Setup

A. The following pictures capture the standard setups in accordance with standard procedures. These are taught in the student Setup Lecture. It is MANDATORY that Cardiac CRNA’s utilize this scheme.

B. The reason for this is so that in the event of an emergency, CRNA Team members moving between OR’s will not have to spend time orienting or locating critical drugs or equipment. Strict adherence to this standard procedure has direct impact on patient outcome in the event of an emergency situation.

Irrespective of the dose to be used, always use the size of syringe identified for each drug, to provide a clear visual cue as to which syringe is which, in addition to labeling.

WHAT YOU WILL NEED:

60 ml syringe Heparin (1000U/ml)
20 ml syringe Propofol (do not draw until induction)
10 ml syringe Rocuronium (100mg/10 ml)
10 ml syringe Ephedrine (5mg/ml)
10 ml syringe Epi (4mcg/ml from 1mg/250 ml bag)
10 ml syringe Fentanyl (250-500 mcg)
10 ml syringe TXA (1000mg/10 ml)
Pre-mixed 10 ml syringe Neosynephrine (100mcg/ml)
5 ml syringe Versed (1mg/ml)
5 ml syringe Lidocaine (100mg/5 ml)

500 ml NS bag (add 1000mg of TXA) with pump tubing plus train plus 3” extension stopcock
NTG pre-mixed bottle with micro-drip and dial flow
Pre-mixed Precedex bag (400mcg/100ml NS)

If EF <25, add to pumps:
- Pre-mixed Epi (4mg/250 NS)
- Milrinone (20 mg/100 ml)
Airway Set up: ETT 8.0, stylet, 10 ml syringe, McGrath 3 or 4 blade, white silk narrow tape, clear tape or 2 tegaderms, small pack od lubricant

Miscellaneous Items

Clear eyeguard and later towel over patient face
Isolate 1000ml with blood set and short extension
Temp probe (in addition to Foley temp probe) insert ONE inch only to the nares
OG tube (stomach decompression before TEE probe insertion) and before exit from OR
9F2L CVL set up
Dual slick 7F
Swan-Ganz if requested
Sterile gloves x 2