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Saved my life in 2017! And then I had the opportunity to work for them and was able to learn the assembly process. Piezo technology is incredible. Learning how my clot was dissolved and actually understanding how the catheter worked! Thanks EKOS!!!
Had a patient with this last night and as a new nurse to ICU I didn’t even know this machine existed until I got to my shift lol. Makes so much more sense now! Thank you for your videos
Love it when the timing works out! So yeah, we treat these patients just like with any other femoral access sites. This obviously will also depending on if it is arterial or venous depending where the clot is that is being targeted. Generally though we can still sit people up some even with arterial sheaths. I think I talked about this with review some studies about it as well in a previous video but I don't recall which. It really depends on your facility policy. It may be flat in bed and reverse trendelenberg if thats what your hospital does.
Caring for these at the bedside is typically fairly straightforward as the system just seems to not be overly fussy. I think the most difficult part is controlling the discomfort associated with the return of circulation to the affected limb, usually the leg from my experiences. I had patients describe it as the worst case of pins and needles they have ever experienced that is exacerbated by them not being permitted to grossly move the affected limb to avoid dislodging the catheter.
Yup definitely usually runs without issue thankfully! And yeah, for cases of limb ischemia, especially depending on how long the ischemia has been going on for, can definitely causes issues and pain for patients. Makes managing them for sure difficult at times.
Can someone explain the sheath. It is able to stay behind? How long after can it be removed or is it left to help open the lumen? What about pt care shortly after the removal? No bending, if in the groin, or lifting arm above head if in IJ? thanks in advance.
@@ICUAdvantage yeah it's an interesting procedure but a bit cumbersome, we would usually go 6f sheathx2 rt IJ and wire both PAs under floro then float ther catheters
Love it. Thank you ,Eddie for this crucial sharing and reassuring you provide to we,nurses. Had 2 cases of such some time ago. Bookings came and patient came back with it. We self learnt ,scary/indeed overwhelming of patients care and safety. How long do we wait before removal of the cath?
Glad you liked it Andrea. Yeah, with anything we do, having good training and then exprience helps to alleviate the stress and anxiety of dealing with stuff. Sorry to hear you had to go through that learning it on your own! Hopefully this will help in some way for some people.
Currently, I'm using Adobe Photoshop of the "blackboard" and screen cast from my computer to an iPad to do the writing. I'm actually testing switching things up a bit for some future changes I want to do, but for the next few medication videos, I'll be using Goodnotes on the iPad and directly screen recording there.
I'm confused with your explanation. You stated that the ultrasonic wave does not mechanically break down the clot, but then a moment later you explained that the fibrin formation was loosened up due to the same waves. Am I misunderstanding?
No you are correct. The ultrasonic waves loosen the fibrin strands in mature clots so the clot isn't as tightly packed together. That said, it doesn't break the strands down. It just allows more passageway through the clot for the medication. I guess my point is that a lot of people think the ultrasonic waves work to actually break down the clot. They do have that physical change in the clot, but don't play any role in the actual breakdown. I hope that makes sense!
❤ Show your support with an ICU Advantage sticker! 👉🏼 adv.icu/support
💲 10% off EACH Month @ Nurisng Mastery membership: 👉🏼 adv.icu/mastery
NOTES for this lesson (and all previous lessons) are availably only to UA-cam and Patreon members. Links to join both here ⬇
► UA-cam: adv.icu/ym | ► Patreon: adv.icu/pm
Literally got my first EKOS tonight and went to get education and bam… my favorite icu education channel comes up with one a day old!
Yes! I love it when the timing works out!
Saved my life in 2017! And then I had the opportunity to work for them and was able to learn the assembly process. Piezo technology is incredible. Learning how my clot was dissolved and actually understanding how the catheter worked! Thanks EKOS!!!
Had a patient with this last night and as a new nurse to ICU I didn’t even know this machine existed until I got to my shift lol. Makes so much more sense now! Thank you for your videos
This procedure saved my life this week. I was really nervous about it but didn’t have much of a choice. The procedure went well.
You were very thorough and informative. Clear to understand!
Loveddddd this video! 10/10
I woke up to this video, I'm attending an ekos training session tomorrow so this is just in time.
Do the patients have to lie flat in the same way one would if they had femoral access sites for a heart Cath? If so what's the recommendation for time
Love it when the timing works out!
