Learning thread (ER medicine) - page 5

Heres an idea. once you learn something new regarding ER medicine, post it here. it will become a nice discussion and we can all learn something. post something that you think most ER rns wont... Read More

  1. by   mhull
    OMG...thanks....that is going to help me alot. My manager has cracked down on us for not putting heights on our triage sheets.




    Quote from ERslave
    FYI: Did you know that if you need the height of a patient( for instance, bedbound pts that cant stand), you have pt stretch arms out to side. The distance from fingertips (from left and right) is same as pts height. Try it on yourself.
  2. by   magicman
    Quote from Stitchie
    Insulin IVP, calcium gluconate IVP and 2 amps of glucagon IVP: changes the biochemistry and K+ goes back into the cells where it belongs.

    HGb will rise 1 pt for each unit; I expect the crit would rise similarly.

    Something I can answer finally -- gee I hope I'm right :imbar
    You can use D50W instead of Glucagon too.
  3. by   Stitchie
    Quote from magicman
    You can use D50W instead of Glucagon too.
    v. cool. I'll remember that in my next experience of dangerous hyper K+.

    Thanks
  4. by   kevro1013
    We had a pt come in in status asthmaticus tonight. After her her hour long nebs and solumedrol ivp, she wasnt much better (RR=32 sat93% on RA). The ER MD ordered Mag sulfate 2 grams iv over 30 minutes. I had never heard of that as a treatment for AE of asthma before. I looked it up in the med book and sure enough under indications, there it was: relaxes smooth muscles in AE asthma. We gave it to her and she got better almost immediately! (I'm sure the solumedrol was also kicking in too).
    Learn something new every day!
    Kevin
  5. by   Peeps Mcarthur
    By Nightengale
    i think its due to their proportionally larger sized head, so lying flat on a backboard will cause the c-spine to be out of line, and difficult to xray. i think there should be a towel under their shoulders. am i right?
    This is to maintain the airway. The head is disproportionate,true, but the airway will be occluded if you don't put something under the shoulders and that is the reason for the precaution.
  6. by   Peeps Mcarthur
    By ERslave
    FYI: Did you know that if you need the height of a patient( for instance, bedbound pts that cant stand), you have pt stretch arms out to side. The distance from fingertips (from left and right) is same as pts height. Try it on yourself.
    Why not just measure from the feet to the head? Like a big fish :chuckle

    That way you could stay on the same side of the pt.
  7. by   RN92
    Quote from Peeps Mcarthur
    By ERslave


    Why not just measure from the feet to the head? Like a big fish :chuckle

    That way you could stay on the same side of the pt.
    A lot of my patients are too contracted to use that method.
  8. by   Peeps Mcarthur
    By ERslave
    A lot of my patients are too contracted to use that method.
    I suppose if you could somehow get one arm extended you could just measure to the manubrium and multiply by 2, but that's not likely without a block and tackle on a contracted pt............................so ,how do you do it?
  9. by   Elle2
    Quote from thanatos
    I'll bite...Beta blockers are contraindicated with cocaine induced MI.

    Another easy one:
    When is succinylcholine contraindated?

    btw: good idea for a thread
    Succinylcholine is also contraindicated in pts. with significant burns or crush injuries. Puts them at risk for hyperkalemia. Chronic renal failure patients would not be good candidates either.
  10. by   rjflyn
    Actually to be more specific it is contraindicated in those injurys outside the acute phase- ie if the injury just happened ive seen given and have had to give to like patients.


    Rj
    Quote from Elle2
    Succinylcholine is also contraindicated in pts. with significant burns or crush injuries. Puts them at risk for hyperkalemia. Chronic renal failure patients would not be good candidates either.
  11. by   thanatos
    Why is it important to alkalinize the urine of an aspirin OD? I'm looking for the specific mechanism that leads to increased elimination from the body.
  12. by   dansdoll
    Quote from Peeps Mcarthur
    By Nightengale


    This is to maintain the airway. The head is disproportionate,true, but the airway will be occluded if you don't put something under the shoulders and that is the reason for the precaution.
    Newly trained TNCC instructor here to validate the fact of airway obstruction as the primary reason to use padding in a peds pt on the backboard. The head is larger and in order to maintain c-spine, and at the same time the airway, padding is needed under the shoulders of peds pts on back boards --
  13. by   jaimealmostRN
    LOOOOVVVVVVE this thread! Ok, what type of "critter" bite can cause pancreatitis?

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