Published Dec 26, 2008
Virgo_RN, BSN, RN
3,543 Posts
Do you see this a lot in s/p MI/intervention patients? Are your docs unimpressed with phone calls to let them know?
pm80
10 Posts
Yeah. That sounds about right. I've only seen it once and I was the only one in the room who thought it was significant that the guy was in IVR.
NurseLay
254 Posts
Yes, I have been seeing this so far. I was told that it is expected because the heart is irritated and that it will subside eventually.
Spatialized
1 Article; 301 Posts
I guess it depends what kind of arrhythmia it is for the docs to be (un)impressed. Some myocardial irritation is normal, as is some residual chest pain, especially post-PCI/MI. The bigger question becomes the stability of the patient. Many times though with an dangerous arrhythmia you'll be calling a Code, versus just calling the doc. PVCs, PACs, short bursts of SVT, extreme brady/blocks, non-sustained VT all are "normal" and would be expected. If a patient who flipped into A-fib, who had never been in fib previously, may require a call to the docs, if nothing more than to inform them and give the option for treatment.
Our post-CABG patients all have A-Fib protocols where the nurse can initiate treatment without even talking to the surgeon, because it is expected that they would go into fib. Same thing with reperfusion, a little bit of arrhtyhmia is expected. Consider what the heart just went through...
~Tom