I have the utmost respect for nurses, I do - I am actually married to one... I know RT's get a lot of crap for being so hit-or-miss when it comes to being good or being terrible, and I guess I have just been taught that RN's are in the same boat.
When I ask you during a intermittent positive-pressure ventilation treatment with a duration of 20 minutes, 2 minutes in "Hey, how high should the CVP get before I become concerned?" she replies "well the normal is 8-10, and he was doing that before the treatment, so he's fine."
Because I am timid and not a complete douche-bag, I decided to just drop it. However, CVP is the central venous pressure, or right-atrial pressure, normal is 8-12 mmHg and it is measured by a line going directly into the heart and sitting in that spot. My IPV increases intra-thoracic pressure inherently, its what it does - its how it works, it is therapeutic. Sometimes the pressures increase other pressures that aren't normally a problem like CVP, ICP and maybe helps mobilize gas in the intestines... but when you're a left-hypoplast post-norwood(sano) and had just had your chest closed 2 hours ago after having an open chest for 3 days, maybe an increased CVP into the low 30's is a red-flag for me to stop my treatment?
Maybe that's something I should know and the nurse shouldn't have to know, but either way - I was embarrassed to have forgotten that very important information from my cardiology classes but then I was put off a bit by this MSN, RN who apparently thinks I am just vibrating the baby and not slamming him with pulsating pressures.
A blog about Respiratory Care by a Respiratory Therapist
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