joeyzstj

joeyzstj LPN

CVICU, ICU, RRT, CVPACU

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All Content by joeyzstj

  1. IV Dobutamine

    joeyzstj replied to bluedevils83's topic in CCU, Coronary, Cardiac

    Our facility only allows Dobutamine to be on the floors when it is a set dose and the patient is stable. They do not allow the floor nurses to titrate Dobutamine. VS are done Every two hours. We...

  2. Vent: CV pt that should have gone back to OR (long)

    joeyzstj replied to jbp0529's topic in MICU, SICU

    With the exception of the idiot fellow griping at you all night, that sounds like a pretty typical night in CVICU . Im fortune in that regard. We dont have fellows. That patient should have went...

  3. Rapid Response Team Members: Input desired!

    joeyzstj replied to robred's topic in CCU, Coronary, Cardiac

    A. 375 Beds B. Myself and an Airway Box with drugs and difficult Intubation equipment. No crash cart is taken due to every floor having one. C. This one I find especially funny. This happens about...

  4. My Dad is in CVICU...need help!!

    joeyzstj replied to EmileeMc's topic in CCU, Coronary, Cardiac

    It sounds like they are referrring to ARDS or ALI with him requiring high amounts of Oxygen. ARDS is just an advanced form of ALI. The heparin isnt going to help rid him of the clots he has, only...

  5. What do you like about CVICU/CCU?

    joeyzstj replied to jspacegirl's topic in CCU, Coronary, Cardiac

    J.....I have worked in ICU, CCU and CVICU where I currently work. CVICU, as someone else mentioned is an area where I believe you have to most autonomy due to the patient population. Most CVICUs I...

  6. APACHE II scoring system

    joeyzstj replied to mhosseinih's topic in CCU, Coronary, Cardiac

    Its widely used where I work as well, however we dont formally chart it. It is used more for determining when to initiate drugs such as Xigris for sepsis. Xigris is a VERY expensive drug and is...

  7. A/C vs. SIMV

    joeyzstj replied to poppy07's topic in MICU, SICU

    Its referred to as Pressure Control or Pressure control plus assist here as well. If you understand ventilator marketing you know that with the exception of APRV, the companies essentially take the...

  8. Questions at the end of the interview

    joeyzstj posted a topic in Student Registered Nurse Anesthetist

    Ive been thinking of this and reading other posts. What are a few good examples of things to ask at the end of the interview when they ask if you have any questions? Also, how about the strength and...

  9. SWANS - Wedging

    joeyzstj replied to Kolt19's topic in CCU, Coronary, Cardiac

    We dont wedge in CVICU. They do it in the other units however. We use PAD which is close enough in a majority of the cases. We had an RN/Paramedic rupture the PA many years ago. They saved the...

  10. Help!!!

    joeyzstj replied to ICURNIAM's topic in Neuro Intensive Care, ICU

    You mentioned that you are a new grad. In most hospitals, there is a 90 day probation period where they can basically fire you or reassign you without the need for an explanation. Im not sure if it...

  11. What did I see???

    joeyzstj replied to nerdtonurse?'s topic in CCU, Coronary, Cardiac

    If the patient was a full code, I probably would have went ahead and prepared to intubate. The initial thing that you should do if the patient is a full code is simply revert back to protecting the...

  12. dialysis nurse thinking about switching to cvicu

    joeyzstj replied to nomadness's topic in CCU, Coronary, Cardiac

    Nomadness.............I think that the assumption that it would be an EASY tansition is a bit overstated. I guess it all depends on the personality of your wife and her critical thinking ability. I...

  13. Which ICU is BEST for Nurse Anesthesia???

    joeyzstj replied to SIGMACHIGUY's topic in Student Registered Nurse Anesthetist

    I have 4 friends who are on admissions boards, and all of them prefer CVICU as the first choice. I think the Duke this covers any type of surgical ICU which a CVICU would be. Cardiac ICU to me is...

  14. Discharged directly from ICU?!?!?

    joeyzstj replied to VivaRN's topic in MICU, SICU

    We discharge people to home sometimes, but not in the situations you have described. It happens in almost all

  15. Have any of you ever had to turn in a coworker for drug use

    joeyzstj posted a topic in CCU, Coronary, Cardiac

    The title pretty well says it all. Have any of you ever had to turn in a coworker for suspected drug abuse? This person is actually someone who I like, however she has been susptected by many of our...

  16. ARDS + prone position

    joeyzstj replied to RoyalNurse's topic in CCU, Coronary, Cardiac

    Yes, we do prone patients and we mostly do it late when all other methods have failed. We have one physician who believes in it strongly and one who does not and says there is not research to back...

  17. New grad to CVICU?

    joeyzstj replied to PaulieGooner's topic in CCU, Coronary, Cardiac

    Our unit primarily hires new grads onto nights so that they can get some experience taking hearts that arent right out of surgery, but maybe several hours post-op which sometimes makes a difference...

  18. ARDS + narcotic overdose

    joeyzstj replied to RoyalNurse's topic in CCU, Coronary, Cardiac

    I searched in "Up to date" and found an article after about 30 minutes of searching that mentioned it, however the main point of the article wasnt directed at this. Ill see if I can dig it up

  19. ARDS + narcotic overdose

    joeyzstj replied to RoyalNurse's topic in CCU, Coronary, Cardiac

    I found somthing mentioning that in opiate overdose, due to CO2 narcosis, the pulmonary capillaries have a membrane leak which would introduce all types of foreign objects into the alveoli. Im not...

  20. Decannulating...

    joeyzstj replied to Mary C's topic in Pulmonary

    If you cant get the orginal trach back in, simply take a 6 cuffed ET tube and insert it in place of the trach. Works like a

  21. Mean Arterial Pressure

    joeyzstj replied to eaetaylor's topic in CCU, Coronary, Cardiac

    We titrate pressors to keep MAP> 65 mmHg in most cases. You are correct. Diastolic pressure, as you know is the period when the coronary arteries are perfused, so it is very

  22. Which ICU is BEST for Nurse Anesthesia???

    joeyzstj replied to SIGMACHIGUY's topic in Student Registered Nurse Anesthetist

    The thing with my CVICU is that we deal with a lot of unstable patients, fast paced codes and all sorts of situations that dont just relate to hearts. When I initially started I wanted to go to ICU...

  23. What liability coverage do you carry?

    joeyzstj replied to nursecass's topic in CCU, Coronary, Cardiac

    None. I have three lawyers in my family who have all suggested I not carry anything. In most cases lawyers will not sue the nurse if there is nothing to sue for. This isnt absolute, however in...

  24. What do you think?

    joeyzstj replied to 4jen's topic in CCU, Coronary, Cardiac

    Go for it. Critical Care (In my opinion) is the best experience you can get. If you can work in CVICU/ICU, you can work anywhere. You will never stop learning and with that type of experience you...

  25. Mediastinal Bleeding and Turning

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

    We dont have a policy that addresses this specificially. We do turn people, however we usually do it if we suspect that they are bleeding and are showing early signs of tamonade.12 hours post op...