marbrit

Dear Eamon: Enjoyed hearing from you and the others on this thread. I agree that the hemodynamic numbers are really important in order to manage fluid replacement. We had S/G numbers and followed the PAW the most (keeping it in the 15 range). CVP was also very important of R heart function but if you could get a S/G with a PAW you were set!! We used SVO2 alot before we got out continunous cardiac out with continuous cardiac index machine. Mostly out pts were afterload impaired (high) so they got dobutamine and amiodarone for awhile. We diuresed according to wt gain and uop less than 30cc/hr. Lasix, of course. Like I said, our docs knew our limitations and allowed us great latitude. Hope you're having nice weather--I guess we'll be seeing snow soon. Sincerely, Marianne in SLC:balloons:

Hi Eamon: I worked cardiothoracic surgery for 14 yrs and still do it when I can--I travel. I loved the adrenaline of getting an immediate post op pt with all kinds of lines and access. These people (cabg, valve and VAD) pts were fun and we had to watch all these parameters and protocols to make sure the pt became stable in 2 to 4 hrs. I see you've been "nursing" for 16 years but it sounds like you're going to be new to cardiothoracic sugery? We had swan-ganz lines in everyone also art lines and sometimes other specialized access/diagnostic lines. Our pts routinely gained at least 3 kg of fluid and it wasn't uncommon to see 10 kg gains--pts got fluid according to protocols and were diuresed also by protocols. Our surgeons trusted us and knew our education on this stuff. We used lots of vasoactive drips too. This is a pretty general overview of my experiience. Have Fun, Marianne at 0715 in SLC, UT:welcome:

Hi and just to let you know even in the places where there is seniority and stuff it's expected that non-moms work the holidays because they don't have little ones! I have personally had the experience after a unit meeting of a nurse with 3 kids say;' "Well, Marianne will work the holidays!" I can laugh about it now (actually several years later) and at the time I thought "Gee, don't we have families too?" The elective surgery choice is a new twist--Hello from Florida

Hi, I would give them gift cards for restaurants; probably the chain-variety type. I love to give gift cards because people can pick out their own gifts.