Left Ventricular Impella 5.0/CP/2.5 Order Set Page 1 of 4

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Left Ventricular Impella 5.0/CP/2.5 Order Set Page 1 of 4"

Transcription

1 Left Ventriclar Impella 5.0/CP/2.5 Order Set Page 1 of 4 See Cardiovasclar Post-Operative IC Order Set See Cardiology Interventional POST Orders 04 PATIENT WEIGHT: kg (reqired) PATIENT HEIGHT: cm (reqired) PATIENT MONITORING: Vital Signs AN Hemodynamic Monitoring 15 mintes for 1 hor, then per nit rotine AN PRN after each pmp performance level (P Level) change Measre Cff Blood Pressre opposite of implant, if axillary placement Mixed Venos Blood Gas draw every AM Monitoring AN ocmentation Gidelines Monitor pmp placement continosly sing dal signal waveforms of motor crrent AN placement signal Measre AN docment catheter depth pon admission AN every 4 hors Monitor AN docment every hor: Pmp performance (P Level) Flow (L/min) Placement Signal (mmhg) Prge Pressre ( mmHg) Motor Pmp position Prge Flid Infsion Rate (ml/hr) Power AC Battery (60 minte battery life) Maintain the appropriate anticoaglation monitoring flowsheet for heparin, argatroban, or bivalirdin ACTIVITY: Bed rest If Axillary Placement: Head of Bed elevated to 30 degrees If Femoral Placement: Head of Bed elevated to maximm of 30 degrees Nrsing Instrction Keep cannlated extremity straight Knee immobilizer PRN to maintain straight cannlated extremity Trn every 2 hors logroll only NRSING: Assessment Vasclar checks to cannlated extremity every hor Assess insertion site for bleeding, hematoma, cannla kinking or movement every hor Interventions tify M Change in nerovasclar stats of cannlated extremity Heme positive stool Hematria Platelet cont less than 50% of IC admission baseline Signs of bleeding, hematoma or cannla movement For alarms that cannot be resolved after trobleshooting with Abiomed Clinical Spport evice Performance Maintain pmp performance level at (P Level) to keep flow at or above L/min tify M if nable to maintain at or above specified flow rate decrease pmp performance (P Level) below P2 as long as the pmp is in the ventricle; te: Retrograde flow will occr across the aortic valve if the pmp is set below P2 ALAR: Nrsing Instrction Contact Abiomed Clinical Spport PRN for trobleshooting:

2 Left Ventriclar Impella 5.0/CP/2.5 Order Set Page 2 of 4 ALAR CONTINE: If Sction Alarm: Redce P Level by 2 levels, bt do not decrease below P2 Assess volme (CVP/PA) stats to ensre adeqate ventriclar filling If filling isses: Follow Impella Hypovolemia protocol for PA < mmhg or CVP < mmhg (refer to pg 4) If NO filling isses: Increase P Level to previos pre-alarm setting Reposition patient-logroll only If Occlsion Alarm: Check for kinks and resolve Assess for Catheter islocation (See Catheter islocation orders below) OTHER INTERVENTIONS: If Catheter islocation is sspected: ecrease P Level to P2 tify M STAT If Cardiac Arrest: tify M STAT ring chest compressions, decrease the P Level to P2 Follow ACLS gidelines AN defibrillate immediately, if indicated CLINICAL ECISION SPPORT If Catheter islocation is sspected or Cardiac Arrest occrs, a Transesophageal Echocardiogram (TEE) is the best method for confirming placement. te: The Impella system ES have to be stopped or nplgged to defibrillate If ACLS sccessfl: Increase P Level by 2 levels every 15 mintes ntil pre-arrest setting is achieved 04 WON CARE: Specialty Bed Transparent occlsive dressing to insertion site. Perform sterile dressing change to insertion site as needed when dressing becomes damp, loosened, or soiled. Beginning Post-op 2, perform sterile dressing change every 24 hors sing transparent occlsive dressing. o not cover catheter sleeve with tape or transparent dressing ANTICOAGLATION TREATMENT PLAN: Start Systemic Heparin Infsion AN Prge Heparin NOW Start Systemic Heparin Infsion AN Prge Heparin on / at : Start direct thrombin inhibitor (argatroban or bivalirdin) (recommended for patient with HIT) See Impella Argatroban Bivalirdin Spplemental Order Set (#) For Heparin Infsion: Baseline ACT prior to starting Heparin infsion ACT therapetic goal between sec for Heparin infsion ACT every 4 hors ntil therapetic goal is achieved AN every 4 hors after each rate change ACT every 6 hors after therapetic goal is achieved Repeat ACT in 2 hors if M orders a bols of Heparin Heparin 25,000 nits in 250mL extrose 5% Water (100 nits/ml) IV Start TOTAL Heparin prge and IV infsion at: 100 kg = 10 nits/kg/hor >100 kg = 10 ml/hr (1000 nits/hr) Max initial dose: 1000 nits/hor (TOTAL OF PRGE AN INFSION) Heparin titration orders for IV infsion If ACT less than 141 sec If ACT sec If ACT sec If ACT sec If ACT sec If ACT greater than 220 sec Increase Heparin infsion by 2 nits/kg/hor Increase Heparin infsion by 1 nit/kg/hor change ecrease Heparin infsion by 1 nit/kg/hor ecrease Heparin infsion by 2 nits/kg/hor tify M

