General
1 low wall suction
Ventilator
Sterile suction tubing
1 x bottle of 4% albumin
DOO
What is the emergency pacing mode?
Is always the last drain to be removed
Which is the pleural drain?
Common organic vasodilator used post-operatively.
Conc: 20mg made up to 50ml (5% glucose)
What is GTN?
Team leader
Scrub nurse
Scout nurse
What are the allocated positions for the resternotomy team?
90-120
What are the common blood pressure targets for a post-operative cardiothoracic patient?
The ability of the pacemaker to detect intrinsic activity
Unintentional wedging
Why do we continuously monitor a pulmonary artery catheter?
GTN
Noradrenaline
50mmol KCL in 5% glucose
Propofol
IV 6mg, 12mg & 18mg
What are the doses of consecutive adenosine administration?
60-80%
What is a normal SvO2?
The minimum electrical stimulus to consistently capture the heart and initiate contraction.
What is the stimulation threshold?
>300ml/hr
When do we escalate drain output in the post-operative cardiac patient?
Mg >1.0
K > 4.5
What are the general aims for electrolytes in cardiothoracic patients?
Decreased breath sounds
Deviated trachea
Desaturation
Respiratory distress
What are the signs of a tension pneumothorax?
Epidural & Paravertebral
What regional blocks require dermatome testing?
Inserted through a sheath, most commonly in an emergency. They make direct contact with the endocardium.
What are transvenous pacing wires?
Tip should be 1-2cm left of the mediastium or no more than the 1 /3 of the hilum.
What is the correct positioning of the PAC on CXR?
Alpha +++++
Beta 1 +++
Beta 2 ++
What adrenergic receptors does noradrenaline work on?
Raised JVP/CVP
Muffled heart sounds
Hypotension
Other symptoms: Decreased UO, narrow pulse pressure, high lactate, decreased drain output.
What are the indications of cardiac tamponade?
SVRI 3100 dys-sec-cm
SVI 20ml/m/beat
CO 2.0L/min
CI 0.9L/min/m
Lactate 4.3
Evidence of LV failure on echo
When is dobutamine indicated?
Start at 10mA, increase by 10mA until capture is achieved. Then set 10mA above that.
How to achieve successful transcutaneous pacing?
Decreases afterload & increases coronary perfusion
What is an intra-aortic balloon pump (IABP)?
Can cause cyanide poisoning at continuous high doses
What are the precautions for SNP? Sodium Nitroprusside
2 x sterile Kidney dish Inc. Gallipot
1 x 3m sterile suction tubing
1 x yankeur sucker
1 x Raytec swabs
1 x Abdominal swabs
Count sheet
What are the contents of pack B in the resternotomy trolley?