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Phase 1 monitoring post CABAG Q15 vitals
SVR, PVR, PAP, CI, CO, pain, RASS
Drains
LOC
Outputs
The temperature has to be above 96 degrees F
Aldrete Score postanesthesia recovery score
complete once when they get to the floor and again after extubation
must be a score of 9 to stop Q15 vitals (phase 1)
Demerol Narcotic, comes from pharmacy, used for shivering while weaning propofol
Increased SVR with all other stable VS can mean the pt is shivering.
epicardial pacing wires first line for bradycardia of post-op pt's
must stay on for the first 24 hours
RSBI (Rapid Shallow Breathing Index) must be 105 or less for 30 min
ABG must be WNL
must be able to follow commands (esp lifting their head)
ambu bag at bedside, suction at bedside
urine output notification to provider less than 30 mL / the first two hours after surgery
drain notification to provider greater than 100 mL / hr between blake and chest tube
ensure patency of the drains
, re-sternotomy common causes: cardiac tamponade, hypovolemia, tension
pneumothorax
can be performed up to postoperative day 10
avoid EPI!!
if there is an IABP (change to pressure trigger)
small surgical tray- ICU
large surgical tray- CTS
found in left cabinet in the med room
cardiac arrest post CABAG
v-tach
v-fib DC shock x 3
amiodarone 300mg
prepare for sternotomy
begin CPR and shock every 2 min
internal paddles - shocking only 20 joules (found separately from sterile package)
Cardiac arrest post CABAG
severe bradycardia, asystole PACE
consider external pacing
sternotomy
start CPR no shock
Cardiac arrest post CABAG
PEA turn off pacing to determine underlying rhythm, exclude v-fib
go from there as you determine what the rhythm is
Phase 1 monitoring post CABAG Q15 vitals
SVR, PVR, PAP, CI, CO, pain, RASS
Drains
LOC
Outputs
The temperature has to be above 96 degrees F
Aldrete Score postanesthesia recovery score
complete once when they get to the floor and again after extubation
must be a score of 9 to stop Q15 vitals (phase 1)
Demerol Narcotic, comes from pharmacy, used for shivering while weaning propofol
Increased SVR with all other stable VS can mean the pt is shivering.
epicardial pacing wires first line for bradycardia of post-op pt's
must stay on for the first 24 hours
RSBI (Rapid Shallow Breathing Index) must be 105 or less for 30 min
ABG must be WNL
must be able to follow commands (esp lifting their head)
ambu bag at bedside, suction at bedside
urine output notification to provider less than 30 mL / the first two hours after surgery
drain notification to provider greater than 100 mL / hr between blake and chest tube
ensure patency of the drains
, re-sternotomy common causes: cardiac tamponade, hypovolemia, tension
pneumothorax
can be performed up to postoperative day 10
avoid EPI!!
if there is an IABP (change to pressure trigger)
small surgical tray- ICU
large surgical tray- CTS
found in left cabinet in the med room
cardiac arrest post CABAG
v-tach
v-fib DC shock x 3
amiodarone 300mg
prepare for sternotomy
begin CPR and shock every 2 min
internal paddles - shocking only 20 joules (found separately from sterile package)
Cardiac arrest post CABAG
severe bradycardia, asystole PACE
consider external pacing
sternotomy
start CPR no shock
Cardiac arrest post CABAG
PEA turn off pacing to determine underlying rhythm, exclude v-fib
go from there as you determine what the rhythm is