICU

    thank you both :icon_roll :icon_roll :icon_roll any other pearls of wisdom you wish to impart on me? i've been doing open heart for years taking care of vads, double valves, triple valves,robotic...

  17. does anyone use swans anymore?

    TopherSRN replied to squirlkeeperCCRN's topic in MICU, SICU

    Why do people want to wedge so badly? The PAD usually correlates and if it doesnt and they're that sick I get a LA line at my new gig. I guess thats the one advantage to the ivory tower. I just don't...

  18. ? about coding the post Open Heart pt???

    TopherSRN replied to rickard's topic in CCU, Coronary, Cardiac

    Its called ACLS protocol. if pt is dead -> give drugs. Do you not have protocols in place for repleting electrolytes? xfuse for Hct 38.3 give tylenol? Protocols are not dx'ing its cook book...

  19. 7 months of Telemetry enough to tansfer to the CCU?

    TopherSRN replied to heartlover07's topic in CCU, Coronary, Cardiac

    Its probably 7 months too

  20. Rough Nights at Work

    TopherSRN replied to incublissRN's topic in CCU, Coronary, Cardiac

    This blows my mind. You have a fresh heart with wires and the first thing thats done is pound on his chest instead of hook his wires up to the pacer that should be at the bedside of EVERY open heart...

  21. Rough Nights at Work

    TopherSRN replied to incublissRN's topic in CCU, Coronary, Cardiac

    They are not going to just give up after they do a cabg/valve on someone. To be honest those gtts and support devices (iabp/crrt) are pretty run of the mill in CVI. As far as him dropping his rate,...

  22. Question on MAZE procedure

    TopherSRN replied to Whisper's topic in CCU, Coronary, Cardiac

    Your getting Transmyocardial Revascularization (TMR) and a MAZE confused. TMR is where a laser is used to 'drill' holes through the myocardium in order to promote collateral capillary beds as a method...

  23. management of digital (toe) necrosis due to levophed

    TopherSRN replied to ccyoung's topic in MICU, SICU

    If they are on high enough doses of pressors to develop mottled/hypoperfused extremities the odds of them walking out of the hospital are slim; so they don't need the toes/extremeities anyway. The...

  24. ? about coding the post Open Heart pt???

    TopherSRN replied to rickard's topic in CCU, Coronary, Cardiac

    they meant trying to pace and get capture first rather than immediately starting compressions. you'd be surprised how often peope forget about their wires. Though oftentimes you wont capture anyway :/...

  25. iabp

    TopherSRN replied to Feldner's topic in CCU, Coronary, Cardiac

    I would looove to work at a facility where balloons are mandated 1:1. While I have had sick balloons that were 1:1, they would have been 1:1 with or without the IABP. We get pre-op balloons and they...