[HSF] Vasopledgia and PA catheters

[Nasser F. Abou'Seada]

Very wise Gabi ..... very insightful .... 

NFA 

> From: gabi ford
> I agree that a SG can give numbers to the surgeon which will tell him
> something an inexperienced nurse may not understand.  This is how it is in
> one hospital I'm familiar with.  Every patient comes back with loads of
> hardware.
> But I also find that in these places everyone always turns to numbers and
> instruments...and does not touch the patients' feet or just sit back and
> look at a patient whose body works...but some numbers are out of range. In
> addition, there tend to be more parameters that trigger a response, and so
> the game takes on a different character.  It becomes number watching and
> doesn't promote maturing of judgment.
> But I understand the constraints...and that the numbers do convey
> information...
> 
> I personally like the slick LA line, the simplicity of it.
> We don't call the docs during the night unless we've cleared this with the
> charge nurse.  In other words, she is the first line.  And they are
> generally very experienced folks.  So, the rule is that you don't call
> unless it's a damn good reason.  ;)
> 
> >We have had one pulmonary artery perforation in the OR requiring
emergency
> >lobectomy.  We never wedge the catheter, and it is usually removed within
> >12 - 4 hours after surgery.  I am sure we could do without them, but it
> >would probably mean extra trips to the hospital in the middle of the
night
> >to "see for yourself."
> 
> On the few cases who have a SG, we don't wedge either, using the LA line
> reading instead.
> 
> Gabi