I'd just like to applaud you for doing such a great job with this channel. Your lessons are great, and as an Intensivist, I certainly would recommend this channel to any students or new graduates. There is a TON of great information on various conditions, treatment models and procedures for CC medicine. Great work!! I'd also like to give a thanks to all the nurses, techs and clerical staff on the CCU floor. You guys make the world turn. I'm proud to work with such professionals. Reason for edit: Spelling correction.
In my last semester of Nurse School. Instructor who taught ER/Crit Care was horrible. Barely passed her exam. Final exam soon. Thank you for this vid. Explains a lot!!! I want to work Critical Care when I graduate. No doubt about it, its what I want to do!!! Subscribed. Liked. I truly hope this helps other student who just aren't quite understanding this concept. Again, thank you and God Bless!!!
The way you explain these topics PLUS the structure/outline + color of the visuals makes it extremely helpful to learn + retain such complex content! I'm not even sure I'm going into ICU Nursing, but the information is just too good not to subscribe :D Thank you for all you do!!
Just had an art line with “whipping” effect last weekend overestimating systolic and underestimating diastolic with a very sharp peak to the waveforms. Thankfully the cardiologist was kind enough to explain what was happening when I called him and I looked it up later.
Fantastic lesson as always, I'm a junior medical ICU RN in Australia, having been in ICU since my 6 month Grad mark. I'm completing my university studies to be qualified, but found your lessons invaluable in my first semester of my degree. ESPECIALLY the CRRT ones. Thanks soooo much
Thank you once again for sharing your knowledge on this topic. A-line is indeed one of the staples in ICU and to know its fundamentals are really important. Great work!
Thanks for the great explanation and description. I am an RN who recently transferred to PACU and needed a crash course on arterial lines. Thanks for the info!
Thank you SO much. I can't say how much your channel is helping me. I just began working in a cardiology ICU , coming from a fairly different background with just a month to fit in it's vital to me having a good, simple and schematic refreshing of my quite dated notions (over '50 nurse here, heh). You are a real lifesaver to me, again I can't thank you enough. Really exceptional material. Grazie! From Italy 🙏🇮🇹
Thank you this has helped tremendously. I am in my last semester of nursing school and was having trouble with a lot of these topics. Now with Hurricane Ian, school closed, my moms house damaged, plus other things. Anyway, Your soothing calm voice and the simple way you explain some complex topics helps while scrambling to catch up on material. Thank you.
Oh man Lisa, it sure sounds like you've had a lot on your plate! Really happy to know that this video was helpful for you and helped to explain things in a way that made sense for you. Wishing you all the best!
I am a new grad in the ICU (almost one month) and we learned about Artic Sun for post-MI patients who are not following commands, I was wondering in the future if you could do a video on it. Thanks you and your videos are so amazingly good.
Congrats on the new position in the ICU. I tend to not cover specific equipment and do more conceptual stuff, but I did cover hypothermia protocol pretty extensively already. Here's the link here if you might find it helpful: th-cam.com/video/zIBflZRGHgs/w-d-xo.html
In my hospital, I find the docs and other providers are very, very adverse to placing these lines and will constantly try and dispute the need or defer it to the next provider. I understand there is a skill with placing these - as with anything. Whenever I see a provider who is proficient with placing them, they don’t seem that difficult clinically speaking to place. Even though I haven’t done them I feel like on a from a pure procedure standpoint they can’t be much more difficult than when I do a PICC line… I understand the risks, but they’re so, so beneficial.
Certainly a skill, but I agree that I don't think it is that difficult. Now, this is coming from someone who was never personally placed one. That said, at many facilities trained respiratory therapists and/or nurses can place them.
Outstanding like usual !. THANK YOU for the video... you get like before I see the video 😁.. can you please explain for me square wave test? Never understood it.. Thank you! Stay safe my friend
Hello, Eddie, I was an infantryman in the army back in 1989-1993. I've been a critical care RN for quite some time, and watching your videos is a great way to review. I purchased a TH-cam membership; however, I am unable to locate the lesson notes. I think I'll do the patreon membership and cancel the TH-cam.
Hey Robert! Sorry I missed this comment! It slipped passed at first. Very cool to run into another Infantryman! A little before my time, but definitely a brotherhood that lasts a lifetime. Not too many of us that ended up in this field, although I do know a few. As for the notes, TH-cam doesn't make it easy to find Membership content. You have to go to the "Community" tab to find the posts for members and thats where I have the link to the Dropbox and the password changes for each month. Patreon does make it easier to find everything. Please let me know if you are able to find it ok, otherwise, yeah certainly just move to Patreon and I think its a bit easier there! I really do appreciate your support!
