Thank you and I have a general question and i won't ever forget your answers. What does it mean when a PT is tilted with the feet up all the way and is rushed to ICU? My question is about the action. I know your blood pressure is really low, this would initiate an RN to do this too the bed, but, to me, it seems you would have to have a point where you would initiate this action. At what point would you take such action? Is there a specific scenario for this, or does it just happen? What vitals would clue/dictate you to initiate this?
As a nurse, you would have to catch someones life, and I saw a PT just get whisked to ICU (with the bed tilted) but I was wondering if there is a signal for this event, cut and dried.
I know I (a CNA) can ask a nurse to ck the PT because the VT's are alarming, but what does an RN do then? What are VT #'s that would cause an RN to tilt the bed and take other immediate action? It sounds chalenging to be responsible to initiate a sequence to potentially save a life. Wow.
Seeing this left an impact on me, and I know I can't expect anyone to just explain it all to me in several sentences. I'd take any sentences i could get here. Is there a time when you would raise a persons head, and lower their feet?
Specializes in RETIRED Cath Lab/Cardiology/Radiology.
Most of the time the vagal episode can be self-limiting, but I've seen a pt vaso-vagal while lying on an X-ray table while the technologist set up for an arthrogram. No needle had touched the pt yet, even, but I was called because the pt c/o not feeling well: diaphoretic, pale, clammy when I ran in (no, unrelated to my appearance, folks). No IV in, no monitor on pt. Did the same as the nurse in Mario's post: first elevate legs, second start IV, third get atropine in. We have "emergency" boxes in our dept for just such times (as well as for allergy-type reactions to IV contrast). If pt had been standing or sitting, yes I'd have put him supine first thing, but he was already lying down, so on to the next tactic!
Other posters have done tremendous job of filling in this subject to educate Mario and refresh the rest of us. You guys rock! --D
Originally posted by mario_ragucci I know I (a CNA) can ask a nurse to ck the PT because the VT's are alarming, but what does an RN do then? What are VT #'s that would cause an RN to tilt the bed and take other immediate action? It sounds chalenging to be responsible to initiate a sequence to potentially save a life. Wow.
Seeing this left an impact on me, and I know I can't expect anyone to just explain it all to me in several sentences. I'd take any sentences i could get here. Is there a time when you would raise a persons head, and lower their feet? http://www.websciences.org/nsf/publications/img/see-saw.gif[/i MG] [/b]
When v-tach alarms, first the nurse must stay calm. Go into the room and check the patient. If they are awake and talking, check the telemetry leads. One is probably loose. I had a v-tach alarm and found the patient scratching her hand with a hair brush. If the patient is turning strange colors, call for help and initiate a Code Blue--the ABC's of CPR--airway,breathing and circulation until the code team arrives. If you know how and it was a witnessed arrest you can try a precordial thump. That is very cool when it works. But sometimes they get violent if they think a nurse is punching them out. We use Trendelenberg when we pull a sheath and the patient vagals. Feet up and fluid wide open until the blood pressure comes back up.
dianah, ASN
8 Articles; 4,742 Posts
Most of the time the vagal episode can be self-limiting, but I've seen a pt vaso-vagal while lying on an X-ray table while the technologist set up for an arthrogram. No needle had touched the pt yet, even, but I was called because the pt c/o not feeling well: diaphoretic, pale, clammy when I ran in (no, unrelated to my appearance, folks). No IV in, no monitor on pt. Did the same as the nurse in Mario's post: first elevate legs, second start IV, third get atropine in. We have "emergency" boxes in our dept for just such times (as well as for allergy-type reactions to IV contrast). If pt had been standing or sitting, yes I'd have put him supine first thing, but he was already lying down, so on to the next tactic!
Other posters have done tremendous job of filling in this subject to educate Mario and refresh the rest of us. You guys rock! --D