Transcript IMC/Telemetry

You Are Now Entering The
IMC/Tele
UNIT
What is an IMC unit?
INTERMEDIATE CARE UNIT
Designed to provide care for those who
need less monitoring than those in the
Intensive Care units, but, still require
more monitoring than those on a
regular medical or surgical units.
What is a TELEMETRY unit?
Provides for continuous
electronic monitoring. Patients
are not necessarily in a critical
state but do have a cardiac
history.
THE IMC/TELEMETRY TEAM
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Nurses
Nurse Manager
CNA’s
Telemetry monitor Techs
Doctors (Internal Med,
Cardiologists,
Electrophysiologists,
Endocrinologists, etc.)
• RT, OT, PT, ST,
Radiology Techs, etc.
Where do the patients come from?
• ER
• ICU
• OR
• Med/Surg floor
Nurse/Patient ratio
1:3 to 1:5
Most Common Conditions
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GI bleeds
Arrhythmias
MI’s
Respiratory
distress
• Angina Pectoris
• Infections
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CHF
Pancreatitis
Pneumonia
Post Surgery
Acute Renal
Failure
Now What?
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Patient is admitted
EKG monitor put on
Equipment placed in room
Treatment occurs
– Tests, procedures,
medication
• Time on unit – 1 day to one
month (average of 4 days)
Common
Equipment
• Heart monitors
– electrodes
• Suction
canisters
• VS machine
Common
Equipment
• EKG monitor
screen
• Oxygen hook up
– Nasal cannula,
masks
• IV pumps and
poles
LABS
Focusing on cardiac labs
Cardiac Markers
• Measured to evaluate heart function. They are often discussed
in the context of MI’s, but other conditions can lead to an
elevation in cardiac marker level.
• Elevation usually means there has been heart damage
• Cardiac Enzymes
– Troponin
– CK
– CK-MB
CODE BLUE
http://www.youtube.com/watch?v=4EWlNpKrCuc
What does an EKG tell you?
It shows you the electrical
activity of the heart.
Ok NOW How do I read it?
I am glad you asked!!!!
• P wave – tells you when the atrium is
contracting
• QRS complex - the contraction of the
ventricles
• T wave – the relaxation of the ventricles
Ok NOW How do I read it?
• Strips are printed in 6 sec. strips.
• To calculate rate - you count the number
of beats per strip if rhythm is regular.
• Measure each component of each heart
beat to determine if it is normal or
abnormal.
Measurements ofHEach Component
ECG Component
Time(sec)
Small square
0.04
Large square
0.20
P Wave
0.10
PR Interval
0.12 - 0.20
QRS
0.04-0.08
EKG Rhythm Examples
This is Normal Sinus Rhythm.
ALL parts of the beat are present.
Everything is working as it should and the
rate is WNL.
EKG Rhythm Examples
This is Sinus Bradycardia.
ALL parts of the beat are present.
The rate however is < 60 bpm.
EKG Rhythm Examples
This is Sinus Tachycardia.
ALL parts of the beat are present.
The rate however is > 100 bpm.
EKG Rhythm Examples
This is Sinus Rhythm with Premature Ventricular
Contractions (PVC’s).
ALL parts of the beat are present.
However, the ventricle occasionally beats early.
EKG Rhythm Examples
This is Atrial Fibrillation.
No definable P or T waves.
Irregular rhythm and rate usually 100-160 bpm.
Atrium is beating about 200-300 bpm
EKG Rhythm Examples
This is 1st Degree Heart Block.
P waves are longer than one block (0.10 sec).
EKG Rhythm Examples
This is 3rd Degree Heart Block (Complete HB).
P waves are consistent BUT NO message being
sent to the ventricles.
Slow rate (ventricle rate)
What’s Next?
•Transfer to
another floor
•ICU
•Discharge
NOW IT IS YOUR
TURN TO
PRACTICE!!!!