3 Left Ventriclar Impella 5.0/CP/2.5 Order Set Page 3 of 4 NTRAVENOS FLIS: Prge Pressre Soltion 500mL extrose 20% in Water (20W) for CP/2.5 and extrose 10% in Water (10W) for 5.0 Clinical ecision Spport: The Impella atomated console will atomatically adjst the prge flow rate to maintain a prge pressre between mmHg and a prge flow rate between 2-30 ml/hor. 500mL 20W with 25 nits/ml Heparin for CP/2.5 and 10W with 25 nits/ml Heparin for 5.0 E: See Heparin Start Time Above 10W prge soltion with direct thrombin inhibitor per spplemental orders for patients with HIT 1000 ml 0.9% rmal Saline (NS) pressrized bag to be infsed via red pressre sidearm PRN for Impella 2.5 AN CP ONLY 04 Prge Pressre Maintenance Nrsing Instrctions Change prge soltion every 24 hors Change prge pressre cassette every 96 hors Complete prge flid change in less than 2 mintes to prevent damage to the catheter pmp ocment changes in prge pressre per policy AN assess trends Monitor Prge Pressres after P Level changes Prge Pressre Trobleshooting For prge pressre LESS THAN 300mmHg If prge flow rate less than 30mL/hor, assess tbing for loose connections or leaks If prge flow rate is eqal to 30mL/hor, change prge flid to 500mL extrose 40% Water (40W) AN tify M For prge pressre GREATER THAN 1100mmHg If prge flow rate is eqal to 2mL/hor, assess tbing for kinks or closed clamps If prge flow rate is greater than 2mL/hor, change prge flid to 500mL extrose 10% Water (10W) If low or high prge pressre alarms REMAIN NRESOLVE after trobleshooting tify Abiomed Clinical Spport If prge pressre remains less than 300mmHg or greater than 1100mmHg tify M and Perfsionist LABORATORY BMP, CBC, ABG,, PT/INR, PTT pon admission AN every AM while on device ABG, Potassim, PRN for hemodynamic instability Mixed Venos Blood Gas every AM while on device ABG every 6 hors for first 24 hors post device implantation RAIOLOGY Portable Chest X-Ray STAT pon admission AN every AM Indication: Confirm Impella position in LV logroll only CONSLTS Conslt WOCN Reason: Low Braden Score (High Risk)

4 [Patient Identifier] Left Ventriclar Impella Hypovolemic Protocol Page 4 If Sction Alarm Assess Volme: Per M orders (see pg 2) PA < OR CVP < Yes HgB > 7 HgB < 7 0.9% NS 250ml bols X 1 Transfse 1 nit of PRBC If Sction Alarm persists and PA or CVP less than above parameters If Sction Alarm persists and PA or CVP less than above parameters Recheck HgB Repeat 0.9% NS 250ml bols X 1 Recheck HgB HgB < 7 Yes 0.9% NS 250ml bols X 1 Transfse 1 nit of PRBC. If Sction Alarm persists IFY M o not exceed 750mL of Crystalloids or 2 nits PRBC withot notifying M RN Signing Off Order: ate: Time:

5 Fll-dose Heparin Flowsheet for Left Ventriclar Impella Keep in MAR section of the Chart (not to be sed when only the prge heparin is being administered) Complete when fll-dose heparin initiated: Patient weight (kg): Affix Patient Label Total dose of heparin initially ordered (prge + standard IV infsion) = 10 nits/kg/hr = nits/hr (max 1000 nits/hr) Prge Heparin Infsion = crrent prge rate ( ml/hr) * 25 nits/ml = nits/hr Begin Heparin IV infsion (100 nits/ml) at nits/hr = nits/kg/hr Signatre ate/time Complete following each ACT measrement: ACT information Goal = sec Heparin dosing information ate/ Time of ACT ACT Vale (sec) IV IV Rate (ml/hr) IV Baseline Prge Total Change needed Change made at On Hold ntil Baseline change or New IV New IV Rate (ml/hr) ACT* de at Signatre * Time of repeat ACT is from the time that the infsion rate is changed Origin ate: 11/12; 10/14 ; 8/15 *1242*

Bone Marrow Transplant Admission Orders: AUTOlogous Hematopoietic Stem Cell Transplant Patients Page 1 of 4

Bone Marrow Transplant Admission Orders: AUTOlogous Hematopoietic Stem Cell Transplant Patients Page 1 of 4 ATOlogos Hematopoietic Stem Cell Transplant Patients Page 1 of 4 Abbreviations ADMISSION: See Patient Stats Certification Order already completed by MD niversal Patient Care Orders: Initiate Rapid Response

More information

Routine, Every 2 hours, Starting today, If temperature greater than 38.5 C initiate Evaluation for Possible Sepsis Physician Order #829

Routine, Every 2 hours, Starting today, If temperature greater than 38.5 C initiate Evaluation for Possible Sepsis Physician Order #829 Height Weight Allergies General Vital Signs [X] Frequent vital signs Indication: Q15 minutes x (# of occurrences): 4 Q30 minutes x (# of occurrences): 4 Q1 hour x (# of occurrences): Q2 hours x (# of occurrences):

More information

Bone Marrow Transplant Admission Orders: ALLOgeneic Hematopoietic Stem Cell Transplant Patients Page 1 of 5

Bone Marrow Transplant Admission Orders: ALLOgeneic Hematopoietic Stem Cell Transplant Patients Page 1 of 5 ALLOgeneic Hematopoietic Stem Cell Transplant Patients Page 1 of 5 Abbreviations ADMISSION: See Patient Stats Certification Order already completed by MD niversal Patient Care Orders: Initiate Rapid Response

More information

Physician s Order Form. Physician s Order Form. Telemetry/Progressive Care Orders. Continued on next page. >>>>>>> Continued on next page.

