Cardiopulmonary Resuscitation: ACLS in the CVICU

Yesterday, @yournursingeducator created a great post on Code Blue tips. @fobiesme asked a very legitimate question regarding how to proceed in patients who are s/p bypass or any open chest situation in the CVICU. This was something I wondered about myself even as someone who taught ACLS for the AHA at a point in my life. It was hard to find a solid answer. Fortunately, as of 2017, the Society of Thoracic Surgeons put forth this consensus statement and algorithm on how to handle cardiac arrest situations in the CVICU population. Since this is relatively new data (only 2 years ago), I understand that the CVICU nurses out there may not be familiar with nor using this particular algorithm. What we did in my shop is that we printed this out with all its pretty colors, laminated it, and placed it on the code carts. Fortunately, this is entirely FREE!

-EJ

Link to full FREE PDF

Dunning J, Levine A, Ley J; STS Task Force. The Society of Thoracic Surgeons expert consensus for the resuscitation of patients who arrest after cardiac surgery. Ann Thorac Surg 2017;103:1005–20.

Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.

Incentive Spirometry: Does it work?

Link to Abstract

Let’s talk about something that’s ubiquitous and yet has some poor data behind it. As the title says, I’m referring to the #incentivespirometer. I’ve always shrugged my shoulders when patients refuse to do it as often as they should (you know, the plastic device is over by the windowsill and the patient is on the other side of the room) and perhaps incorrectly so after this study. The sample size seemed a bit small, 80 in each group, and the primary outcome is #radiologist based #correlateclinically. Either way, they were able to show some good secondary outcomes and in a world where we are being evaluated for every single extra day in length of stay, that may be the single biggest finding of this study (at least in my opinion). As mentioned in the study, we spend a billion dollars a year on these things. Guess I need to invest in those companies haha. But seriously, there’s no way we are getting them out of our facilities to save that cash so we might as well use them properly. That was not financial advise, by the way. 

-EJ

Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.