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CT Assist Blog

Everyone is Watching: Why you should learn to become a clinician leader

Posted by Liza Szelkowski, PA-C on Oct 2, 2018 8:47:00 AM

I’m not the chief. It’s not my problem. No one cares what I think, or how I act. We have likely all heard or thought these words a million times. I can’t say that I haven’t thought them myself. I’ve written about the importance of functioning as a team in the past, and a large part of that comes from each member looking out, not only for him or herself, but for the team as a whole.

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Topics: CT Surgery

Broken Heart Syndrome: A brief overview of Takotsubo cardiomyopathy

Posted by Liza Szelkowski, PA-C on Jan 24, 2018 10:32:00 AM

In my years practicing as a cardiac surgery PA, I have only come across two patients with Takotsubo cardiomyopathy (TTC).  Perhaps large teaching centers have higher volumes of this type of patient.  When I came across my most recent patient, I was reminded that it is a fascinating, if not terrifying, disease process.  Here is a brief review of the epidemiology, causes and clinical presentation, and outcomes after diagnosis.  I have also included a few articles I found useful or reference.

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Topics: Cardiac Surgery, CT Surgery

ACLS Guidelines for Cardiac Surgery Patients: Is it time for a change?

Posted by Liza Szelkowski, PA-C on Feb 27, 2017 9:34:00 AM

 Any mid-level practitioner who is responsible for running codes in the postoperative cardiac surgery population knows that there are a lot of moving parts in these scenarios. There are a lot of people to keep track of, and a lot of jobs to do in a short amount of time. Practice and experience keep mistakes to a minimum which, hopefully, produces a positive outcome. Unfortunately, I have been in several code situations where, even though we did everything right, there was still a less than favorable outcome. What I'm referring to are situations where ACLS guidelines have been applied, but have failed. For example, you pushed a milligram of epinephrine in a code, and your patient’s blood pressure went to three hundred mmHg, requiring a return to the operating room for bleeding. Perhaps your staff was doing appropriate CPR, hard and fast just like they teach it, and a saphenous vein graft was ripped off the heart, or an aortic suture line ruptured. I've even seen CPR cause a patient’s sternum to cut into his ventricle and cause catastrophic bleeding.

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Topics: CT Surgery, Cardiac Surgery, acls

Transitioning a Patient to Step Down Status: Using a SOAP note format to guide decision making - CT surgery

Posted by Liza Szelkowski, PA-C on Feb 2, 2017 12:06:00 PM

 Your patient has made it out of the operating room, and you have succeeded in stabilizing him or her. Perhaps you were able to wean the patient from the ventilator quickly, or maybe the patient was in cardiogenic shock for weeks. Regardless of how the journey started the sign out is that your patient is now ready to transition to step down status, and it's your job to determine if he or she is ready.

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Topics: CT Surgery, Cardiac Surgery

Preservation of the Adventitia of the Greater Saphenous Vein during Endoscopic Vein Harvest

Posted by Liza Szelkowski, PA-C on Nov 24, 2016 11:04:00 AM

History

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Topics: Cardiac PA, CT Surgery