nightshift82

Thanks you are correct. I was also upset about the intervention of deflating the balloon and inserting it higher and then re-inflating. Is this a practice that others are doing? Any thoughts?

The catheter has been in place for a few days...they are deflating the balloon, not taking it out but advancing it higher...thinking that it may be in the neck or urethra...still not sterile. Anyone heard og this practice?

Many years ago some nurses who cared for patients complaining of pain or urge to urinate post foley insertion would deflate the balloon,re-adjust the catheter and re-inflate the balloon. I would never do this because this because it was not sterile. I recently heard of it again and was wondering if others practice the same? If there is a concern that the balloon became dislodged into the urethra it should be removed and a new catheter placed?

Thanks for your response...I thought I was crazy. One of the patients died and the other for possible LVAD at the transfer hospital. I did speak with the Datascope RN for our region and confirmed the same 1:1 for frequency. I have not been able to catch up with the interventionist. As for some of the strange issues with the pump console I was told to video it and send the clip to the hotline.... had not thought of that b/c with the other console your would it up with the phone cable to the hotline.

Sorry I forgot to add that I do not know the LVEDP and both were SR-ST not AF and were large AWMI. I did not take care of them but was posed the question. Also with this same console I did care for a patient who had a great ECG and R wave...no arrhythmias and the new Cardiosave Hybrid would stop pumping and alarm trigger loss and go to pressure mode. I would have to force it back to ECG trigger by pulling the pressure cable...augmentation was better in ECG trigger. I had already changed all te electrodes before I resorted to pulling the pressure cable in and out. I was close to replacing the ECG cable from our other IABP and calling the hotline when it finally stopped?? I was told this happened again with our last patient. Anyone having this issue?

I work at a small community hospital which used the Arrow/Teleflex IABP for years and we have recently switched from Arrow AutoCAT II to Datascope Cardiosave Hybrid. There was very little support from the company compared to Arrow which is very frustrating. I have read the manual over 200 pages. I was told that these two consoles use very different technologies and that there is not a bellows system with Datascope/Maquet? Does anyone use this console and my second question is that we have had the interventionist order 1:2 instead of 1:1 for the frequency in two of the most recent post-PCI patients with DHF/cardiogenic shock on levophed which makes no sense to me and he could not explain the rational. Timing was good with regards to inflation and deflation points with augmentation 80 and MAP 60. These patients did not get worse but they did not get any better and both were flown out. Both were on intubated and HR were between 90-120. I was not sure if the reason was because of the HR but I thought that 1:2 was for HR >150?

1:1 until rewarmed

I have a question about getting all the air out of the bag before you prime the line and then > to the 300mm of pressure. For years I have always taken great pains to remove the air before I prime the pressure bag. I read ? an article some whre that stated it was a old sacred cow but I can't remember where I read it or maybe it was a seminar. Anyway it kinda made sense in that it was most important to have the line free of air and that the small amt of air in the bag would be pushed to the top when the bag was>to 300mm and would not enter the system. It was stressed the importance of never lying the bag on the bed during transfer or transport in that the the air in the chamber could enter the tubing. The question was raised about if the fluid got low in your system wouldn't air get pushed in the tubing and the answer was that the pressure in the body would be greater if the fluid ran out and you would see blood in the tubing then. So I have looked on several sites regrding this and it's about 60-40 in favor of getting the air out before you prime the the tubing. We don't have a policy that states this and I am currently a preceptor. Any hard facts and or opinions? Any thing evidence based?

Thanks for the information. Will be interesting to hear your results.

Thanks so much. Great information! I have the same concerns. Some of the articles were vague and did not give full disclosure of the study design but I have since gotten more information. We did have 3 over the past 6mos. 0 for the previous 3yrs. Our bathing practice had change in the past 12 mos. We were using the packaged bag baths and due to $ went back to basins and soap. I feel there is a correlation but no one is listening. The knee jerk reaction is to use CHD baths for all. I understand but wish we looked at our whole practice. Thanks again.

Thanks for the spelling correction. I have found the internet is very forgiving in regards to my spelling.

Thanks for the article. I found some others and one that discussed that perhaps it is a good prevention but each hospital should look at the infection rate prior to instituting a policy. They all seem very positive in regards to risk vs benefit.

Of course I did not mean to openly give the email without permission and then it could be shared privately. I have no problems with a lit search as previously stated but it is always helpful not to have to re-do the search if someone has that information available and is able to share it. I will just do a goggle search for companies and the chlorohexidene. I was just trying to get an idea of how common it is. Thanks all those who replied.

Thanks! Is this is a daily bath? And is there a way you could inform me of the nurse educators email in order to save same time regarding the research? Is there a company that supplies these for you?

I work in a community hospital, Cardiac Intensive Care (mix of MICU/occ SICU and Cardiac(PCI)) rare if any trauma and no open heart. Our nurse manager who took away our packaged bag baths over a year ago due to ?cost (using basins and washcloths again). Now she would like to try the 2% chlohexidene bath packs because we have had recent >>> in our central line infections..hmmmm:confused:. She read a study that showed a significant