DiannaM

Thanks, anybody else have anything to add? Hi there. I work for a cardiology practice in Louisville, KY. My docs were discussing TMRs the other day. We refer to the CV surgeons for TMRs as a last resort. (referred a chick last week ... 40ish, DM, HTN, s/p CABG, with progressive disease and tiny vessels ... not a candidiate for PCI or re-op CABG) I'm not entirely sure what the "success" rate is here in town .... you know, do these patients survive, how is the quality of life, etc. We did have a guy a few months ago that was s/p TMR 10 years ago! One of my docs made the point, do the patients feel better because of the "channels" burned into the heart, or are all the nerves just severed?? Hell, I don't know ... does the heart even have nerve endings?? Something to think about. We do use ECP for patients with intractible/inoperable angina, as well as CHF. (Chick who was referred for TMP came from our ECP clinic) Anyone else using that?? Dianna

Hey there! I work for a large cardiology group, and one of my job requirements is to become certified to do stress testing (treadmills, Cardiolytes, Adenosine, et al). This is thru the American College of Sports Medicine; and the certification is called a Certified Exercise Specialist. Basically -- it's so that I can monitor the patient during the stress tests -- a doc just has to be present in the hospital in case I need him. Anyone gone thru this before?? Any advice??? Thanks! Dianna

Anne.... I totally agree. That's something that I am struggling with at the moment as well .... apply for one of the 3 NP programs here in town and fight for a job when I graduate; or.... move to another city; let my exhusband/family raise my child and worry about her while I am in CRNA school. I don't know what will happen; but I feel that it is incredibly important to impress upon my daughter to follow her goals and dreams; and that women are capable of anything. one of the many issues facing me as I look at the long term goals.... Here's a question... anyone do a CRNA program as a single mom? Did you survive? Did your child/ren make it?? Dianna

In my institution (400+ bed), nurses in the Seated Recovery, CCU and PCU (cardiac step-down unit) are certified to pull sheaths. We wait until the ACT is below 160. Our patients remain on Reopro, and we will start to use Aggrastat soon. We use manaul pressure, Compressar, or the Fem-Stops. Using the C-Clamp seems to be the easiest. we usaully premedicate the patients with MSO4 and Phenergan. We waste 10 cc from each sheath (arterial and venous), to make sure there are no clots