MIS

I hesitated to ask, but with the experience that members of this board have I thought I would get a better response than from previously asked questions on other boards...here goes: When infusing pressors thru central line (i.e. swan infusion ports) is it best to infuse thru the vip port or thru the cordis? Is it best to run your maintenance fluid behind your pressor and titrate pressor doses? I read some info that some units run pressors at set doses and slowly increase/decrease carrier solutions for titration. I thought that was a little weird. Also, say if I'm infusing levo and dopamine thru vip port and i titrate dopamine up, will the pt. get a little "bolus of levo" because of the increased rate that the dopamine is running at? I feel like i'm getting mixed info from my unit and wanted some feedback here. Thanks

I currently certified on IABP. The hospital I work at put a bunch of us through a 2-day training period. We also had to pass an oral exam type thing and then our first pump patient that we are assigned to we have a resource available to us. My first IABP on my own was little scary but after a couple hours of hands on, I became a little more comfortable with it. Blake

Thanks everyone for your suggestions and opinions. It helps to make tough decisions when others have taken the road before you. For other reasons too long to mention, I will probably stay where I am and soak up as much clinical experience as possible and request to cross-train to our CVICU after a while. Thanks again. Blake

Just wondering if anyone could give me some direction regarding what experience is preferred when applying to CRNA school? In researching programs and different ICU's, it seems that SICU wins out on being the best. Currently I work in a fairly busy CCU. Since I haven't really had any experience with surgical patients in a critical care setting, I'm wondering what additional skills and knowlegde I might obtain if I did go that route? Any help would be great. If in fact I would be better prepared (CRNA school), I would consider moving to a bigger facility (Level I)and work in a SICU. Blake

Our facility has similar guidelines for pulling IABP's. Physician pulls pump after ACT levels are less than 150 and holds manual pressure for 5min and then the nurse steps in and finishes, usually holding pressure for 20-30min. Whether or not we use a fem-stop varies from doc to doc.