Monday, May 6, 2013

Counterpulsation and the rise of the machines

This past weekend was really good.

Saturday night I took my first patient with an intra-aortic balloon pump/IABP. I'd been dodging that ball for so long. Finally got one and it was not super bad. Meaning, the machine behaved for my shift. I had taken the class to train on the IABP twice, but for patients in cardiogenic shock, many of the cardiologists have been leaning more towards the Impella, so we just don't see IABP's very often. Instead of being super crazy, it was actually one of the best shifts I've had in a long time. The patient was a 1:1 and I actually had time to do things the way the way they ought to be done, talk with the family . . . and clocked out at 0730. Yes, you read that right. I think if more shifts were like that I would probably like nursing.

It just amazes me how this machine counterpulsates seemingly at lightening speed. I mean, at the beginning of my shift my patient had a heart rate of 170/min. That balloon was inflating and deflating nearly three times per second. 

What is an IABP, in 40 seconds:


What is an IABP, in about 8 minutes:


'Pretty sure everyone knows how much I complain about work, though I hesitate to complain about it to med-surg nurses. If you regularly have 6 patients, imagine listening to someone whine who usually has two or three? I have tremendous respect for good floor nurses; I could never do what they do.

One, or two, or three ICU patients can still keep you busy . . . but that's a rant for another post. Suffice it to say some of these patients are living on the edge. For instance, their blood pressure plummets during the seconds it takes you to change/hang a new bag of levophed (an intravenous liquid cousin of epinephrine). Keeps you on your toes.

On another note, Ryan's friends had a crawfish boil.  Coming home for breakfast, these guys met me in the refrigerator:

Many moons ago my parents took us to New Orleans. Along the way we stopped at some restaurant and got what I remember to have been a mountain of crawfish. I'd forgotten how much work there is to do for so little meat! But when you tast 'em, it's worth it.

7 comments:

  1. Still amazed your job is keeping people alive.

    And I've been thinking so much about the Crawfish festival ... and missing it. Btw, thanks for the early mornin' text. Nice message to wake up to.

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  2. "some of these patients are living on the edge." --> Aerosmith earworm juxtaposed with hospital room imagery.

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  3. HAPPY NURSE'S DAY/WEEK, FRIEND!!!!!!! :)

    (you don't mind me saying friend, right? I mean... we kind of are in the blogging world kind of way... right? Right.)

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    Replies
    1. A very happy nurses' week to you too, amiga!

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