msjellybean replied to Emergent's topic in Emergency
I was in the ER several times as a kid. I was 3-4 and being stupid in day care and split my chin open, needed sutures. When I was 5, I fell off a slide and had a humeral neck fracture. In my teen years, I went a few times - after a car accident (par...
msjellybean replied to Emergent's topic in Emergency
In my ED, we have two nurses stations. One larger, more central area that shows all the monitors and a smaller area that only shows the monitors in the rooms close to that station. It seems to be an unwritten rule that everyone is responsible for loo...
msjellybean replied to exit96's topic in Emergency
Access to our ED is badge controlled. Visitors get an ED visitor sticker, which allows them access through the locked doors. Mental health patients and combative patients are stripped only to a gown and their belongings secured in a staff only area. ...
As always, refer to your P&P. In my facility, if a patient has a port, it is expected that you will access it and use it. Unless the doc suspects it as an infection source. In which case, we generally will access it long enough to draw quantitat...
msjellybean replied to Gabby-RN's topic in Emergency
This is tPA for CVA. We do use it PEs and DVTs, but I'm not sure what the standards are because we don't do that in the ED. All of that is started in IR and then sent to the ICU. VS and neuro checks, q15 minutes during infusion and 1 hour post infusi...
msjellybean replied to Emergent's topic in Emergency
We have an alcoholic frequent flyer, who typically presents drunk after a fall of some kind. She has had 8 brain CTs so far this year. I hate to think about how much radiation her brain has received over the last few years. Unfortunately my ED got a ...
msjellybean replied to dsherman's topic in Emergency
We're supposed to initiate the CP order set with in 3 minutes of presentation to registration. From presentation to registration we have 7 minutes to get the EKG complete. Our standing orders include: place on monitor with q30 minute vitals, CXR, 12 ...
msjellybean replied to Frizbeeboy's topic in Emergency
Depending on what scrubs I'm wearing, the location tends to vary a bit. But... in my left top pocket I have my phone, gum, and carmex. Top right pocket is a couple pens, dry erase marker, & a sharpie. My trauma shears go in one of the cargo pocke...
This is facility specific. My hospital allows our techs do d/c PIVs, provided they show us the catheter before disposing of it. Since that rarely ever happens, most RNs d/c their own lines.
msjellybean replied to Anna Flaxis's topic in Emergency
Reminds me of an incident I had a few weeks ago while sending a patient upstairs. College age girl with SOB x5 days. Chest CT reveals multiple PEs... described by the radiologist as "significant" clot burden. As I'm waiting for her bed to be ready, I...
Pt came in via EMS for a fall. A&O x4, no SOB or cardiac complaints. BP stable. Lab calls with a critical hemoglobin of 2.4. A recollect is automatically ordered, based on that level. After the phlebotomist drew her, he showed us the tubes. Looke...
msjellybean replied to hella_RN's topic in Emergency
I don't mind taking holds, so long as they aren't ICU patients. And my reasoning is this: while they're held in our department, they are to receive the same care standards as if they were actually on the floor. Except I can still have up to 3-4 mor...
msjellybean replied to garn12's topic in Relations
I'm an ED nurse now, but worked on the floor for 3.5 years, frequently with a 6:1 ratio and one tech. If the IV site became problematic, I'd would start a new line and move on with my day. I don't understand why it's such a big issue for so many peo...
msjellybean replied to Sassy5d's topic in Emergency
Anecdote from when I was a floor nurse... had a rapid response code on a patient and by the time EKG got there, she was already to the ICU. They ended up performing the EKG on her roommate (oops!). But here's the kicker - found new ST elevation.