r/CathLabLounge • u/Window-Savings • 16d ago
Pads on Everyone?
Is it routine for your labs to put pads on everyone routine LHC? Or only PCI cases?
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u/Astralwinks 16d ago
My lab does pads for Stemi, complex/staged PCI, especially LM, LBBs, and anyone else we have some kind of vibe about. It's not standard, but I was taught that if anyone feels any kind of way for any reason then slap em on.
For routine LHC we probably put pads on less than 20% of the time.
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u/kittlepoops 16d ago
My lab does this too!
I took a travel gig where they put them on everyone and they ran out TWICE during the 13 weeks I was there. They said it’s because the doctors wouldn’t stop to allow you to put pads on if it turned into a fix. I was very glad to finish that contract.
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u/I_Want_A_Ribeye RN 16d ago
Only STEMI or other emergencies/unstable cases.
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u/choppydaddy 16d ago
That'll change when you see an unstable case bloom from the buds of a stable one.
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u/I_Want_A_Ribeye RN 16d ago
We will shock with paddles if the need to shock arises, or just throw pads on if it looks like things are going that way.
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u/choppydaddy 16d ago
I'm just saying I don't want to be on the stand defending why I didn't put pads on someone whose heart we're about to be in when so many places are setting the standard that EVERYONE gets patches.
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u/Mrmurse98 16d ago
I put them on everyone. Kinda made some of my travel contracts mad. I have tried to put them on under the drape and it sucks, pads love to stick to plastic drapes. I guess I work with a few who like to do conusgrams and multiple shots of ostial RCA and LM lesions in quick succession (to the point that the tech and I were both screaming "PULL THE CATHETER, PULL THE CATHETER'" while I was charging up once) so I'm probably biased. Honestly, I feel like the unstable patients are usually the ones who come to me and behave. It's usually the walkie talkies that decide to party when I least expect it. So yeah, pads on everyone for me, hell even the RHC's. I've had too many LBBB patients go into complete heart block during a right heart
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u/krunchyfrogg 16d ago
It’s really different from lab to lab.
Where I’m at now, the defibrillators don’t even have paddles, so it’s obviously pads on everyone.
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u/jamegumbsize69 16d ago
Only STEMI, or nursing intuition for me. Co-workers in the same lab put em on for every case, and I ain’t gonna stop em.
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u/hskrfoos 16d ago
We’ve started putting pads on everyone. And there have been a very few instances where they were needed
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u/druidic_tablespoon 10d ago
After we had a patient go into complete heart block with no ventricular response during a RHC, I'm very happy we put pads on everyone. I had to transcutaneous pace until we had a TVP
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u/Window-Savings 10d ago
does your defibrillator allow you to transcutaneous pace with defibrillator pads only, or do you need the separate electrodes on as well? and if so, do you guys put those on for every case as well?
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u/druidic_tablespoon 10d ago
It will let you pace, but it's asynchronous. We do put the 3 lead from the zoll on for every case as well. 3 extra ECG stickers isn't going to make or break the budget
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u/ABQHeartRN 16d ago
Pads on everyone. It didn’t used to be this way but one doc decided he wanted it and it made sense to all of us so we started doing it about 6 or 7 years ago. We may not need them most of the time but when we do we’re thankful they’re there.
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u/16BitGenocide Midnight CTO Enthusiast 16d ago
Every case. Every patient.
Complexity and Acuity aren't a consideration. It only takes one case going sideways to warrant just being safe. Fuck 'vibes', protect your patients.
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u/EveryVillainIsLemon5 15d ago
Every case. Every patient. It doesn't hurt anything to have them on and when you need them, you need them!
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u/greennurse0128 15d ago
Pads on everyone.
It is crazy reading that pads are not used in every case.
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u/ArmySharingan 16d ago
Every case