Hey.. a great mentor .. thankw for improving our knowledge. I hve a request plz cover a video on job description /bascics of icu technologist/emergency technologist ..plz consider my request.☺️
I absolutely appreciate the time and dedication you invest in these lessons Eddie. I am very grateful for sharing your knowledge on these complex topics. Thank you again 💓.
There a links in the descriptions for the notes if that’s what your talking about. They are available to either TH-cam or Patreon members. I do also have a whole series on ECG but nothing on 12-lead yet.
Hey thank you for your amazing videos. I’m a bit confused though regarding the vessel compliance. As far as I understand the compliance is supposed to be inversely proportional to elasticity. What am missing in this basic physiological concept? Thanks.
Hi and welcome and thanks for your support with membership! If you go to the "Community" tab from the main ICU Advantage TH-cam page, you'll see the members only posts there. Look for the most recent video posted as that will have the link to the Dropbox as well as the current password.
At 10 min 12 sec of this video , you mentioned that, Regardless of what the SBP /DBP, MAP will remain relatively the same . I did not understand why you had to mention the statement. MAP will differ based on patients contractility status, patients blood vessel resistance etc., right?
I should have been more clear. What I meant was, if all other factors the same (same CO, HR, volume status, etc) if the only difference is how elastic the vessel is, you will see different SBP and DBP when comparing elastic and not, but the MAP will be the same even though the SBP/DBPs are different. Hope that makes sense.
There is a tiny little detail at the illustration in the intro. Branches originating from aortic arch should be presented posteriorly to the brachiocephalic vains also sublclavian vain is anatomicly anteriorly to sublclavian artery. But as always, love the content and can't write how much I appreciate your job. Once I become an ICU resident and start earning some money, I will definitely become a patron to repay at least a little bit.
I hate it when people say “more accurate” for arterial lines. As an experienced RN, I understand what you mean when you say that but a newer RN or an RN who is not familiar with arterial line will think that arterial lines are ALWAYS more accurate than a BP cuff which is simply untrue. And I think an important addition to your video about art lines would be close correlation between the arterial blood pressure and NIBP. If your BP cuff is reading a systolic BP of 170 and your art line is reading a systolic BP of 60, then you know that there is some troubleshooting needed.
I hear ya, but I tried to be very clear and repeatedly stated if it is properly working. This series is going to be 5 lessons long probably and I will be covering more info that has to do with being able to determine how well the line is functioning, as well as assessment and troubleshooting, which are all necessary in this equation.
@Tyrell Jackson I never said that he said that they’re “always” more accurate. I’m saying that an RN who is unfamiliar with arterial lines will think that arterial lines are always more accurate than BP cuffs because someone else says that they’re more accurate. An arterial line will only be as accurate as the RN’s ability to correctly interpret arterial waveforms, correctly identify abnormal waveforms, correctly trouble shoot the system, and correctly maintain a working arterial line system. So if you have an RN who doesn’t know anything about arterial lines, who isn’t able to identify if the arterial waveforms are adequate or not, who isn’t able to tell when they need to troubleshoot the system, then indeed, you may have an inaccurate arterial BP reading. So we cannot conclude that arterial lines are “more” accurate. I will also add, the accuracy of arterial BP readings and their waveforms become significantly decreased after X amount of days. So we can’t say that arterial lines are “more” accurate. However, we can say that when a fairly new arterial line has adequate waveforms, the NS bag is adequately pressurized, the transducer is appropriate leveled and zeroed, and the patient is not moving their arm drastically, then yes, the arterial BP reading can be more accurate that the BP cuff.
here’s the thing though - only certain units accept art lines so if you’re an RN working in a specialty area that uses them, you are responsible for learning how they function/how to ensure accuracy. this education really doesn’t apply to nurses who don’t take patients with art lines (ie most med surg nurses). so it’s really not misleading
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ICU is intense (no pun intended) your lessons help me study on my days off and come back with a better understanding each shift
I'd just like to applaud you for doing such a great job with this channel. Your lessons are great, and as an Intensivist, I certainly would recommend this channel to any students or new graduates. There is a TON of great information on various conditions, treatment models and procedures for CC medicine. Great work!! I'd also like to give a thanks to all the nurses, techs and clerical staff on the CCU floor. You guys make the world turn. I'm proud to work with such professionals.