So yeah, we treat these patients just like with any other femoral access sites. This obviously will also depending on if it is arterial or venous depending where the clot is that is being targeted. Generally though we can still sit people up some even with arterial sheaths. I think I talked about this with review some studies about it as well in a previous video but I don't recall which.
It really depends on your facility policy. It may be flat in bed and reverse trendelenberg if thats what your hospital does.
Can you please do talk on ---- LVAD - Impella - Mechanical support devices ----- Neuromonitoring (EVD) ---
Yes I've got all those on the todo list to get to sooner than later!
Thank you! I had this patient yesterday and had no idea what to do besides check vitals and assess cite, and pulses.
Glad that you found this lesson helpful and hopefully feeling better about the next one 😊
Caring for these at the bedside is typically fairly straightforward as the system just seems to not be overly fussy. I think the most difficult part is controlling the discomfort associated with the return of circulation to the affected limb, usually the leg from my experiences. I had patients describe it as the worst case of pins and needles they have ever experienced that is exacerbated by them not being permitted to grossly move the affected limb to avoid dislodging the catheter.
Yup definitely usually runs without issue thankfully!
And yeah, for cases of limb ischemia, especially depending on how long the ischemia has been going on for, can definitely causes issues and pain for patients. Makes managing them for sure difficult at times.
Love your videos!
Can you also do a video on CRRT? My unit has a lot of patients on those machines!
Thank you!
I actually have a whole series on CRRT :)
ua-cam.com/play/PL2oVjKTYocdPD_4IKD-eN6IgVJV_MJjTs.html
Awesome! Thank you so much! Keep up the good work!
Great vid!
Thank you!
Very very informative as well.. plz add some vidoes about wenning (extubation ).
Thank you, sir. Very informative.
You're welcome. Glad you liked it.
Thanks so much this really helps
Glad to hear it and you're welcome!
Can someone explain the sheath. It is able to stay behind? How long after can it be removed or is it left to help open the lumen? What about pt care shortly after the removal? No bending, if in the groin, or lifting arm above head if in IJ? thanks in advance.
Which is normally preferred first Impella if that does not work or not effective next step Ekos?
I used to put these in all the time in my last cath lab. So many drip lines!
Very cool. I always thought it'd be cool to see it placed. Only ever dealt with them after the fact.
@@ICUAdvantage yeah it's an interesting procedure but a bit cumbersome, we would usually go 6f sheathx2 rt IJ and wire both PAs under floro then float ther catheters
how much this eqiupment and catether? is there this ekos in vietnam?
Love it. Thank you ,Eddie for this crucial sharing and reassuring you provide to we,nurses. Had 2 cases of such some time ago. Bookings came and patient came back with it. We self learnt ,scary/indeed overwhelming of patients care and safety.
How long do we wait before removal of the cath?
Glad you liked it Andrea. Yeah, with anything we do, having good training and then exprience helps to alleviate the stress and anxiety of dealing with stuff. Sorry to hear you had to go through that learning it on your own! Hopefully this will help in some way for some people.
Excellent job
Thank you!
What do you use to film your videos? I like the style.
Currently, I'm using Adobe Photoshop of the "blackboard" and screen cast from my computer to an iPad to do the writing. I'm actually testing switching things up a bit for some future changes I want to do, but for the next few medication videos, I'll be using Goodnotes on the iPad and directly screen recording there.
Thank you
I'm confused with your explanation. You stated that the ultrasonic wave does not mechanically break down the clot, but then a moment later you explained that the fibrin formation was loosened up due to the same waves. Am I misunderstanding?
No you are correct. The ultrasonic waves loosen the fibrin strands in mature clots so the clot isn't as tightly packed together. That said, it doesn't break the strands down. It just allows more passageway through the clot for the medication.
I guess my point is that a lot of people think the ultrasonic waves work to actually break down the clot. They do have that physical change in the clot, but don't play any role in the actual breakdown. I hope that makes sense!
Yassss!! Thank you so much!!
😊 Haha yup here ya go! You were the most recent request, but certainly been requested a bit. Hope you enjoyed it.
Have you ever been an ER nurse ?
Not directly no. I did respond to the ED for traumas but then returned back to ICU when over.