❤ 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 KZbin and Patreon members. Links to join both here ⬇ ► KZbin: adv.icu/ym | ► Patreon: adv.icu/pm
@JuanHernandez-ut9ge2 жыл бұрын
I absolutely love your videos!!! I'm a new grad in the ICU and your videos are very informative!!! I do have a request, is it possible to make a video on proper trach care, the different sizes/types, and what to do if it comes out please?
@skidy12 Жыл бұрын
New critical Care Paramedic, appreciate your videos! Especially this series!
@surayawh77302 жыл бұрын
I JUST started as a fresh grad RN in the ICU, and safe to say it's been quite challenging adjusting to the RN lifestyle, much less an ICU RN. But your videos have given me such a confidence boost knowing that I'm learning new info for my practice, instead of waiting around to encounter something totally new that would otherwise have me in a confused panic hahaha. Much appreciated and love to see your videos!
@ICUAdvantage2 жыл бұрын
So cool! Yeah the hope is to provide the info in a way that makes sense and hopefully help in your understanding when you do encounter something again. Glad you find them helpful!
@mohammadkhalil6522 жыл бұрын
Good lecture and good lecturer
@ICUAdvantage2 жыл бұрын
Thanks Mohammad!
@divinedimacali18802 жыл бұрын
Thank you for this very informative review. You provided me with a very quick review of the medication. More power to you.
@ICUAdvantage2 жыл бұрын
You're very welcome!
@evomusic1720 Жыл бұрын
ER nurse. This is so helpful as a new grad.
@ICUAdvantage Жыл бұрын
Awesome and congrats on the new ED gig!
@cinimatics Жыл бұрын
We use this all the time in the cath lab, great video!
@ICUAdvantage Жыл бұрын
Oh yes! Thank you!
@sophienelson68732 жыл бұрын
Love these videos! Thank you for such great content!
@ICUAdvantage2 жыл бұрын
So glad to hear you love them Sophie and that they are helpful
@munganiayvonne35482 жыл бұрын
Great icu teacher... You are the best... Mwalimu Asante Sana 🇰🇪🇰🇪❤️❤️
@ICUAdvantage2 жыл бұрын
Thank you!
@wmp93912 жыл бұрын
Keep it up bubba! I appreciate your time to making such good info to review
@ICUAdvantage2 жыл бұрын
Thanks! Will do and glad you enjoyed it!
@_peanutttbuttercupcakes_36952 жыл бұрын
Thank you for this! Very comprehensive.
@ICUAdvantage2 жыл бұрын
Glad it was helpful!
@tatendafambi98192 жыл бұрын
Yeeees im the first one here. Thank you so much for all these videos!! Sooo helpful!!!
@ICUAdvantage2 жыл бұрын
Nice! And you are very welcome. Thanks for your support!
@dsfnful2 жыл бұрын
Thank you for this video! Can you do a video next on TPA administration in stroke patients?
@ICUAdvantage2 жыл бұрын
I do have a video already talking about TPA, but more just as a med review.
@dsfnful2 жыл бұрын
@@ICUAdvantage I am starting a job soon in the neuro intensive care unit so your videos are super helpful. Thanks alot!
@NS-kj7dt Жыл бұрын
Thank you🙏
@yadirasorcini44622 жыл бұрын
Thank you! You do an amazing job!!!
@ICUAdvantage2 жыл бұрын
Thank you. I appreciate that!
@Illusion666 Жыл бұрын
I thought the one inaccuracy would be that renal function does NOT matter and it is the anticoagulation of choice in patients with super low renal function?
@markmaeder43342 жыл бұрын
Need a video for EVD/Camino’s!
@ICUAdvantage2 жыл бұрын
Yes! I do have both EVD and covering ICPs as topics on the todo list. Hopefully sooner than later. Probably won't specifically cover the Camino or Bolt devices themselves, but the ICP concepts around it.
@dalaisand54532 жыл бұрын
You are amazing 🤩 so smart.
