joeyzstj

joeyzstj LPN

CVICU, ICU, RRT, CVPACU

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All Content by joeyzstj

  1. Insulin Drip Protocol

    joeyzstj replied to TulsaTime's topic in MICU, SICU

    We use the same type of protocol. We compare previous and current Blood Glucose and adjust accordingly. The protocol really never allows a change of more then 2 units at a time. Blood sugars...

  2. CVP and PAD

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

    A lot of hospitals dont wedge anymore due to the risk of rupture to the pulmonary artery and subsequent mortality rates due to that. Our CVICU had it happen about 15 years ago by a nurse who was also...

  3. Rythym question

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

    A few questions, and maybe Im reading what you are trying to say wrong, but how were you getting a PRI with the P buried in the T? I have actually seen something similar to this which I thought was...

  4. Am I just a nervous new grad or is the ICU not for me?

    joeyzstj replied to Sterren's topic in MICU, SICU

    Again, I think the point she was trying to make was that it is "Different" as you put it. The degree of intensity is different. I have worked agency and been on several floors and units. You cant...

  5. Post-Surgical Cardiovascular ICU Books???

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

    Postoperative Care in Cardiac Surgery By Robert Bojar is the best book for CVICU I have ever read. "The ICU book" is also a great book. Get on google books and you can read a lot of books mostly for...

  6. Am I just a nervous new grad or is the ICU not for me?

    joeyzstj replied to Sterren's topic in MICU, SICU

    "Oh, so you don't think that floor nurses caring for 10 patients have any idea about "DEGREE OF INTENSITY"...so what about gtts (u don't have to figure it out any more..smart pumps..:-{ ) codes..all...

  7. Am I just a nervous new grad or is the ICU not for me?

    joeyzstj replied to Sterren's topic in MICU, SICU

    Wendy.........Every GN's problem is time management . Thats why you normally start out with one patient and then progress to two patients and then on your own with a preceptor peeking around the...

  8. Am I just a nervous new grad or is the ICU not for me?

    joeyzstj replied to Sterren's topic in MICU, SICU

    Ignore orientation times or what your friends are doing. I orientate several new employess and it isnt always about the skill (or lack thereof) so much as staffing cruches and things of that nature....

  9. IABP and CPR

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

    You can do a few things. You can put it into semi-auto mode and change to arterial pressure trigger or ECG mode (according to DataScope) if you werent already in that, so that it will inflate and...

  10. Opening a new heart program

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

    Thats the type of training your hospital needs listed above. I would love to be a part of something like that, but it would be insane getting it together. Let us know how it

  11. Opening a new heart program

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

    If you read a lot of the posts on here, many hospitals require several month of orientation before they allow staff members to even touch a fresh heart. AS JBP0529 mentioned, for someone experience...

  12. Opening a new heart program

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

    No, and there is a VERY good chance it IS going to be a disaster. The people recovering hearts need to know how to deal with post-op hearts and valves. This is a huge chance of error that requires...

  13. NIHSS stroke scale

    joeyzstj replied to ferde1's topic in Neuro Intensive Care, ICU

    We use it on a daily basis............and it sucks. Its a very good scale, is time consuming when you have multiple things going on in the unit. It is mandatory on all of our carotids as well as...

  14. New to Cardiac Surgery ICU and need guidance

    joeyzstj replied to mjs5312's topic in CCU, Coronary, Cardiac

    Hello. I want to thank you for this post. I personally appreciate that fact that although you are having a difficult time, you are still able to recognize the ability it requires to work in a CVICU...

  15. General assessment in SICU

    joeyzstj replied to JLKNurse's topic in MICU, SICU

    OK...........The point that Im trying to make is that placing your hand in a confused patients hand and having them grip really isnt a correct response to a neuro assessment. When you place you hand...

  16. For those of you on interview boards

    joeyzstj posted a topic in Student Registered Nurse Anesthetist

    Ive been thinking and Im curious. I seriously am wondering...........if you were interviewing me, a nurse who has been in CVICU/CVPACU for over two years and a RRT who worked primarily in ICU, CVICU...

  17. IV pump placement/Room set up

    joeyzstj replied to TulsaTime's topic in MICU, SICU

    This is funny to me becasue we have people in my unit that get all bent out of shape when I put a pump on the side of the bed as opposed to the head of the bed. I agree with you. I would place the...

  18. General assessment in SICU

    joeyzstj replied to JLKNurse's topic in MICU, SICU

    In the CVICU we use the NIH stroke scale a lot in addition to our routine neuro assessment due to the fact that we deal with a lot of carotids and/or procedures that could cause a stroke. My daily...

  19. EKG and Axis

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

    Axis deviation is unimportant to people who dont understand it or cant explain it to you:D. There is a great book entitled "12-lead ECG for Acute and Critical Care Providers" and semiar by a national...

  20. Pronation and pressure sores.

    joeyzstj replied to dissle's topic in MICU, SICU

    Yes, a critical care intesivist/pulmonologist that I worked for had it a few years back. I will ask him next time I work where he got it. Basically, with prone ventilation you are trying to change...

  21. What would you do for this patient?

    joeyzstj replied to UM Review RN's topic in CCU, Coronary, Cardiac

    This patients BASELINE pressure is 100 systolic as menioned in the post. The patient intitially has a 40% decrease in blood pressure followed by a 30% decrease in blood pressure that...

  22. Chest tubes/Open Heart Surgery

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

    As dean mentioned, the Left Internal Mammary Artery is on the inside of the chest wall cavity and is used very commonly due to the fact that is one of the few vessels in the body not effected by...

  23. Highest PEEP you've seen?

    joeyzstj replied to poppy07's topic in Neuro Intensive Care, ICU

    Usually at levels of 15 cmH20 significant hypotension occurs. APRV is a great alternative mode however you need very skilled practitioners to use it (Properly) and to understand and Identify the...

  24. Pronation and pressure sores.

    joeyzstj replied to dissle's topic in MICU, SICU

    Im curious, are you proning the patients mostly for surgical reasons or for ventilation reasons such as ARDS patients with poor oxygenation? Hillrom makes a bet that is pretty amazing and is made...

  25. TPA didn't infuse

    joeyzstj replied to JeffTheRN's topic in MICU, SICU

    So everything was connected and properly in place? Was it just a pump/casette malfunction causing it to not