Physician s Order Form. Physician s Order Form. Telemetry/Progressive Care Orders. Continued on next page. >>>>>>> Continued on next page. DATE: TIME: DATE TIME INTRAVENOS FLID and MEDICATION Status: Admit to Telemetry Admit to Progressive Care nit Transfer to Progressive Care nit Note: Discontinue Previous Orders Transfer to Telemetry nit

More information

Effects of alpha-1 adrenergic receptor antagonist, terazosin, on cardiovascular functions in anaesthetised dogs

Effects of alpha-1 adrenergic receptor antagonist, terazosin, on cardiovascular functions in anaesthetised dogs Indian Jornal of xperimental Biology Vol. 42, December 24, pp. 1195-1199 ffects of alpha-1 adrenergic receptor antagonist, terazosin, on cardiovasclar fnctions in anaesthetised dogs R Sharma & V M Ahja

More information

IDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015

IDPH ESF-8 Plan: Pediatric and Neonatal Surge Annex Sample Pediatric Admission Orders 2015 Purpose: To provide guidance to practitioners caring for pediatric patients who need inpatient hospital care during a disaster. Disclaimer: This guideline is not meant to be all inclusive, replace an existing

More information

Hypothermia Short Set-Critical Care HYPOTHERMIA SS- CRITICAL CARE

Hypothermia Short Set-Critical Care HYPOTHERMIA SS- CRITICAL CARE Hypothermia Short Set-Critical Care HYPOTHERMIA SS- CRITICAL CARE Inclusion Criteria all must be present Cardiac arrest with return of spontaneous circulation (ROSC) ROSC within 60 mins of witnessed arrest;

More information

NURSING DEPARTMENT CRITICAL CARE POLICY MANUAL CRITICAL CARE PROTOCOLS. ACTIVASE (t-pa) INFUSION PROTOCOL FOR ACUTE MYOCARDIAL INFARCTION

NURSING DEPARTMENT CRITICAL CARE POLICY MANUAL CRITICAL CARE PROTOCOLS. ACTIVASE (t-pa) INFUSION PROTOCOL FOR ACUTE MYOCARDIAL INFARCTION NURSING DEPARTMENT CRITICAL CARE POLICY MANUAL CRITICAL CARE PROTOCOLS ACTIVASE (t-pa) FOR ACUTE MYOCARDIAL INFARCTION I. PURPOSE: A. To reduce the extent of myocardial infarction by lysing the clot in

More information

POST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT

POST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT PHYSICIAN S SHEET Automatically Activate, if not in agreement, cross out and initial Activated by Checking Box ALLERGIES: None known YES Patient s Height: Patient s Weight: ALL MEDICATION and INTRAVENOUS

More information

IV Fluids. Nursing B23. Objectives. Serum Osmolality

IV Fluids. Nursing B23. Objectives. Serum Osmolality IV Fluids Nursing B23 Objectives Discuss the purpose of IV Discuss nursing interventions in IV therapy Identify complications of IV therapy Differentiate between peripheral line, central line, and PICC

More information

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG

PHYSICIAN SIGNATURE DATE TIME DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S Nursing Orders Communication Order If CVP unavailable, administer fluid boluses every 30 minutes except monitor O2 requirements Comments: Every

More information

ATI Skills Modules Checklist for Central Venous Access Devices

ATI Skills Modules Checklist for Central Venous Access Devices For faculty use only Educator s name Score Date ATI Skills Modules Checklist for Central Venous Access Devices Student s name Date Verify order Patient record Assess for procedure need Identify, gather,

More information

Organ Donor Management Recommended Guidelines ADULT Brain Death (NDD)

Organ Donor Management Recommended Guidelines ADULT Brain Death (NDD) Date: Time: = Always applicable = Check if applicable ADMISSION INSTRUCTIONS Neurological Determination of Death (NDD) has been performed by at least 2 licensed physicians Contact initiated with BC Transplant

More information

ST. DOMINIC-JACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI

ST. DOMINIC-JACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI Date & Time TAVR Pre-Op Admission Clinical Pathway Page 1 of 3 1. Admit as INPATIENT to Dr.. For Surgery Today or Tomorrow 3. Diagnosis: 4. Allergies: Pharmacy Mnemonic: PRETAVR 5. Vital signs on arrival.

More information

Echo assessment of patients with an ECMO device

Echo assessment of patients with an ECMO device Echo assessment of patients with an ECMO device Evangelos Leontiadis Cardiologist 1st Cardiology Dept. Onassis Cardiac Surgery Center Athens, Greece Gibbon HLM 1953 Goldstein DJ et al, NEJM 1998; 339:1522

More information

Mechanics of Cath Lab Support Devices

Mechanics of Cath Lab Support Devices Mechanics of Cath Lab Support Devices Issam D. Moussa, MD Chief Medical Officer First Coast Cardiovascular Institute, Jacksonville, FL Professor of Medicine, UCF, Orlando, FL None DISCLOSURE Percutaneous

More information

Hemodynamic Monitoring and Circulatory Assist Devices

Hemodynamic Monitoring and Circulatory Assist Devices Hemodynamic Monitoring and Circulatory Assist Devices Speaker: Jana Ogden Learning Unit 2: Hemodynamic Monitoring and Circulatory Assist Devices Hemodynamic monitoring refers to the measurement of pressure,

More information

!'9ICATION SURVEY FORM (MSRA page 1 of 4)

!'9ICATION SURVEY FORM (MSRA page 1 of 4) 2..3. :9?j-,129: exp. :-!-89 X-127 id LBE: COXiACT EA: E FO!4 CODE: LAT AHE: TAL: TCTO: This form shold be completed in three stages. ection A shold be completed at the eception sation. The transcr:ption

More information

Title: RN Specialty Practice: RN Procedure: Epidural Catheter Removal. I.D. Number: 1080

Title: RN Specialty Practice: RN Procedure: Epidural Catheter Removal. I.D. Number: 1080 Policies and Procedures Title: EPIDURAL CATHETER REMOVAL RN Specialty Practice: RN Procedure: Epidural Catheter Removal I.D. Number: 1080 Authorization: [X] Former SKtnHR Nursing Practice Committee Source:

