CVME Insider: Nursing Knowledge That Matters

Is a Respiratory Therapist (RT) more than just a breathing treatment provider? So I have had experience in nursing for over 20 years and have specialized in Infusion Therapy for over 6 years.  Recently, I was teaching an IV class in which the facility was using a Respiratory Therapist to insert and maintain their PICC's.  I was a little taken aback by this discovery as I have never heard of such a thing. Well I contacted the California Board for Respiratory Therapist and they responded back fairly quick and the following was their response; "Good afternoon Mr. Stansbury. The Respiratory Care Board of California (Board) often receives inquiries related to PICC and central line insertion.   In its responses the Board has stated that that licensed respiratory care practitioners are authorized to insert and care for PICC lines, so long as appropriate training, guidelines, and competencies are provided/documented by the licensed health care facility ...

2015 ACLS Summary of Key Issues and Major Changes Vasopressors for Resuscitation : Vasopressin 2015 ( Updated ) : Vasopressin in combination with epinephrine offers no advantage as a substitute for standard-dose epinephrine in cardiac arrest. 2010 ( Old ): One dose of vasopressin 40 units IV/ intraosseously may replace either the first or second dose of epinephrine in the treatment of cardiac arrest. Why: Both epinephrine and vasopressin administration during cardiac arrest have been shown to improve ROSC. Review of the available evidence shows that efficacy of the 2 drugs is similar and that there is no demonstrable benefit from administering both epinephrine and vasopressin as compared with epinephrine alone. In the interest of simplicity, vasopressin has been removed from the Adult Cardiac Arrest Algorithm. ETCO2 for Prediction of Failed Resuscitation 2015 ( New ): In intubated patients, failure to achieve an ETCO2 of greater than 10 mm Hg by waveform capnog...

Basic Life Support (BLS)/CPR Quality Changes The AHA states that High quality CPR continues to be of primary importance in optimizing outcomes for cardiac arrest. Several alterations to the BLS/CPR guidelines have occurred as a result of this end goal of providing high quality CPR. Compression Depth : The recommended depth of chest compressions will remain at, at least 2 inches (5 cm). In addition to this, avoiding excessive chest compressions deeper than 2.4 inches (6cm) allowing for complete chest recoil between each compression is emphasized. This compression depth limit was implemented because there is some evidence that complications may arise when compression depth exceeds this limit. Compression Rate : During cardiac arrest lay rescuers and health care providers should perform chest compressions at a rate of 100 to 120 per minute. This change added an upper limit of 120 to the recommendation because compression rates greater than 120 per minute negativel...