Reason for edit: Spelling correction.
Just started in SICU as a new grad and your videos have been guiding me through this journey. Thank you for being so clear!!!
In my last semester of Nurse School. Instructor who taught ER/Crit Care was horrible. Barely passed her exam. Final exam soon. Thank you for this vid. Explains a lot!!! I want to work Critical Care when I graduate. No doubt about it, its what I want to do!!! Subscribed. Liked. I truly hope this helps other student who just aren't quite understanding this concept. Again, thank you and God Bless!!!
Thank you! I’m new to anesthesia where I work as a technician in a training hospital. My IVs are right on. I started A Lines today. Pray for me 😂
Just started my intensive angio training. How are you getting on now?
@@goodyeoman4534 excellent! Love what I do.
Great information for a new ICU RN! Thank you
Welcome to the ICU! Glad you liked it
Lecture starts at 2:00
The way you explain these topics PLUS the structure/outline + color of the visuals makes it extremely helpful to learn + retain such complex content! I'm not even sure I'm going into ICU Nursing, but the information is just too good not to subscribe :D Thank you for all you do!!
Thank you for that Vanessa! Glad you liked it!
Just had an art line with “whipping” effect last weekend overestimating systolic and underestimating diastolic with a very sharp peak to the waveforms. Thankfully the cardiologist was kind enough to explain what was happening when I called him and I looked it up later.
Fantastic lesson as always, I'm a junior medical ICU RN in Australia, having been in ICU since my 6 month Grad mark. I'm completing my university studies to be qualified, but found your lessons invaluable in my first semester of my degree. ESPECIALLY the CRRT ones. Thanks soooo much
Floypiiiiypooo oo
Thank you once again for sharing your knowledge on this topic. A-line is indeed one of the staples in ICU and to know its fundamentals are really important. Great work!
Thank you. I'm excited for this series. Going to cover a lot of good info.
@@ICUAdvantage Wow! I’m sure a lot of us will be looking forward to this. All the best to you and your team!
Pediatric CVICU nurse here! Can’t wait for the next lesson :)
Thanks for the great explanation and description. I am an RN who recently transferred to PACU and needed a crash course on arterial lines. Thanks for the info!
ICU Advantage crawled so confident care academy could run. Eddie for president
Thanks Ron!
Thank you for this videoI learned so much more than I did in class and your way of explaining this topic really helped things click for me.
Yay! So glad to hear this and happy that it spoke to you!
Great overview of A-lines. Thank you.
Yes, I've had one before in my right arm but I didn't feel it. The area where it was put in at was numbed very well
Thank you SO much. I can't say how much your channel is helping me. I just began working in a cardiology ICU , coming from a fairly different background with just a month to fit in it's vital to me having a good, simple and schematic refreshing of my quite dated notions (over '50 nurse here, heh).
You are a real lifesaver to me, again I can't thank you enough. Really exceptional material. Grazie! From Italy 🙏🇮🇹
Thank you so much for the great comment! I really appreciate the kind words!
Thank you this has helped tremendously. I am in my last semester of nursing school and was having trouble with a lot of these topics. Now with Hurricane Ian, school closed, my moms house damaged, plus other things. Anyway, Your soothing calm voice and the simple way you explain some complex topics helps while scrambling to catch up on material. Thank you.
Oh man Lisa, it sure sounds like you've had a lot on your plate! Really happy to know that this video was helpful for you and helped to explain things in a way that made sense for you. Wishing you all the best!
Please consider making videos on the following topics as well:
i. Antibiotics and sepsis
ii. Blood and products
I do have a series on Blood as well as a lesson on Septic Shock. Antibiotics are on the todo list.
I am a new grad in the ICU (almost one month) and we learned about Artic Sun for post-MI patients who are not following commands, I was wondering in the future if you could do a video on it. Thanks you and your videos are so amazingly good.
Congrats on the new position in the ICU. I tend to not cover specific equipment and do more conceptual stuff, but I did cover hypothermia protocol pretty extensively already. Here's the link here if you might find it helpful: th-cam.com/video/zIBflZRGHgs/w-d-xo.html
@@ICUAdvantage sweet! I think that would be most helpful. Thank you!!!
Great Eddie!!! I'm moving on in my internship and Art line is the next topic.
thanks for this video. new grad started in icu 5 mos ago. very clarifying and easy to understand.
Awesome! Congrats on the new position Olga! Glad you liked it.