More information

Relax and Learn At the Farm 2012

Relax and Learn At the Farm 2012 Relax and Learn At the Farm Session 9: Invasive Hemodynamic Assessment and What to Do with the Data Carol Jacobson RN, MN Cardiovascular Nursing Education Associates Function of CV system is to deliver

More information

Baptist Health South Florida - Therapeutic Hypothermia for Comatose Survivors of Cardiac Arrest Critical Care / ICU Admission Orders

Baptist Health South Florida - Therapeutic Hypothermia for Comatose Survivors of Cardiac Arrest Critical Care / ICU Admission Orders Date: Time: Inclusion Criteria all must be checked: Non traumatic cardiac arrest with return of spontaneous circulation (ROSC ) Mean arterial blood pressure maintained greater than 50 either with fluids

More information

UMC Health System Patient Label Here PHYSICIAN ORDERS

UMC Health System Patient Label Here PHYSICIAN ORDERS Weight Allergies Patient Care Vital Signs Per Unit Standards, Q5 min during critical event. Insert Peripheral Line Use 20 gauge or larger. Notify Nurse (DO NOT USE FOR MEDS) Place crash cart with cardiac

More information

CENTRAL ECMO WHEN AND HOW? RANJIT JOHN, MD UNIVERSITY OF MINESOTA

CENTRAL ECMO WHEN AND HOW? RANJIT JOHN, MD UNIVERSITY OF MINESOTA CENTRAL ECMO WHEN AND HOW? RANJIT JOHN, MD UNIVERSITY OF MINESOTA Background How to do Case reports When to do Managing complications Post operative management strategies CASE PRESENTATION 46 year old

More information

Role of the Sympathetic Nervous System

Role of the Sympathetic Nervous System Role of the Sympathetic Nervos System in the Renal Response to Hemorrhage JOHN R. GCL, JR., and AimED G. T. CASPER From the Endocrinology Branch, National Heart Institte, National Instittes of Health,

More information

HAEMODYNAMIC IN THE CATH LABORATORY INTRO TO BASICS

HAEMODYNAMIC IN THE CATH LABORATORY INTRO TO BASICS HAEMODYNAMIC IN THE CATH LABORATORY INTRO TO BASICS BY NOOR FADZLY ALIAS CARDIOVASCULAR TECHNOLOGIST NCL Department National Heart Institute Kuala Lumpur INTRODUCTION ROLES OF HAEMODYNAMIC MONITORING PURPOSE

More information

SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY

SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY PS1070 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: ADMISSION/DISCHARGE CRITERIA: CARDIOVASCULAR INTENSIVE Job Title of Reviewer: Director, CVICU EFFECTIVE DATE: REVIEWED/REVISED DATE: POLICY

More information

Understanding the Cardiopulmonary Bypass Machine and Its Tubing

Understanding the Cardiopulmonary Bypass Machine and Its Tubing Understanding the Cardiopulmonary Bypass Machine and Its Tubing Robert S. Leckie, MD Division of Cardiac Anesthesia, Beth Israel Deaconess Medical Center ABL 1/09 Reservoir Bucket This is a cartoon of

More information

Policies & Procedures. RNSP - RN Procedure. I.D. Number: 1097

Policies & Procedures. RNSP - RN Procedure. I.D. Number: 1097 Policies & Procedures Title: ESOPHAGEAL TAMPONADE TUBE (MINNESOTA Tube) ASSISTING WITH INSERTION, CARE OF A PATIENT, ASSISTING WITH REMOVAL RNSP - RN Procedure I.D. Number: 1097 Authorization [x] Nursing

More information

United Concordia Dental Plans of Pennsylvania, Inc.

United Concordia Dental Plans of Pennsylvania, Inc. United Concordia Dental Plans of Pennsylvania, Inc. 441 Deer Path Road Harrisbrg, PA 1711 877-215-3616 www.nitedconcordia.com Dental Plan Certificate of Coverage Jly 1, 216 throgh Jne 3, 217 The benefit

More information

Introduction. Invasive Hemodynamic Monitoring. Determinants of Cardiovascular Function. Cardiovascular System. Hemodynamic Monitoring

Introduction. Invasive Hemodynamic Monitoring. Determinants of Cardiovascular Function. Cardiovascular System. Hemodynamic Monitoring Introduction Invasive Hemodynamic Monitoring Audis Bethea, Pharm.D. Assistant Professor Therapeutics IV January 21, 2004 Hemodynamic monitoring is necessary to assess and manage shock Information obtained

More information

Interfacility Protocol Protocol Title:

Interfacility Protocol Protocol Title: Interfacility Protocol Protocol Title: Mechanical Ventilator Monitoring & Management Original Adoption Date: 05/2009 Past Protocol Updates 05/2009, 12/2013 Date of Most Recent Update: March 23, 2015 Medical

More information

Ray Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California

Ray Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California High Risk PCI Making Possible the Impossible Ray Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California Disclosures Abiomed Research Support Consulting Agreement

More information

From Recovery to Transplant: One Patient's Journey

From Recovery to Transplant: One Patient's Journey From Recovery to Transplant: One Patient's Journey Tonya Elliott, RN, MSN Assist Device and Thoracic Transplant Coordinator Inova Transplant Center at Inova Fairfax Hospital Falls Church, VA Introduction

More information

CRRT Procedures. and Guidelines. CRRT: Guidelines

CRRT Procedures. and Guidelines. CRRT: Guidelines CRRT Procedures 2013 and Guidelines Guidelines for the utilization of CRRT (Continuous Renal Replacement Therapies) at Monroe Carell Jr. Children s Hospital at Vanderbilt CRRT: Guidelines CRRT Contacts:

More information

You have a what, inside you?

