cabg notes

Question 0

when is amicar given?

Answer 0

prior to incision and after coming off pump

Question 1

best ways to prevent arrhythmia coming off CPB?

Answer 1

1. warm patient to ~37 degrees
2. magnesium 2 grams
3. lidocaine 100 mg

Question 2

1. when is heparin given
2. what is a side effect of heparin administration
3. what should you do and what do you tell the physician after administration?

Answer 2

1. a small dose usually around 2500 units is given when removing saphenous graft; the other 300 units/kg is given prior to going on pump
2. hypotension d/t histhamine release
3. hit the timer and let the physician know when 3 (or 5) minutes have passed.

Question 3

1. when is protamine given and what should you do tell surgeon?
2. what is it given with (and why)?

Answer 3

1. protamine is given prior to coming off pump; let surgeon know when it is half way done
2. given with calcium to combat the hypotensive effects

Question 4

what should you remember to do when FULLY coming off bypass (most important thing)?

Answer 4

turn on the ventilator