Tell me what it's like in your Trauma ICU!

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Hi everyone!

Im a new grad that just recently accepted my first position starting in a trauma intensive care unit. At my hospital where ill be working, the floor ill be on is split between a trauma ICU and a Cardio-Thoracic ICU. Which means Im guessing that I will possibly float between the two units. I very excited to start! I have to admit that throughout nursing school and after I have developed a real love for the CV system. However I always imagined myself working with the injured and am excited to begin training as a Trauma nurse.

I see alot of info on CV nursing, and Neuro nursing but not a whole lot about what a Trauma ICU nurse does. Is working on a Trauma ICU much different than Neuro ICU? Will I still get alot of experience with Cardio and other systems? I understand I will see MVAs, GSWs, head traumas/hemorrhages and there is alot of neuro involved. But I would like to hear first hand from those working on a trauma unit - what type of equipment and lines do you work with often, what type of procedures are you doing often at the bedside, common meds used/titrated, and just some general info on what its like in a Trauma ICU.

Im very excited and eager to learn. I just completed an EKG course and a critical care course prior to getting accepted and Im working on reading the ICUFaqs book (I purchased the hardcopy) and the AACN Critical Care book.

As I mentioned my first love is cardio, I'm happy to have been given this opportunity and gain employment as a nurse let alone in an ICU (God has been good!) but I also would be interested in transferring possibly to the CTICU after maybe a year - maybe this wont be so hard as its the same floor ill be working on...thoughts? I'm hoping that I will get cross trained to both units.

Any other tips for a new grad and info you can give about your unit is SO much appreciated! Ill be starting in 2-4 weeks and I know there are BIG challenges ahead. I want to keep using this time in between as a good head start, as much as possible.

I look forward to your thoughts...thanks SO MUCH!

:heartbeat

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Wow! your situation is very similar to mines. I am a new grad that just got hired into a trauma icu which is also split into a cardio thoracic icu. I also read the icufaqs. and bought the aacn book haha. Did you get hired at la county? and where did you take a critical course at, I want to do this also

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We are mostly neuro, but with neuro you get trauma... Bedside procedures include bolts, evds, central lines (cordis, macs, swans and plain triple lumens) art lines, trachs, pegs, bronchs. Medications include 3%, mannitol, neo, Levo, vaso, milrinone, nimbex, fentanyl, Ativan, propofol, Dilaudid, versed, metoprolol, dilt, amioradone, esmolol.

I may have forgot some, those are off the top of my head. You will also become friends with ct, MRI, and ir people.

Mike.

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Hey thank you for your replies! RNfeb - Yep, La county...PMing you. =) I did my Critical Care course with California School of Health Sciences. http://cshs.edu/ The teachers were great and it was a good review of all the systems, but I think the real learning is definitely gonna be on the job.

Mike - thanks! Ive been reviewing alot of those drugs and ICP monitoring devices....as much as I look them up tho I just get a sense that I wont really fully understand them until orientation...I think thats when Ill understand why one med is chosen over another.

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strawberry- I am not allowed to send any private messages til i have 15 post(thats what it says), But yea we are going to be co workers how great. Im in the same exact boat as you i just took my ekg test and passed it. I am also waiting for my budget number. are you on days or nights?

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Every unit is different but we use 3% and goal sodiums are 145-155. Mannitol for a goal serum osmo as close to 320 as possible, we hold if > 320. As far as pressors go, depending if we are triple H'ing someone and how aggressive we need to be we shoot for SBP goals of 160-180 or 140-160... neo is our first line, then levo, and then vaso if needed. We also alternate blouses between .9 and album for cvp goals of 6-10. We mainly use nicardipine for those unclipped aneursysms and prn labetolol and hydralazine. Esmolol, diltiazem, and amiordorone for rhythms. Although I've seen other services use esmolol for sbp goals. We like nicardipine better. And my favorites, sedation... our go to's for short term (hopefully) we use fentanyl and propofol. If they are on it for a few days, we switch to ativan or versed. I've seen dilaudid drips... never moprine unless they are pallitiave. Every unit is different, you will learn everyday Lu are on the unit. Good luck.

Mike.

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How cool is that?! Hehe...I'm going to be days...the position is for relief nurse tho...I hope I'll get close to full time hours...how bout you? Do you know if well be floating to both units or not? I called to schedule my EKG test but I guess the lady is out of the office till next week. I'm ready to take it....but I guess I have to wait to hear from her.

Mike thanks so much for the info...very interesting. I can't wait to start learning hands on!

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