You have a what, inside you? Costal Emergency Medicine Conference You have a what, inside you? Less than mainstream medical devices encountered in the ED. Eric Ossmann, MD, FACEP Associate Professor Duke University Medical Center

More information

Physician Orders ADULT: Asthma and Bronchitis Plan

Physician Orders ADULT: Asthma and Bronchitis Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase, Phase: Asthma and Bronchitis Phase, When to Initiate: Asthma and Bronchitis Phase Non Categorized Problem: Asthma Problem:

More information

DRUG ALLERGIES WT: KG

DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available ONLY at: BMC-A BMC-B BMC-C BMC-D BMC-N BMC-S BMC-T Non Categorized SUB (SUB)* SUB Alert Protocol(SUB)* SUB Alert Protocol Lab Tests(SUB)* Quality Measure Sepsis Bundle Nursing

More information

LIFEGIFT BRAIN DEATH PLAN

LIFEGIFT BRAIN DEATH PLAN Diagnosis Weight Allergies Admit/Discharge/Transfer ***THIS PLAN IS TO BE ED ONLY ON THE LIFEGIFT ENCOUNTER, WITH DR LIFEGIFT AS THE ATTENDING*** Patient Status Pt Status: Inpatient (Inpatient only procedure)

More information

1/21/2016. HeartMate II Indications for Use. Ventricular Assist Device Overview. Jon G. Echterling MSN, CCRN, FNP-BC. Learning Objectives

1/21/2016. HeartMate II Indications for Use. Ventricular Assist Device Overview. Jon G. Echterling MSN, CCRN, FNP-BC. Learning Objectives Ventricular Assist Device Overview Jon G. Echterling MSN, CCRN, FNP-BC February 5, 2016 Learning Objectives Identify the components and operation of the HeartMate II LVAD Describe the path blood follows

More information

Objectives. Objectives 9/11/2012. Chapter 11 Intravenous Cannulation. Copyright 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company

Objectives. Objectives 9/11/2012. Chapter 11 Intravenous Cannulation. Copyright 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Chapter 11 Intravenous Cannulation Objectives Define the term intravenous cannulation Recall the indications and contraindications of intravenous cannulation Identify the equipment used to perform intravenous

More information

Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan

Physician Orders ADULT: Kidney-Panc/PancTransplant Post Op Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase T;N, Phase: Kidney-Panc/Panc Transp Post Op Phase, When to Initiate: Kidney-Panc/Panc Transp Post Op Phase Vital Signs Vital

More information

Management of Cardiac Arrest Based on : 2010 American Heart Association Guidelines

Management of Cardiac Arrest Based on : 2010 American Heart Association Guidelines Management of Cardiac Arrest Based on : 2010 American Heart Association Guidelines www.circ.ahajournals.org Elham Pishbin. M.D Assistant Professor of Emergency Medicine MUMS C H E S Advanced Life Support

More information

Introduction to Cardiopulmonary Bypass. Syllabus for TSDA Boot Camp Ron Angona, Perfusionist University of Rochester Medical Center

Introduction to Cardiopulmonary Bypass. Syllabus for TSDA Boot Camp Ron Angona, Perfusionist University of Rochester Medical Center Introduction to Cardiopulmonary Bypass Syllabus for TSDA Boot Camp Ron Angona, Perfusionist University of Rochester Medical Center Why CPB To facilitate a surgical intervention Provide a motionless field

More information

Bariatric Surgery Post Op Plan PACU Phase

Bariatric Surgery Post Op Plan PACU Phase Bariatric Surgery Post Op Plan PACU Phase PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Code Status

More information

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE TITLE: ISSUED FOR: INTERMITTENT FLUID AND MEDICATION THERAPY Nursing DATE: REVIEWED: PAGES: RESPONSIBILITY: RN, LPN I, LPN II Per Job Description 03/81 8/09

More information

Cardiothoracic Fellow Expectations Division of Cardiac Anesthesia, Beth Israel Deaconess Medical Center

Cardiothoracic Fellow Expectations Division of Cardiac Anesthesia, Beth Israel Deaconess Medical Center The fellowship in Cardiothoracic Anesthesia at the Beth Israel Deaconess Medical Center is intended to provide the foundation for a career as either an academic cardiothoracic anesthesiologist or clinical

More information

ACLS Review. Pulse Oximetry to be between 94 99% to avoid hyperoxia (high oxygen tension can lead to tissue death

ACLS Review. Pulse Oximetry to be between 94 99% to avoid hyperoxia (high oxygen tension can lead to tissue death ACLS Review BLS CPR BLS CPR changed in 2010. The primary change is from the ABC format to CAB. After establishing unresponsiveness and calling for a code, check for a pulse less than 10 seconds then begin

More information

Right Ventricular Failure: Prediction, Prevention and Treatment

Right Ventricular Failure: Prediction, Prevention and Treatment Right Ventricular Failure: Prediction, Prevention and Treatment 3 rd European Training Symposium for Heart Failure Cardiologists and Cardiac Surgeons University Hospital Bern June 24-25, 2016 Disclosures:

More information

Education for Self Administration of Intravenous Therapy HOME IV THERAPY PICC. Portacath

Education for Self Administration of Intravenous Therapy HOME IV THERAPY PICC. Portacath HOME IV THERAPY PICC Portacath Who To contact Cardio-Respiratory Integrated Specialist Services (CRISS) Office hours 0800 1630 hours Ph: 364 0167 Weekends and after hours, phone Christchurch Hospital operator

More information

DRUG ALLERGIES WT: KG

DRUG ALLERGIES WT: KG DRUG AND TREATMENT Available ONLY at: BMC-B BMC-D BMC-N BMC-S Non Categorized Quality Measure Sepsis Bundle Admit to Inpatient Patient Status: Inpatient, Level of Care: Intensive Care (8), Diagnosis: Please

