vent!!! OR admission

[OhioCCRN, MSN, NP]

Pt just had a huge surgery with a 1.5L bloodloss

comes to the SICU w/ an accessed dialysis permacath and a #20

no a-line, no #18, nothing.....

oh and the CRNA made sure they zapped him with some neo to get through the elevator and hallways

of course he starts crashing the minute the neo wears off and we are trying to get him settled....

the CRNA stands there and starts lecturing us on the finer points of dialysis catheters as we are trying to get him lined...

oh did i mention he was getting dialysis that night? yeah....

End Vent...

[VANurse2010]

Haha, I bet renal loved​ them playing w/their line.

[icuRNmaggie, BSN, RN]

You should have taken her aside and said :

"The pt is unstable has no central access and you may have compromised the HD catheter.

If anything happens to this man I am holding you responsible."

Then silence. Then say " he needs a central line and an a line now."

Unless there is an intensivist present and the patient is intubated, she is responsible for the phase 1 recovery from general anesthesia.

I would also make her fill the HD cath with 1:1000 heparin if the lumens were used and not just the pigtail,( and I dont think the cuffed permacaths have pigtails) we are not authorized to do so.

I would document very well and write a narrative report for risk management.