Archives for August, 2013

RESUSCITATION OF THE CARDIAC SURGICAL PATIENT

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Cardiac surgery patients are different from many other patients for a number of reasons when it comes to resuscitation post arrest. arterial line, Swan-ganz catheter (generally), and cardiac monitor; thus allowing for very early defibrillation without the use of external cardiac massage (ECM). ECM should be avoided if at all possible due to risk of […]

MEDICAL MANAGEMENT OF AORTIC DISSECTIONS

Aortic dissections are a medical emergency.  They can be treated either medically or surgically.  Generally the treatment of choice for ascending aortic dissections is surgical intervention.  Surgical intervention is also used for complicated descending dissections.  Various issues determine whether an aortic dissection will be treated medically or surgically.  We will be addressing the medical management […]

IMPORTANCE OF ST-SEGMENT MONITORING POST AMI

Patients that have had a myocardial infarction should have continuous ST-segment monitoring post MI/cath.   Following are the indications for ST-Segment monitoring post AMI. Evaluating post-MI ischemia Evaluating reocclusion after angioplasty or atherectomy.   Evaluating reperfusion after thrombolytic therapy. The expected practice, as put forth by the AACN (American Association of Critical Care Nurses) is […]

JOINT COMMISSION: ACUTE MI CORE MEASURES

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The Joint Commissions Core Measures serve as a standardized assessment measure for care given in specific areas.  Despite widespread dissemination of the core measures, safety goals, and related quality guidelines, there is significant variation in their application across hospitals.  The reasons for this are varied but include differences in guideline familiarity, provider training, and tools […]

SURVIVING SEPSIS, PART 3

As mentioned in my previous blog posts sepsis is a significant problem in the hospital settings of the world, costing countries billions of dollars a year in health care costs.  In order to combat this problem, countries from around the world came together in the fall of 2002 and launched the Surviving Sepsis Campaign.  In […]

SURVIVING SEPSIS, PART 2

As mentioned in my previous blog post sepsis is a huge problem in the hospital setting in the world, costing countries billions of dollars a year in health care costs.  In order to combat this problem, countries from around the world came together in the fall of 2002 and launched the Surviving Sepsis Campaign.  In […]