Thanks for this! Do you have any videos about types of acute MI’s or treatment of STEMI’s?
Nothing yet
So very helpful! Thanks for your educational video...Nick, Australia
Awesome. Thats honestly what I hope these videos are for people. Glad you liked it Nick!
Why would someone dislike this? Let alone two someones?? This is amazing info!
2 idiots that wished knew this much but don’t
Idiots who think there’s a difference between hypertension and high blood pressure
@dinamap
Lol I meant a dinamap would. Ha. Cheesy I know I’m sorry. This vid was awesome.
Thanks so much! Super informative!
I'm applying for nursing programs soon and appreciate the jumpstart!
Best of luck on your nursing journey!
Thank you so much. A definite good lesson and refresher training for us all.
You are very welcome Andrea. Glad you liked it! :)
In my hospital, I find the docs and other providers are very, very adverse to placing these lines and will constantly try and dispute the need or defer it to the next provider. I understand there is a skill with placing these - as with anything. Whenever I see a provider who is proficient with placing them, they don’t seem that difficult clinically speaking to place. Even though I haven’t done them I feel like on a from a pure procedure standpoint they can’t be much more difficult than when I do a PICC line… I understand the risks, but they’re so, so beneficial.
Certainly a skill, but I agree that I don't think it is that difficult. Now, this is coming from someone who was never personally placed one. That said, at many facilities trained respiratory therapists and/or nurses can place them.
THIS CHANNEL IS AMAZING !!
You do a great job man 🙏🏻
Thank you so much 👍 Apprecitre that.
Thank you for this video! Do you have videos on IABPs and impellas?
Not yet but soon hopefully!
IABP video would be great!
❤❤❤ this really helps. Thanks so much!
Can't wait for the next lesson😊
I'm excited for it too :)
Howdy, thanks for making this video. I have a question about the Aline. Can you explain the role of an Aline during a code or ROSC. Thanks
If there’s rosc then you have a positive wave form, because you’ll get a pulse pressure
Outstanding like usual !. THANK YOU for the video... you get like before I see the video 😁.. can you please explain for me square wave test? Never understood it.. Thank you! Stay safe my friend
Thank you thank you! And YES, keep an eye out for the next lesson in this series... it should help with your inquiry! :)
@@ICUAdvantage Thank you 😘😘😘😘😘
Great and hope you can make a video talking about Picco
I've had this request and have it on the todo list. I'll have to learn more about it though as I've never used it.
Hello, Eddie,
I was an infantryman in the army back in 1989-1993. I've been a critical care RN for quite some time, and watching your videos is a great way to review. I purchased a TH-cam membership; however, I am unable to locate the lesson notes. I think I'll do the patreon membership and cancel the TH-cam.
Hey Robert! Sorry I missed this comment! It slipped passed at first. Very cool to run into another Infantryman! A little before my time, but definitely a brotherhood that lasts a lifetime. Not too many of us that ended up in this field, although I do know a few.
As for the notes, TH-cam doesn't make it easy to find Membership content. You have to go to the "Community" tab to find the posts for members and thats where I have the link to the Dropbox and the password changes for each month. Patreon does make it easier to find everything.
Please let me know if you are able to find it ok, otherwise, yeah certainly just move to Patreon and I think its a bit easier there! I really do appreciate your support!
Great channel, Awesome content
Thank you!
Hi Eddie! Do you have any videos on how the pulse ox works and Beer Lambert law?
So sorry, but I do not.
Hey.. a great mentor .. thankw for improving our knowledge. I hve a request plz cover a video on job description /bascics of icu technologist/emergency technologist ..plz consider my request.☺️
Thank you very much from Germany
Very cool! YOu're welcome
Amazing!!!
I absolutely appreciate the time and dedication you invest in these lessons Eddie. I am very grateful for sharing your knowledge on these complex topics. Thank you again 💓.
Hey....have you made any video on pediatric atls guideline?
Unfortunately I have no experience with peds and don't cover those topics on this channel. So sorry.
Just joined and not being able to retrieve the notes. How long does it take for membership to kick in. Thank you
Just a heads up that I responded to you on the community post
You are the best ♡
Thank you!
Thank you for the good videos, where can I get transcripts of the content? Also, can you post something on ECG reading and 12 leads?
There a links in the descriptions for the notes if that’s what your talking about. They are available to either TH-cam or Patreon members. I do also have a whole series on ECG but nothing on 12-lead yet.