More information

I. Subject: Therapeutic Bronchoscopy and Bronchoscope Assisted Intubation

I. Subject: Therapeutic Bronchoscopy and Bronchoscope Assisted Intubation I. Subject: Therapeutic Bronchoscopy and Bronchoscope Assisted Intubation II. Policy: Therapeutic flexible fiberoptic bronchoscopy procedures and bronchoscope assisted intubations will be performed by

More information

Recommendations. for the Governance & Administration of Destination Marketing Fees

Recommendations. for the Governance & Administration of Destination Marketing Fees Recommendations for the Governance & Administration of Destination Marketing Fees Febrary 2011 Alberta Hotel & Lodging Association Destination Marketing Fee Recommendations Introdction & Backgrond Since

More information

Hypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC

Hypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC Hypothermia in Neonates with HIE TARA JENDZIO, DNP(C), RN, RNC-NIC Objectives 1. Define Hypoxic-Ischemic Encephalopathy (HIE) 2. Identify the criteria used to determine if an infant qualifies for therapeutic

More information

Use of Blood Lactate Measurements in the Critical Care Setting

Use of Blood Lactate Measurements in the Critical Care Setting Use of Blood Lactate Measurements in the Critical Care Setting John G Toffaletti, PhD Director of Blood Gas and Clinical Pediatric Labs Professor of Pathology Duke University Medical Center Chief, VAMC

More information

(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder

(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder (Page 1 of 5) Allergies/Sensitivities/Reactions: Height: Inches cm Weight: Kg Pounds = Automatic = Physician s option, Check off to Order Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental

More information

Atrial Fibrillation Version 2 11/4/15 This order set must be used with an admission order set if patient not already admitted.

Atrial Fibrillation Version 2 11/4/15 This order set must be used with an admission order set if patient not already admitted. Patient Name: Diagnosis: Allergies with reaction type: Atrial Fibrillation Version 2 11/4/15 This order set must be used with an admission order set if patient not already admitted. Telemetry Medical Telemetry:

More information

Johnson County Emergency Medical Services Page 23

Johnson County Emergency Medical Services Page 23 Non-resuscitation Situations: Resuscitation should not be initiated in the following situations: Prolonged arrest as evidenced by lividity in dependent parts, rigor mortis, tissue decomposition, or generalized

More information

Alberta Surgical Fractured Hip Care Pathway Version 3: Last Updated February 9, 2018

Alberta Surgical Fractured Hip Care Pathway Version 3: Last Updated February 9, 2018 Alberta Surgical Fractured Hip Care Pathway Assessment / Pain Mngmt EMS Transport Neurovascular assessment Vital signs Pain assessment Splint only (no traction) Position of comfort Start IV and use appropriate

More information

SYSTEM-WIDE POLICY & PROCEDURE MANUAL. Policy Title: Hypothermia Post Cardiac Arrest Policy Number: PC-124. President & CEO Page 1 of 9

SYSTEM-WIDE POLICY & PROCEDURE MANUAL. Policy Title: Hypothermia Post Cardiac Arrest Policy Number: PC-124. President & CEO Page 1 of 9 Approved By: President & CEO Date Page 1 of 9 POLICY: PURPOSE: To define and describe the implementation of induced hypothermia post cardiac arrest and the nursing assessment and interventions required

More information

Titrating Critical Care Medications

Titrating Critical Care Medications Titrating Critical Care Medications Chad Johnson, MSN (NED), RN, CNCC(C), CNS-cc Clinical Nurse Specialist: Critical Care and Neurosurgical Services E-mail: johnsoc@tbh.net Copyright 2017 1 Learning Objectives

More information

PRE SURGICAL TESTING DEPARTMENT ADVOCATE LUTHERAN GENERAL HOSPITAL STANDARD FOR CHART REVIEW

PRE SURGICAL TESTING DEPARTMENT ADVOCATE LUTHERAN GENERAL HOSPITAL STANDARD FOR CHART REVIEW Purpose: To provide a standard action plan for chart review of pre-admission testing done for scheduled surgical patients. PST will follow these guidelines for review, taking into consideration the patient

More information

FUNDAMENTALS OF HEMODYNAMICS, VASOACTIVE DRUGS AND IABP IN THE FAILING HEART

FUNDAMENTALS OF HEMODYNAMICS, VASOACTIVE DRUGS AND IABP IN THE FAILING HEART FUNDAMENTALS OF HEMODYNAMICS, VASOACTIVE DRUGS AND IABP IN THE FAILING HEART CINDY BITHER, MSN, ANP, ANP, AACC, CHFN CHIEF NP, ADV HF PROGRAM MEDSTAR WASHINGTON HOSPITAL CENTER CONFLICTS OF INTEREST NONE

More information

Ventricular Assist Devices and Emergency Services

Ventricular Assist Devices and Emergency Services Ventricular Assist Devices and Emergency Services Margaret Murray, DNP, FAHA Clinical Nurse Specialist- Cardiac Surgery, Cardiac Transplant and Ventricular Assist Devices ma.murray@hosp.wisc.edu Janean

More information

Pediatric Order Set 0 through 16 yrs age Addressograph Stamp

Pediatric Order Set 0 through 16 yrs age Addressograph Stamp Date Pediatric Order Set 0 through 16 yrs age Time 1. [ ] Place in Observati: [ ] Mitored Telemetry Bed [ ] Unmitored Bed OR [ ] Admit to Inpatient: [ ] Med-Surg Telemetry Mitor [ ] Med-Surg 2. Diagnosis:

More information

Standardize comprehensive care of the patient with severe traumatic brain injury

Standardize comprehensive care of the patient with severe traumatic brain injury Trauma Center Practice Management Guideline Iowa Methodist Medical Center Des Moines Management of Patients with Severe Traumatic Brain Injury (GCS < 9) ADULT Practice Management Guideline Contact: Trauma

