loafin'

loafin' specializes in PULMONARY/CRITICAL CARE.

Latest Activity

1. Nitrates, Desaturation & pulmonary shunting

   loafin' replied to Toby's mum's topic in CCU

   I agree, just adding more info.

2. Nitrates, Desaturation & pulmonary shunting

   loafin' replied to Toby's mum's topic in CCU

   Actually, with nitrates and topical anesthetics that you mentioned as well as others can cause methemoglobinemia. They can change the structure of hemoglobin to where it cannot hold o2, thus causing sats to rapidly decrease. If methemoglobin levels a...

3. Ice for a vented patient???

   loafin' replied to OkieICU_RN's topic in MICU

   Well SuperRT, I just happen to be a RRT and a RN. This has gotten way off topic, it's supposed to be about whether to give ice to an intubated patient. Nobody has mentioned giving a patient all the ice they could hold. As I stated in previous posts t...

4. Ice for a vented patient???

   loafin' replied to OkieICU_RN's topic in MICU

   If the cuff pressure is high enough to hinder swallowing then the patient has tracheal malacia and/or the trachea in necrosing. Ask your RT if he/she has ever heard of a chronic home ventilator patient who's trached and eats solid foods and drinks l...

5. Ice for a vented patient???

   loafin' replied to OkieICU_RN's topic in MICU

   Where is your info coming from? When we suction the vent alarms high pressure, it has nothing to do with losing the cuff seal. No, it's not easy to swallow with an ET tube in your mouth. Where do you think the natural oral secretions that a patient p...

6. Ice for a vented patient???

   loafin' replied to OkieICU_RN's topic in MICU

   Why not give ice? The airway is protected and pt's can't aspirate unless the et tube cuff blows or et tube comes out. On any intubated pt there are secretions setting on top of the et tube and that's one reason we tell them to cough as we extubate as...

7. ABG rule of 15

   loafin' replied to phiposurde's topic in Emergency

   it is actually called winter's formula. bicarb x 1.5 + 8= expected paco2 +/-2

8. assessment question

   loafin' replied to zacarias's topic in Pulmonary

   I will address your question regarding the respiratory meds. Both xopenex and albuterol are both beta2 agonist or sympathomimetics. The medications bind to beta2 receptor sites in the bronchial smoothe muscle causing relaxation. I will explain the di...

9. any CRNAs as mid-level providers in the ICU?

   loafin' replied to blee1's topic in CRNA

   Vanderbilt University has an acute care NP program that after graduation you have an option for early interview to anesthesia school at Middle Tennessee School of Anesthesia. You will be able to practice as both. Vandy is the only one that I've check...

10. Developing care plan for a pt in DTs.. trying to figure out the lab values..

    loafin' replied to RNstudent86's topic in General Students

11. Developing care plan for a pt in DTs.. trying to figure out the lab values..

    loafin' replied to RNstudent86's topic in General Students

    alcohol level, smoking hx, any chemistries done, how much 02 client has on, if any. sometimes it takes a bit more than an abg to figure out exactly what is going on.

12. ABG help

    loafin' replied to Megsd's topic in Student Assist

    I know this, but thank you for clarifying that oxygen does play a very inportmant role in pH. A lactate level would be drawn of course,but we would know that it was lactic acidosis just by doing a venous gas with the p02 being virtually the same as t...

13. ABG help

    loafin' replied to Megsd's topic in Student Assist

    Actually oxygenation does affect pH. The most profound acidosis I've ever seen was on a client who had cyanide poisoning who had a pH of 6.6. He had a normal p02 and sat with abg. I drew venous gas and was vertually identical. He was in anearobic met...

14. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU

    BabyMO1, PM me if my reply to asoldierswife05 still did not explain enough.

15. please help with these ABG's

    loafin' replied to emmycRN's topic in MICU

    You understand exactly. There is a formula called winter's formula for expected pco2 with a given hco3. The abg and client on bipap is a big clue Remember HCO3 compensates slower than co2. And actually the bicarb might be slightly lower than client's...