Did you know that Platte Valley Medical Center’s ICU provides the same level of care (in most cases) that you would receive in a large Metro ICU  (with the exception of Trauma, open heart and brain surgery)?  Most of you have heard about some of the new procedures we have been doing in the cath lab.  Well that means that the ICU staff cares for those patients after the cath lab staff completes the procedure.

Over the past three years we have seen a tremendous increase in the numbers and types of procedures that we are doing in the cath lab.  We have purchased Electro-Physiology equipment and now do AV node ablations.  AV node ablations are used to treat rapid irregular heartbeats, AV Node Ablation is a procedure by which the heart’s AV node (Atrioventricular node, the electrical pathway that connects the top chambers to the bottom chambers of the heart) is modified to restore normal heart rhythms. This procedure involves cauterizing or freezing the AV node to block or alter electrical conduction through this region of the heart. During a typical AV node ablation, a permanent pacemaker is implanted in the chest to mechanically regulate the pulse rate in the lower chambers of the heart (ventricles) to match the natural pulse rate in the upper chambers of the heart (atria).

Michele Siem and Nathan Border hold a sample of the Cath Lab’s new balloon pump.

We also have been opening more complex coronary lesions.  At times when patients are either having a heart attack or when we attempt to open several complex lesions the heart muscle needs some assistance in order to pump blood more effectively to the rest of the body.  Sometimes when that happens we assist the heart by placing a balloon pump in the patient.  A balloon pump is placed in the patient’s aorta and inflates and deflates with each heartbeat.  This helps to push blood to the coronary arteries and the rest of the body and also decreases the pressure the heart needs to pump against.  Caring for patients on the balloon pump requires the nurse to constantly monitor the patient to determine how the patient is tolerating the process.  Recently, we had a patient with a balloon pump in ICU who was awaiting transfer to a facility that does open heart surgery.  Nathan Border was able to care for that patient with the assistance of staff from the cath lab.  Nathan received a special heart shaped pin to commemorate his caring for this more complex patient.

Other types of complex patients that are cared for in the ICU include very sick patients on the ventilator.  Some of these patients require turning them on to their stomach to improve the blood flow to certain parts of their lungs.  This requires a team effort.  These patients have tubes into their tracheas that are connected to the ventilator, which is sustaining their breathing. They often have several IV’s with critical medicines flowing through them.  It usually requires five of our staff to help turn.  One person (usually a Respiratory Therapist) manages the Endotracheal tube with two nursing staff on each side to help turn the patient.  In most cases when we have turned patients we notice a dramatic improvement in their respiratory function.

The doctors and nurses that care for critical care patients at Platte Valley provide excellent care.  We have critical care specialists from St Anthony’s that come out to see our patients twice a week and provide phone rounds daily.  The physicians from St Anthony’s frequently comment on how great the care is here.  One of the best things you can do for patients on ventilators is to get them up and move them (if their condition tolerates it).  We are very privileged to have a wonderful Physical Medicine Department that comes to the ICU and works with the nurses there to help get our patients moving.  Did you know that we have had patients up in a chair at the side of their bed while they were on the ventilator?  We have even had patient that were able to get out of bed and walk beside the bed while they were still on the ventilator.  That is Evidence-Based Patient Care at its best.

Please do not think that because we are small we provide any less care.  Often the care is as good (or better) than you would receive at a larger Metro facility.  And while I may be a little biased, I feel we also add the element of not only providing care for you we also care about you.

Happy Critical Care Month!!!

Michele Siem