ratio's with induced hypothermia patients

AnthonyD · May 12, 2015

Ours are 1:1, usually the whole time. On a rare occasion, they are paired during maintenance phase.

dah doh, BSN, RN · May 12, 2015

1:1 until they are re-warmed.

Abogherie · May 15, 2015

Our TH patients are 1:1 throughout the phase till rewarming unless there is no other alternative for staffing. There is a significant amount of charting, monitoring, labs, and other tasks that are built into the TH protocol in our facility that make them very busy. They do have a research team that studies everyone of them with their outcomes so that does effect how they are managed as well in terms of nursing care needed. Also the shifting of electrolytes across the cell membranes during the cooling and rewarming phases increases the risks with these patients that should be kept in mind as well.

calivianya, BSN, RN · May 15, 2015

We never make ours 1:1... just treat them like a regular ICU patient. They're not usually higher acuity than any of the other patients on the floor, so I guess that's why they're not singled. We only single our CRRTs and occasionally a fresh admit on sepsis protocol if staffing allows.

MunoRN, RN · May 15, 2015

I'm curious what ICU's that keep these patients 1:1 throughout TH staff for other types of patients? They are busy, but once they're cooled they're well within "normal" ICU busy, so are all the ICU patients 1:1?

jamst149 · May 17, 2015

Never 1:1. In fact no matter the patien my hospital (UPMC Presby) virtually never single assigns a nurse. Only exception is ecmo/vads/fresh hearts in the cticu

Also IMO cooling them isnt the hard part. Its rewarning them. Rewarm too fast and their brain swells

calivianya, BSN, RN · May 18, 2015

I'm curious what ICU's that keep these patients 1:1 throughout TH staff for other types of patients? They are busy, but once they're cooled they're well within "normal" ICU busy, so are all the ICU patients 1:1?

Because they're lower acuity ICUs and the TH patients are well and above the normal level of difficulty. My first ICU job was that. Getting a TH patient was something to brag and whisper about, one of those rights of passage kind of things that the first time you got one, you could know that your charge nurse had faith in your abilities and you were finally a trusted part of the team sort of thing.

TH was the only type of patient that was 1:1. We didn't do CRRTs and who knows about the fresh hearts... I didn't work CICU.

Also, we had to chart two temps q15 minutes and our TH machines did not connect to the monitors, so someone literally had to be in the room every 15 minutes to record the q15 minute temps because only one set of temps pulled to the computer. I think having to be in the room every 15 minutes had something to do with the 1:1 staffing.

littlepeopleRNICU · May 19, 2015

I work in NICU, and when we cool we do try to have them 1:1 if numbers allow for it. If not, we hope we have an awesome, helpful charge nurse and podmates to help out ðŸ˜‰ it usually ends up being 2:1, or if it was as admit assignment, 3:1 IF a baby cannot be moved to another assignment. That circumstance really sucks, bc our cooling kids are usually a hot mess anyway, even outside of the cooling process.

When we warm, it's usually 2:1.

DogLover17 · May 20, 2015

I thought we were always 1:1...but then I realized all of my hypothermia patients had an IABP! 1:1 during the cooling phase, but usually if we have a hypothermia the other patient is pretty stable.

Here.I.Stand, BSN, RN · May 21, 2015

Ours are 1:2 during maintenance and rewarming; possibly during cooling too, but I can't remember offhand. I'm not in a CVICU though, and we only really use hypothermia for severe TBIs with elevated ICPs not responding to other interventions. I wish they were 1:1; those are some sick people

jamst149 · Sep 12, 2016

It's the rewarming phase you need to be worried about!!! To fast and cerebral edema=bad news!!

jamst149 · Sep 12, 2016

You really can't cool them fast enough.