luckyou

The most accurate way is to use a doppler and a cuff with a needle pressure gauge.

I am currently in perfusion school, and will be starting CRNA school in the spring so I can give you some insight into what it takes to get into both. Perfusion programs are considerably easier to get into than CRNA programs mainly because it's a little known profession and there are far fewer applicants. There are about 25 perfusion programs and 110ish CRNA programs nation wide. The perfusion program I'm in is 18mo and pre-reqs are a bachelors degree, 9 hours of chem including organic and biochem, 5 hours of pre-calc mathmatics, 4 hours of physics, and 7 hours of A+P. You don't need any prior clinical experience, but I can tell you my experience as an ICU nurse and ECMO specialist put me way ahead of everyone else in my class. CRNA school requires a BSN or bachelors with an ADN. Minimum 1 year ICU experience (few get in with only 1 year), biostats, physics, college level math class, organic/bio chem...programs nation wide are in the process of switching to the DNP plan of study and vary in length from 24-36mo. I enjoy perfusion school. It's challenging but I've decided to switch to CRNA for a few reasons: 1 it's what I have always wanted to do and the reason I got into nursing in the first place. 2 there are about 3500 perfusionists in the US compared to 40000ish CRNAs way easier to find a job or change jobs. 3 CRNA's are LIP's perfusionists are not. 4 I see myself getting bored after 5 years or so. 5 Perfusionists starting salary 80000ish CRNA 130000ish. Perfusion is a great career, and it is what I would be doing with my life had I not been accepted into CRNA this year. If you are interested in perfusion try and set up a time to shadow one. All of the perfusionists I know are smart, easy going, nice guys. If you have any other questions let me know.

Agreed, if your goal is CRNA cardiac/surgical ICU in a teaching institution is your best bet. As a new grad there is essentially zero chance of working part time on different units. There really is no reason to try and work in the OR anyway. Have you shadowed in the OR? Do you have an idea of what nursing in the OR is like? If that's where you want to work that's cool, but I don't know of any schools that will accept OR experience, and very few that accept ER.

Well, I think I'm going to finish. Figure I've put over a year into it so what's another 7 mo? Also, the situation is somewhat compounded by the fact that I got into CRNA school at the same university/OR I'm at for perfusion...don't want to burn any bridges, and maybe it will help me get a cardiac gig down the road. I'm not to concerned with not making it through school...the program has a

Hello, I have just been accepted into CRNA school to start in May of 2012. I am currently in Perfusion school which is 50+ hrs a week, I have a 2yo, and I am still working 50% as a Nurse/ECMO specialist. Things are busy. I'm about 13 months into the Perfusion program which will end about a week before CRNA school starts I'm wondering what any CRNA's out there think about this situation. Do you think it is worth while to finish Perfusion school? Or would you quit, work full time, and try and save as much money as possible before CRNA school starts? I would really like to finish, but I'm not sure if the experience I will gain will be very beneficial as a CRNA. Thoughts? Thanks.

Interesting...An alergic rxn had crossed my mind...but is it even possible to be alergic to human albumin?

The Pt. was very unstable but the BP drop was directly related to the albumin bolus. Pt had a right IJ cordis w/ swan, I was running my drips through the VIP and bolusing through the cordis which was a dedicated line w/ nothing else running through it so I didn't bolus a line full of anything and the extra pressure wouldn't have caused a backflow through the VIP (swan was at 51cm VIP port was far past the tip of the cordis). Acute barrow receptor response was my inital thought, but it doesn't explain the BP drop with albumin and not with NS. I asked one of the cardiac anesthesiologists and he didn't have an answer for me...really stumped on this one.

The info will vary from instituation to institution and the doseages will also vary depending on how your unit runs drips (mcg/kg/min or mcg/min) here are ranges for some common gtts off the top of my head on my unit Epinepherine 0.01-0.1 mcg/kg/min Norepinepherine 0.01-0.2 mcg/kg/min Vasopressin 0.01-0.04 units/min Phenylepherine 0.01-1.0 mcg/kg/min Milrinone 0.25-0.75 mcg/kg/min Dobutamine 1-20 mcg/kg/min Dopamine 0.5-20 mcg/kg/min Esmolol 50-300 mcg/kg/min Diltiazem 5-15 mcg/kg/min Nitroglycerine 0.5-5 mcg/kg/min Nitroprusside 0.5-5 mcg/kg/min Amiodarone 150mg bolus followed by 1 mcg/min for 6hrs then .5 mcg/min cisatracurium sp? 0.03-0.1 mcg/kg/min Heparin usually has a nomogram or at my discretion while I'm running ECMO Fentanyl 25-effect mcg/hr Ativan .5-effect mg/hr Propofol 5-100 mcg/kg/hr Insulin 1-?? units/hr There are more but the ones I've listed will probably cover you close to 90% of the time. Again each institution will be different. Also more important than doseages is knowing what the drugs actually do physiologically and how to titrate them in conjunction with one another. This takes experience but if you know how the drugs are actually acting on your Pt. it will be easier for you. Good luck!

While maybe not the best drug (can cause very vivid halucinations) ketamine will cause the release of endogenous catecholamines and usually won't drop your pt's pressure as much as midaz or loraz...tho it is still a partial cardiac depressant.

Hello, I had a Pt. last night, 84yo immediate PO redo CABG, had trouble coming off pump, on a balloon pump, epi, mil, norepi, vaso, vented, etc...anyway I was giving an albumin bolus pressure started to drop went up on the pressors and when the infusion was finished the pressure recovered. Later on I gave another albumin bolus same thing. I stopped the infusion and the pressure came back up. We then tried NS and had no drop in pressure. Anyone have any insight as to why albumin would drop blood pressure? Thanks