OptimusPrime replied to Kgibson089's topic in Cardiac
Obviously, not all new grads are created equally. So it's not unheard of for a new nurse to be hired in the cath lab, pick it up and do well. However, I do not recommend it o the nurses that rotate through as students. I started out as a paramedic...
We used technetium almost exclusively, barring the times the nuclear reactor in Canada failed, then we used Thallium. I would personally do anywhere from 15-20 stress tests/day. Each receiving technetium. I would stand only a few feet from the pe...
Contact the manufacturer and see if they'll send a rep out for an inservice. they are usually great about this. We had a VAD patient in the city I worked as a paramedic in and they sent out a rep and did one for all of our medics. Worth a shot.
Staying calm is great, if you're calm because you have a handle on whats going on. I've seen some very "funcionally frantic" nurses that are awesome, but there's not a calm bone in their body when it comes to emergencies, but they rock. I've also see...
not true... The amount of radiation THEY are exposed to is usually about the same as an xray. And how could the amount they emit be dangerous for you, when the amount receive is so much larger, and it's safe for them? I worked in nuclear medicine doi...
Well, kinda and kinda not. A chest tube is placed to drain either fluid and/or air. Even after CABG's, you will see an air leak sometimes, and that is fine. You just need to be aware of it and make sure it doesn't get worse. It means that there is...
Assess your patient. o2 sats, WOB, lung sounds, HR, RR/min, and eye color... Maybe they're fine without being intubated and all they need is some oxygen. Maybe they need an ambu, maybe not. Why were they intubated initially? Where and how much of...
OptimusPrime replied to aCRNAhopeful's topic in CCU
We very rarely use femoral A-lines. Infection being the biggest reason. Almost all of our post-op hearts have a radial A-line. But, occasionally they will come back with a femoral a-line. When this happens, most of the time it's fine, pt's wake u...
OptimusPrime replied to sicushells's topic in MICU
The pt is in a respiratory alkalosis. pH > 7.45 with a low pCO2. There's no such thing as overcompensating, the body just doesnt do it when it comes to acid/base and ABG's. Bicarb could be low d/t renal function.
Yes, the high potassium could have been a result of the code. Acidotic environments tend to draw K+ out of the cell and lead to hyperkalemia, and Im sure this pt was acidotic. Also, the sample may have been hemolyzed, but if that was the case, the ...
OptimusPrime replied to hepatocyte62's topic in MICU
hmmm, The only thing that is coming to my mind is with CABG pt's. These pt's might have a lower tidal volume and pain is the limiting factor with them. So, by giving them an opiate and relieving the pain, they're able to breathe deeper. Other than ...
OptimusPrime replied to Tornadochaser's topic in CCU
Well, it is a pretty simple explanation, it was a misunderstanding on my part. They were saying that on the newer models, there is no need to manually switch from EKG to pressure triggering, the IABP will do that automatically, if in the auto mode....
OptimusPrime replied to Tornadochaser's topic in CCU
I'm not exactly sure what their rational for this is... I work again Tues. so I'll find out exactly what our policy is and exactly what datascope recommends, and if it is EKG triggering, I'll find out why... Thanks for the replies so far...
OptimusPrime replied to Tornadochaser's topic in CCU
Talked to a Datascope rep and another one of our more experineced ICU RN's the other day and they both said that during CPR, leave the IABP on EKG trigger. I questioned them, just to make sure, and they both said that switching to AP during CPR is ...
As an educator, I give my students alot of advice up front. What I believe are the two most important are: 1.) Learn how to learn. This means knowing what type of learner you are and how to utilize that to UNDERSTAND the material better, not just m...
OptimusPrime replied to deadlydevil's topic in CCU
Clamping a chest tube will never cause a tamponade, it's just impossible. The thoracic cavity can hold well over the amount of blood circulating in our bodies. Therefore, one could potentially hemorrhage out, but not tamponade.
A true SVo2 needs to be drawn from the distal port on the PA catheter. If drawn from a PICC, it's a ScVO2. The two numbers are very closely related and there was a study published in the journal of critical care medicine some time ago that stated t...
I agree, if looking at a 12 lead. But, pt's on the bedside monitor usually don't have a continous 12 lead, so we are stuck looking at one, maybe two leads.
Same goes for axis, no 12 lead, no way to determine axis.