ghmccart

ghmccart has 3 years experience and specializes in ICU/CVICU.

Latest Activity

1. IV Methylene blue post OHS vasoplegia

   ghmccart replied to RN12345656's topic in CCU, Coronary, Cardiac

   sounds like a protamine reaction that i have seen in the past, interesting that the epi was at just 0.2 mcg/ min, could have gone up to 10 eh>? and the vasso could be at 0.4.. interesting

2. Lopressor drip

   ghmccart replied to traumagirll99's topic in CCU, Coronary, Cardiac

   I wonder about using nicardipine for vasodilation, never used metop gtt, wouldn't, that night RN let it fly way to long, but good job dealing w it. thats why good thorough saftey checks always pay...

3. Pulling Sheaths on a Cardiac Stepdown

   ghmccart replied to ItalianRN's topic in CCU, Coronary, Cardiac

   it sounds like you are at one of those crossroads in life where you will be making a choice which will take you down two different paths. If you take the ethical stance in the sake of pt safety and...

4. Primacor drip

   ghmccart replied to Genista's topic in CCU, Coronary, Cardiac

   this positive inotrope is also a prodysrhthmic so watch for that! it vasodilates especially in the pulmonary vasculature, and is often used for folks who have pulmonary hypertension and are in need...

5. Transvenous Pacemaker

   ghmccart replied to juraviel's topic in CCU, Coronary, Cardiac

   we turn our patient with TVP's per policy q2 hrs, just make sure that their line is secure and locked, watch it close, and you know you dont have to turn them too much, just a little but to shift the...

6. Mediastinal Bleeding and Turning

   ghmccart replied to SH18D's topic in CCU, Coronary, Cardiac

   if we have MT bleeding > 100 ml/hr x2 hr or >200 ml/hr x1 we call, then most likely check serial coags/cbc, consider underlying cause medical or surgical, then consider tight BP control,...

7. chest tube removal

   ghmccart replied to corkyrn's topic in CCU, Coronary, Cardiac

   I pull mediastinal tubes in my OHS patients, not pleural tubes however. Try to pay attention to the difference on XR or communicate with

8. Book for CV-ICU

   ghmccart replied to CoCo612's topic in CCU, Coronary, Cardiac

   I was A new grad into ICU two years ago, and have since trained into the CVICU, I use Bojar's manual of perioperative care in adult cardiac surgery, fouth addition. If you are looking for a complete...

9. where did i go wrong? please comment

   ghmccart replied to BandEmom's topic in CCU, Coronary, Cardiac

   what an experience, First off, if you still like being a nurse, and you want to, then dont let one experience where you DID advocate for the pt get you too down, but I too would have felt bad about...

10. CHF question

    ghmccart replied to haji's topic in CCU, Coronary, Cardiac

    in one word optimize this pt maybe has an ef of 23 lets say, bad pump=all the things you listed. diuretic would be good as a part of the therapy, but this pt could possible benefit from an...

11. iabp

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

    just like most things in real critical care, it depends on the situation. could be 1:1 if unstable, or 1:2, I would not do more than

12. What do you never leave home without?

    ghmccart replied to RNCRNA2BE's topic in CCU, Coronary, Cardiac

    one bag w/three ring binder for educational stuff, couple crit care refs, chapstick etc, gum for bad breath, other things work in and out of the rotation. on my person I carry crit care ref. and very...

13. Milranone and B/P

    ghmccart replied to MacNurse's topic in CCU, Coronary, Cardiac

    my concern is that you did not look up the medication and anticipate that before you gave it, it is a serious cardiac medication and should be given by knowledgable hands. asking us hear on this...

14. Right Ventricular Infarct--thing I thought I knew...

    ghmccart replied to papawjohn's topic in CCU, Coronary, Cardiac

    msybe the pts MI allthough inferior maybe stable and not in need of so many fluids, and with the mitral regurg. preload and pacing are still good for RV

15. Hemodynamics question

    ghmccart replied to nursing4him's topic in CCU, Coronary, Cardiac

    It is important to know the physiological diff between cardiogenic shock, and septic scock, and throw in anaphylactic, hypovolemic, and neurgenic shock. taking the time to get these straight in your...