@sherribugd37992 жыл бұрын
What is the advantage to ordering an Anti-Xa as opposed to an APTT? Thanks.
@mamadelosgatos262 жыл бұрын
Heparins act a little bit on factor X and Xa and acts a lot on thrombin in the clotting cascade. APTT checks multiple clotting factors and has a wider margin. Anti Xa has a very tight "heparin specific" margin. Since most of the action happens on thrombin, if the anti Xa level is monitored during heparin infusion, it's more reliable and accurate to measure small differences in tenths of a unit, rather than a range of 30-40 whole seconds. Compare to measuring 3cc medication in a 20cc syringe versus a 5cc syringe. Somehow that's what helped make it make sense in my head.
@ICUAdvantage2 жыл бұрын
Mamadelosgatos answered pretty well! Just to expand on it, aPTT is pretty unspecific general evaluation of the intrinsic and common pathways of the clotting cascade. That said, these pathways are also influenced by many other factors besides just the effect of heparin, including various biological mechanisms that could be going on, especially in the critically ill. Anti-Xa is more specific to the effects of Heparin on this clotting as Factor Xa is bound by the antithrombin-heparin complex, preventing its availability in the clotting cascade. Studies have shown that using anti-Xa to monitor Heparin infusions leads to shorter times to therapeutic levels and reduces the number of dosing adjustments that are needed. TLDR Anti-Xa is more specific for heparin and quicker to achieve therapeutic goals.
@davidmixer53202 жыл бұрын
Awesome, thanks much~!
@ICUAdvantage2 жыл бұрын
You're welcome David!
@adamae3980 Жыл бұрын
This might be a silly question but what exactly is a "Unit?" How do units compare to a mcg/mg/g and why is "unit" used over mg/g?
@sushmarai4382 жыл бұрын
36th like by me Love from nepal The way u explain amazing 💖
@ICUAdvantage2 жыл бұрын
Woohoo!! Thank you Sushma. How cool.
@mariali6491 Жыл бұрын
How do we compute is it's a continous drip?
@Nadia-yo8lt2 жыл бұрын
Good review, thank you. How would i, as a nurse, see HIT present itself clinically though? If bleeding is rare
@ICUAdvantage2 жыл бұрын
Good question Nadia. Typically what drives our suspecting HIT is a drop in platelets for someone on heparin, and typically this is without a drop in Hgb/Hct. I haven't personally seen it, but we can see rashes at injection site, redness and swelling in extremities, and new clot formation or enlargement due to the hypercoagulable state. That said, every time I've seen it, the suspicion started with dropping platelets.
@Nadia-yo8lt2 жыл бұрын
@@ICUAdvantage Thank you very much for your response and great content :)
@ICUAdvantage2 жыл бұрын
Truly my pleasure 😊
@BriBorgersen2 жыл бұрын
What I am trying to figure out is the difference between iv pushing heparin and subcutaneous. On the vial it states IV or SQ use, not hep lock. So how does either effect the body differently?
@ICUAdvantage2 жыл бұрын
Slower absorption SQ. Smaller dose, but can be slow absorbed into system circulation over time. This is why we can use this as DVT prophylaxis but not doing that as single IV push.
@janmotesicky78132 жыл бұрын
Hi. Thank you for great lectures. What is your target anti-Xa level?
@ICUAdvantage2 жыл бұрын
Glad you enjoyed it! Anti-Xa goal is 0.3-0.7 IU/ml
@Amanda.c912 жыл бұрын
so when im starting heparin, I say to the pt, "this is to prevent any other clots from forming! :) " and he says, "well what about the one I already have?" im like errrrrr welp we shall find out together soon lol but then I never find out 😂 they dont stick around in the ER that long. Some clots stay with the pt for life though, hmm?
@ICUAdvantage2 жыл бұрын
Good question! So the body will naturally break down clots over time. Large, mature clots may take a long time, or need either removal (surgical or Cath) or through thrombolysis (think TPA). Giving heparin to those with clots already, such as PE, helps to prevent formation of new clots AND also helps to prevent further enlargement of the clot already present.