More information

Epidemiology of Heart Failure in Adults

Epidemiology of Heart Failure in Adults Cardiac Critical Care : Focused on IABP & PCPS Epidemiology of Heart Failure in Adults Prevalence Incidence Mortality 2004 Hospital Cost 2007 2004 Age 20+ (New Cases) All Ages Discharges Age 35+ 2004 All

More information

Introduction to IV Therapy. BY Terry White, MBA, BSN

Introduction to IV Therapy. BY Terry White, MBA, BSN Introduction to IV Therapy BY Terry White, MBA, BSN Important It is West Virginia State Law that nursing students (LPN and RN) are forbidden to start IVs or draw blood samples on patients Taking this class

More information

Optimize vent weaning and SBT outcomes. Identify underlying causes for SBT failures. Role SBT and weaning protocol have in respiratory care

Optimize vent weaning and SBT outcomes. Identify underlying causes for SBT failures. Role SBT and weaning protocol have in respiratory care Optimize vent weaning and SBT outcomes Identify underlying causes for SBT failures Role SBT and weaning protocol have in respiratory care Lower risk of developing complications Lower risk of VAP, other

More information

After the radial artery, the femoral artery is the second most common site for arterial cannulation. One advantage of femoral artery cannulation is

After the radial artery, the femoral artery is the second most common site for arterial cannulation. One advantage of femoral artery cannulation is Arterial Line An arterial line is a thin catheter inserted into an artery. Arterial line placement is a common procedure in various critical care settings. It is most commonly used in intensive care medicine

More information

ARROW EZ-IO Intraosseous Vascular Access System Procedure Template

ARROW EZ-IO Intraosseous Vascular Access System Procedure Template ARROW EZ-IO Intraosseous Vascular Access System Procedure Template PURPOSE To provide procedural guidance for establishment of intraosseous vascular access using the ARROW EZ-IO Intraosseous Vascular Access

More information

Canadian Stroke Best Practices Initial ED Evaluation of Acute Stroke and Transient Ischemic Attack (TIA) Order Set (Order Set 1)

Canadian Stroke Best Practices Initial ED Evaluation of Acute Stroke and Transient Ischemic Attack (TIA) Order Set (Order Set 1) Canadian Best Practice Recommendations for Stroke Care: All patients presenting to an emergency department with suspected stroke or transient ischemic attack must have an immediate clinical evaluation

More information

Endocrinology Cases and Clinical Pearls QUANG NGUYEN, DO, FACE, FTOS LAS VEGAS ENDOCRINOLOGY 5/5/18

Endocrinology Cases and Clinical Pearls QUANG NGUYEN, DO, FACE, FTOS LAS VEGAS ENDOCRINOLOGY 5/5/18 Endocrinology Cases and Clinical Pearls QUANG NGUYEN, DO, FACE, FTOS LAS VEGAS ENDOCRINOLOGY 5/5/18 Q1 A 59-year-old man with an 18-year history of diabetes mellits is being treated with inslin glargine

More information

Lumbar Drain Management Thoracic Aortic Aneurysm Surgery

Lumbar Drain Management Thoracic Aortic Aneurysm Surgery Lumbar Drain Management Thoracic Aortic Aneurysm Surgery Presented By Tonya L. Page MSN, APRN, ACNP-BC What is a Lumbar drain? A small, flexible, soft plastic tube placed in the lower back (lumbar area)

More information

Extracorporeal Life Support Organization (ELSO) General Guidelines for all ECLS Cases August, 2017

Extracorporeal Life Support Organization (ELSO) General Guidelines for all ECLS Cases August, 2017 Extracorporeal Life Support Organization (ELSO) Introduction General Guidelines for all ECLS Cases August, 2017 This guideline describes prolonged extracorporeal life support (ECLS, ECMO), applicable to

More information

TELEMETRY/STEPDOWN UNIT SKILLS CHECKLIST

TELEMETRY/STEPDOWN UNIT SKILLS CHECKLIST TELEMETRY/STEPDOWN UNIT SKILLS CHECKLIST NAME: DATE: Please check the appropriate letter of proficiency for the following types of clinical situations and equipment. LEVEL OF PROFICIENCY A = Able to teach

More information

Talking About. And Dying. A Discussion Tool For Residential Aged Care Facility Staff

Talking About. And Dying. A Discussion Tool For Residential Aged Care Facility Staff Talking Abot Dementia And Dying A Discssion Tool For Residential Aged Care Facility Staff Acknowledgements: Development of this booklet was spported by the Astralian Government Department of Health and

More information

Enzyme-linked Immunoassay Index for Anti-NC16a IgG and IgE Autoantibodies Correlates with Severity and Activity of Bullous Pemphigoid

Enzyme-linked Immunoassay Index for Anti-NC16a IgG and IgE Autoantibodies Correlates with Severity and Activity of Bullous Pemphigoid Acta Derm Venereol 2016; 96: 191 196 INVESTIGATIVE REPORT Enzyme-linked Immnoassay Index for Anti-NC16a IgG and IgE Atoantibodies Correlates with Severity and Activity of Bllos Pemphigoid Monika KALOWSKA

More information

Intravenous Fluid and Drug Therapy

Intravenous Fluid and Drug Therapy 11 Intravenous Fluid and Drug Therapy OUTLINE Overview Direct Intravenous Injections Continuous Intravenous Injections Solution Additives Calculating IV Components as Percentages Calculating IV Flow Rates

More information

Cardiac Electrical Therapies. By Omar AL-Rawajfah, PhD, RN

Cardiac Electrical Therapies. By Omar AL-Rawajfah, PhD, RN Cardiac Electrical Therapies By Omar AL-Rawajfah, PhD, RN Outlines What are cardiac electrical therapies Ablation Defibrillation Cardioversion What are the nursing considerations for each type of therapy

More information

CC (in oitro)=computation constant for in oitro 8uid Row;

CC (in oitro)=computation constant for in oitro 8uid Row; Detection of Renal Blood Flo Abnormalities in Septic and Critically Ill Patients Using a Nely Designed Indelling Thermodiltion Renal Vein Catheter* Matthe Brenner; M.D.; Gary L. Schaer; M.D.; Doglas L.

