Subclavian DVT

Nurses General Nursing

Published

Has anyone cared for a patient with this?

My pt had no activity restrictions......I was worried about a PE. What are some key things to assess with this patient? What can I do to help prevent a PE?

Thanks in advance.

Or not.

No, I'm not trying to confuse you, but a large portion of the patients I've cared for with PEs generally have vague c/o like SOB or diminished lung fields, and no c/o pain, no sputum production.

We really depend on D-dimers and CT angios to help dx PEs.

~~~

yes, they are the tests that help pinpoint the diagnosis, but i was trying to give her an idea of what the pt may present like clinically since she's a student.

alteration in resp status and all..blah blah blah!:chuckle

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~~~

yes, they are the tests that help pinpoint the diagnosis, but i was trying to give her an idea of what the pt may present like clinically since she's a student.

alteration in resp status and all..blah blah blah!:chuckle

Cat Fight

I'm not going to get into a big stink over this I'm putting 2 in and out of here.

The symptoms couldn't be to awefully vague to warrant foley's, angio's , D-dimers...The described vague symptoms presented in the ED would be lucky to get a chest xray let alone seven thousand dollars worth tests.

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Specializes in Utilization Management.
Cat Fight

I'm not going to get into a big stink over this I'm putting 2 in and out of here.

The symptoms couldn't be to awefully vague to warrant foley's, angio's , D-dimers...The described vague symptoms presented in the ED would be lucky to get a chest xray let alone seven thousand dollars worth tests.

Maybe in your ER. Here, you say "indigestion" and you get admitted for "Chest Pain R/O MI." :p

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Specializes in Utilization Management.
foley's,

What????!!!!

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Maybe in your ER. Here, you say "indigestion" and you get admitted for "Chest Pain R/O MI." :p

No, what I will do is give them a GI cocktail if there's good HX then they go home if they better with OTC pepcid.

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Specializes in Utilization Management.

Do that here and you'll get sued when the patient turns out to have had an MI or GI problem that went uninvestigated.

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Specializes in Utilization Management.

Anyhow, to make what could be a stupid catfight a tad less stupid, a PE IS a differential dx for CP. I repeat, I have had a lot of patients who insist that "there isn't a lot of pain" with their condition.

I've also had a couple whose first s/s of pain was to throw the clot and be unable to be resuscitated.

The point is, they might not "look sick." But it's serious, very serious.

And I say that very respectfully, despite our lighthearted professional banter.

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Anyhow, to make what could be a stupid catfight a tad less stupid, a PE IS a differential dx for CP. I repeat, I have had a lot of patients who insist that "there isn't a lot of pain" with their condition.

I've also had a couple whose first s/s of pain was to throw the clot and be unable to be resuscitated.

The point is, they might not "look sick." But it's serious, very serious.

And I say that very respectfully, despite our lighthearted professional banter.

Wait a minute you don't know what a GI cocktail because your a floor nurse trying to puff your chest and talk ER to me. That's why your rambling it's okay ;-) :balloons:

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Specializes in Utilization Management.
Wait a minute you don't know what a GI cocktail because your a floor nurse trying to puff your chest and talk ER to me. That's why your rambling it's okay ;-) :balloons:

Yes, I do. That's because I, a good floor nurse, actually read the ER report. :chuckle (They leave out words too.)

You know, it's funny isn't it, that I've never, in all the years I've worked Tele, had an ER nurse call the floor to actually ask if the ER's Dx was correct?

So if I wanted to "puff out my chest and talk ER" to you?? I'd probably ask (ala Mae West) why don't you to come on up to Tele and see us sometime. ;)

Where you can actually follow through on a patient's stay in the hospital. And maybe learn a few things, not the least of which would be respect for what we floor nurses do.

:saint: 'Cause we're goooooood baby, we're veryvery good. :saint:

:rotfl:

PS This "catfight" has been waged in memory of a patient who coded and died after c/o SOB--from massive, multiple PEs--seconds after his CT Angio.

(The last sentence is of course, not funny and not part of the joke.)

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Yes, I do. That's because I, a good floor nurse, actually read the ER report. :chuckle (They leave out words too.)

You know, it's funny isn't it, that I've never, in all the years I've worked Tele, had an ER nurse call the floor to actually ask if the ER's Dx was correct?

So if I wanted to "puff out my chest and talk ER" to you?? I'd probably ask (ala Mae West) why don't you to come on up to Tele and see us sometime. ;)

Where you can actually follow through on a patient's stay in the hospital. And maybe learn a few things, not the least of which would be respect for what we floor nurses do.

:saint: 'Cause we're goooooood baby, we're veryvery good. :saint:

:rotfl:

PS This "catfight" has been waged in memory of a patient who coded and died after c/o SOB--from massive, multiple PEs--seconds after his CT Angio.

(The last sentence is of course, not funny and not part of the joke.)

That's because we don't have a need to check on the dx cause we're always right. Besides I would hate to have to make you stop and answer the phone you know in between the call lights, filling up water pitchers, passing trays, picking up trays, changing the beds. giving bed baths, switching out the grape jelly for the apple butter, making sure there's plenty of chairs for the company, making sure Granny gets it on channel 8 at noon, sure there feet are covered, oh it's time to pass out the trays again. Oh baby girl you know you can only cat fight with another girl too. Oh time to pass out trays again!

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Specializes in Utilization Management.

That's because we don't have a need to check on the dx cause we're always right. Besides I would hate to have to make you stop and answer the phone you know in between the call lights, filling up water pitchers, passing trays, picking up trays, changing the beds. giving bed baths, switching out the grape jelly for the apple butter, making sure there's plenty of chairs for the company, making sure Granny gets it on channel 8 at noon, sure there feet are covered, oh it's time to pass out the trays again. Oh baby girl you know you can only cat fight with another girl too. Oh time to pass out trays again!

:rotfl: :rotfl:

Hey, you forget I work nocs. So we're not only lazy but we sit around all night with our feet up, dozing at the monitors while the patients get a good nights' sleep.

Oh, sometimes we get our jollies waking cardiologists up at 3 am just to hear them scream (those guys are SUCH day shift types! :p) but really, should that count as work??!!

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Wow a subclavian DVT I think that spook me too flashyrn2be I wouldn't want them on the floor I'd feel more comfortable having them in the ick-u. The jugular however sounds bad but remember it's got the whole body to go through to get back to the heart and lungs by then it's dissipated enough to not be of concern.

not a nurse yet but a little confused here. Wouldn't the blood trace through jugular (internal or external) vein straight to subclavian to brachiocephalic vein straight into the sup. vena cava to right atrium of the heart?

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