@@ICUAdvantage I went over the ECG, thank you for the hard work and great explanation
@@xindin265 My pleasure!
Sir would you please recommend me a best and easy book for icu and emergency care
Very informative...
How can i get the notes..
Any link
Hey thank you for your amazing videos.
I’m a bit confused though regarding the vessel compliance. As far as I understand the compliance is supposed to be inversely proportional to elasticity. What am missing in this basic physiological concept? Thanks.
Thanks eddie
You're welcome Tony!
how much days art line should stay in the patient
I know how busy you've been but can you update on covid treatments as are done now. Please.
Honestly, we are kind of doing the same stuff as early on which I mostly covered already. There hasn't really been anything significantly different :|
Hi. I am member, how can I access the notes?
Hi and welcome and thanks for your support with membership!
If you go to the "Community" tab from the main ICU Advantage TH-cam page, you'll see the members only posts there. Look for the most recent video posted as that will have the link to the Dropbox as well as the current password.
@@ICUAdvantage Thank you 😊
At 10 min 12 sec of this video , you mentioned that, Regardless of what the SBP /DBP, MAP will remain relatively the same . I did not understand why you had to mention the statement. MAP will differ based on patients contractility status, patients blood vessel resistance etc., right?
I should have been more clear. What I meant was, if all other factors the same (same CO, HR, volume status, etc) if the only difference is how elastic the vessel is, you will see different SBP and DBP when comparing elastic and not, but the MAP will be the same even though the SBP/DBPs are different. Hope that makes sense.
Can inserting an A line lead to nerve damage in the wrist?
I’d image if inserted incorrectly or if multiple attempts were made.
Yes it can. It's not a common complication, but it is possible.
There is a tiny little detail at the illustration in the intro. Branches originating from aortic arch should be presented posteriorly to the brachiocephalic vains also sublclavian vain is anatomicly anteriorly to sublclavian artery.
But as always, love the content and can't write how much I appreciate your job.
Once I become an ICU resident and start earning some money, I will definitely become a patron to repay at least a little bit.
What’s the chances of infection?
So a art line is not a sheath?
An A-line is mandatory if we are trying to provide proper high quality patient care.
Depending on the situation, but I don't disagree
I hate it when people say “more accurate” for arterial lines. As an experienced RN, I understand what you mean when you say that but a newer RN or an RN who is not familiar with arterial line will think that arterial lines are ALWAYS more accurate than a BP cuff which is simply untrue. And I think an important addition to your video about art lines would be close correlation between the arterial blood pressure and NIBP. If your BP cuff is reading a systolic BP of 170 and your art line is reading a systolic BP of 60, then you know that there is some troubleshooting needed.
I hear ya, but I tried to be very clear and repeatedly stated if it is properly working. This series is going to be 5 lessons long probably and I will be covering more info that has to do with being able to determine how well the line is functioning, as well as assessment and troubleshooting, which are all necessary in this equation.
@Tyrell Jackson I never said that he said that they’re “always” more accurate. I’m saying that an RN who is unfamiliar with arterial lines will think that arterial lines are always more accurate than BP cuffs because someone else says that they’re more accurate. An arterial line will only be as accurate as the RN’s ability to correctly interpret arterial waveforms, correctly identify abnormal waveforms, correctly trouble shoot the system, and correctly maintain a working arterial line system. So if you have an RN who doesn’t know anything about arterial lines, who isn’t able to identify if the arterial waveforms are adequate or not, who isn’t able to tell when they need to troubleshoot the system, then indeed, you may have an inaccurate arterial BP reading. So we cannot conclude that arterial lines are “more” accurate. I will also add, the accuracy of arterial BP readings and their waveforms become significantly decreased after X amount of days. So we can’t say that arterial lines are “more” accurate. However, we can say that when a fairly new arterial line has adequate waveforms, the NS bag is adequately pressurized, the transducer is appropriate leveled and zeroed, and the patient is not moving their arm drastically, then yes, the arterial BP reading can be more accurate that the BP cuff.
here’s the thing though - only certain units accept art lines so if you’re an RN working in a specialty area that uses them, you are responsible for learning how they function/how to ensure accuracy. this education really doesn’t apply to nurses who don’t take patients with art lines (ie most med surg nurses). so it’s really not misleading
Hopefully there aren't any RNs in ICU who don't know that, lol
It is more accurate though. The goal is to have the Maps match up.
Lol “don’t be that person” - Eddie, 2021 👍
Hi
Hello!
Your narration is too fast...