AetherPulse

Hello, I am new to the CTICU, on my 10th week with a preceptor (have had 6 different ones) there is a lot of movement when a new open heart comes out, so far I have one receive under my belt but am still working on my own system to perfect if anyone has experience and could toss a critique I'd love that.. we are a cardiac hospital so the patients are really sick, we do CABGs valves bentalls ECMO CRRT Balloons.. everything you can imagine except transplants).. anyone who can throw more stuff that I need to consider or something I'm missing completely.. thanks! PRE ARRIVAL Ensure all supplies are in the room -suction connector+ splitter -glucometer + strips, lab tubes abg -bp cuff -dopplers in the room -blood warmer in the room -body warmer in the room -Vigelio, A LINE/PA LINE/CVP LINE ECG cord to do -Enter pt info in Vigelio (ht/wt/gender) -Patient history (past medical history) on cardex -Page Respiratory Therapist -take current bed out of the room UPON ARRIVAL (assisting) -transfer from transport to SICU monitoring (A Line/PA Line/CVP Lines/ECG/SPO2) plug in patient bed -connect drains to suction, empty foley, clear pumps, draw labs/blood sugar/ABG (receiving) -check out patient rhythm/BP, pulses, assess lungs while pt still being bagged, check out surgical sites, check drains, urine output, write down the drips vs lines (Anesthesia Report) ask if there were any major events? dysrhythmias/arrests? what lines does the patient have? any trouble with the lines? last abx time? easy intubation? (Next) 12 lead ECG, CXR(review ET tube/Swan Placement/Chest Tubes/Opacities/OGT) talk to physician about corrections and ask for orders (when you have time after) untangle all the lines, label all the drips with times, start morphine protocol, determine if you can extubate patient (check Vt/NIF/follow commands FiO2 40%, lift head) turn off propofol drip if they can be. start Aldrete score 15 minutes after, check labs & correct electrolytes Screen for major events (excessive bleeding: give volume/PLTS/FFP/PRBC. abnormal ABG:adjust vent settings/give bicarb/adjust ET tube. Tamponade: high CVP, Low Diastolic pressure.