More information

PRE-OP SHORT HISTORY & PHYSICAL

PRE-OP SHORT HISTORY & PHYSICAL PRE-OP SHORT HISTORY & PHYSICAL Rev 4/16 First Name Last Name Medical History and Health Information: These uestions are for your benefit and assure that your past and present health status will be taken

More information

Victoria Chapman BS, RN, HP (ASCP)

Victoria Chapman BS, RN, HP (ASCP) Victoria Chapman BS, RN, HP (ASCP) Considerations: Age Sex Body Composition Hydration Status Chemotherapy Use Access History Considerations: Immunosuppression Use Chemotherapy Frequency of plasma exchanges

More information

Physician Orders ADULT: Vascular Surgery AAA Repair Open Post Op Plan

Physician Orders ADULT: Vascular Surgery AAA Repair Open Post Op Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: AAA Repair Open Postop Phase, When to Initiate: Initiate Powerplan Phase Phase: Mechanically Ventilated Patients Phase,

More information

Prevent, Promote, Provoke: Voices from the Substance Abuse Field

Prevent, Promote, Provoke: Voices from the Substance Abuse Field Prevent, Promote, Provoke: Voices from the Sbstance Abse Field PREPARED BY DAVID S. ANDERSON, PH.D. PROFESSOR OF EDUCATION AND HUMAN DEVELOPMENT DIRECTOR, CENTER FOR THE ADVANCEMENT OF PUBLIC HEALTH GEORGE

More information

Physician Orders ADULT: PCI Post Procedure Plan

Physician Orders ADULT: PCI Post Procedure Plan Initiate Orders Phase Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: PCI Post Procedure Phase, When to Initiate: Initiate Powerplan Phase Phase: Post Cath/PCI Hydration Protocol Phase,

More information

Physician Orders. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out.

Physician Orders. LEB NICU Sepsis Plan [X or R] = will be ordered unless marked out. Height: cm Weight: kg Allergies: [ ] No known allergies [ ] Latex allergy [ ]Other: [ ] Initiate Powerplan Phase, Phase: LEB NICU Sepsis Phase Admission/Transfer/Discharge [ ] Patient Status Initial Inpatient

More information

Management of Anticoagulation during Device Implants; Coumadin to Novel Agents

Management of Anticoagulation during Device Implants; Coumadin to Novel Agents Management of Anticoagulation during Device Implants; Coumadin to Novel Agents DR D Birnie Invited Faculty Core Curriculum Heart Rhythm Society May 8 th 2014 Disclosures Boehringer Ingleheim Research Support

More information

PEDIATRIC ARGININE CLONIDINE STIMULATION TEST PLAN

PEDIATRIC ARGININE CLONIDINE STIMULATION TEST PLAN Diagnosis Weight Allergies Patient Care Arginine Clonidine Stimulation Test Guid (Arginine Clonidine Stimulation Test Guidelines) See Reference Guidelines. Vital Signs Routine, q1h, With BP, During the

More information

ED Stroke Panel Page 1 of 2

ED Stroke Panel Page 1 of 2 ED Stroke Panel Page 1 of 2 Reference EMMC *************************Usec: Call Operator to page a Stroke Alert ********************** Laboratory Bedside Glucose Monitoring ONCE Notify provider if glucose

More information

Modern Left Ventricular Assist Devices (LVAD) : An Intro, Complications, and Emergencies

Modern Left Ventricular Assist Devices (LVAD) : An Intro, Complications, and Emergencies Modern Left Ventricular Assist Devices (LVAD) : An Intro, Complications, and Emergencies ERIC T. ROME D.O. HEART FAILURE, MECHANICAL ASSISTANCE AND TRANSPLANTATION CVI Left Ventricular Assist Device An

More information

Aviation Rescue Swimmer Course

Aviation Rescue Swimmer Course Aviation Rescue Swimmer Course Primary Survey LT 5.4 December 2003 1 Objectives List the procedures used in a primary survey. Demonstrate primary survey procedures used in a mock trauma (moulage) scenario

More information

The Whopper has been Burger King s signature sandwich since 1957.

The Whopper has been Burger King s signature sandwich since 1957. CHAPER 8 Linear Regression WHO WHA UNIS HOW Items on the Brger King men Protein content and total fat content Grams of protein Grams of fat Spplied by BK on reqest or at their Web site he Whopper has been

More information

Cardiac Arrest & Therapeutic Hypothermia. Continuing Education May 2012

Cardiac Arrest & Therapeutic Hypothermia. Continuing Education May 2012 Continuing Education May 2012 Cardiac Arrest & Therapeutic Hypothermia Questions/comments on this CE are welcome and should be directed to: Diana Neubecker RN BSN PM NWC EMSS In-Field Coordinator dneubecker@nch.org

More information

Physician Orders ADULT

Physician Orders ADULT Admission Height (Actual) : cm Admission Weight (Actual): kg Allergies: No known allergies Medication allergy(s): Latex allergy Other: Non-Categorized ATTENTION SURGEON: Please discontinue Open Heart Post

More information

Naloxone Intranasal EMT OPTIONAL SKILL. Cell Phones and Pagers. Course Outline 09/2017

Naloxone Intranasal EMT OPTIONAL SKILL. Cell Phones and Pagers. Course Outline 09/2017 EMT OPTIONAL SKILL Naloxone Intranasal Cell Phones and Pagers Be courteous to your classmates! Please set your cell phones and/or pagers to silent or turn them off. Course Outline Introduction and Overview

More information