bellehill

bellehill RN

Neuro Critical Care

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About bellehill

bellehill has 9 years experience as a RN and specializes in Neuro Critical Care.


Latest Activity

  1. Pupillometer guideline

    We obtain a pupillometer reading on admission for all our neuro patients. Our protocol is to call the MD for: NPi CV %change >1mm difference between pupils We also trend the NPi and if there is a difference between R/L pupils of >0.7 or if the...
  2. TIA PRESENTATION

    We treat any stroke symptoms the same with the standard benchmark goals. Door to doc in 10 minutes, door to CT in 20 minutes, door to CT read in 45 minutes and door to TPA in 60 minutes if applicable. Our hospital uses a "stroke alert". The important...
  3. Neuroscience - I need some help in Cerebral Circulation

    Grab a textbook, preferably by Hickey and look at it then draw it. I always learned better when I drew the subject (like the Circle of Willis). I think I drew the COW a million times when I was studying for the CNRN. If you can draw it you can visual...
  4. Flotrac for Triple H therapy

    An update: we are seeing great success using the Flotrac. Our goal is SVV40 and CVP>8 for non-vented and >12 for vented patients. If two of the three parameters are not in range we bolus the patient. No more swans...YEAH! Just recently had a p...
  5. Levophed shortage

    We have a Neo shortage as well, anyone else? We have been using Dopamine and Epinephrine.
  6. Problems with shift to shift report

    Have you tried a bedside report? If you are having trouble remembering what happened during the day go in the room and talk about the patient. Chances are you will remember and the patient will appreciate knowing how thorough you were with report (if...
  7. Shared Governance

    Our unit has a shared governance with 4 different quadrants: customer service, quality of worklife, practice and research, and education. Each quadrant has a chair and co-chair as well as the chair and co-chair of the shared governance. Ours meets on...
  8. Need some Precedex advise

    In our neuro patients it seems to work very sporadically. We were just inserviced on Precedex and it is not to be used for the patient when they are wild. Ideally, you would get the patient calm with Ativan/Haldol/Versed and start the Precedex drip w...
  9. "One Born Every Minute"

    Is anyone watching "One Born Every Minute" on Lifetime? It was taped at Riverside Methodist Hospital in Columbus. I work there (not L&D) and I love to see the exposure. Even if you don't work at Riverside, what a great opportunity for Central Ohi...
  10. Pregnant in Neuro ICU?

    I worked in a busy Neuro ICU my entire pregnancy. I was supposed to work the night I had my child. It is like any nursing job. You take normal precautions just like you would with any patient, even if you aren't pregnant. If you want to try neuro the...
  11. Flotrac for Triple H therapy

    Thanks. We are going to be looking at the SVV, SVI and CVP. If 2 of the 3 numbers are below the parameters the patient will be bolused. This has worked well so far!
  12. cscc or mount carmel

    I agree with birdie22, go with the BSN and work as a tech. Nursing jobs are very competitive in Columbus.
  13. Thoughts on/advice for new grads in Neuro ICU please...

    One thing I see in new nurses on our neuro ICU is they do not understand the emotional toll they will encounter everyday. The neuro ICU is a sad place to work. We do have those cases that really lift you and and make you proud, but they feel far betw...
  14. Flotrac for Triple H therapy

    So what are you using to monitor fluid status and cardiac output? I certainly don't miss the swans, what a pain they were.
  15. Flotrac for Triple H therapy

    We recently started using the Edwards FloTrac for our Triple H patients. The first round went really well, the second round did not go as well. The problem we are having is the variability with the numbers. We are following the Stroke Volume Variatio...