keermie

Latest Activity

1. Combitubes and curiosity

   keermie replied to trakstar's topic in CRNA

   The combitube is appealing because of ease, but can be cumbersome. A much better alternative which follows a lot of the same principles of the combitube is the King LT. The similarity is that there are 2 cuffs. You intubate the esophagus blind, wh...

2. Interesting Case

   keermie replied to Brenna's Dad's topic in CRNA

   In a TIVA, the BIS will monitor agents like propofol but not fentanyl. So depending on what you are using for your TIVA and the ratio . . . interpret your BIS from this rationale. Also, I would not only reprogram the pacer because you will be unabl...

3. Aggressive fluid therapy in Severe Septic Shock and ARDS.

   keermie replied to Diprivan/Vented's topic in CRNA

   Contrary to what we had been told for countless years, the popular opinion at the moments is that there is no longer such an infusion of dopamine which helps with renal perfusion. You will find sources to support renal dose dopamine, but they are no...

4. Question

   keermie replied to stevierae's topic in CRNA

   Ketamine hits the NMDA receptors? I used the word MDA in an interview for school, and an anesthesiologist took offense to it even though all the ones I had worked with previously called themselves the same thing. I still got in but it got me red i...

5. CRNAs and SRNAs, what's in your fanny..

   keermie replied to TraumaNurse's topic in CRNA

   I am with Craig on this one. I used to carry one around until the senior students hazed me by buying me a little pony pink fanny. The hazing is relentless. Also, I got so frustrated with having a PDA because it consumed my life to keep it off the ...

6. Opinions on BIS Monitors?

   keermie replied to mrigas's topic in CRNA

   Being that jello is essentially a quad, I believe that a spinal infusion of vodka does remarkably well being that it is able to blunt jello's sympathetic hyper reflexia. Finding the L2-L3 is a bit of a challenge, likened to trying to harpoon a 450 l...

7. Using same syringes all day

   keermie replied to stevierae's topic in CRNA

   The hepatitis outbreak (100 and counting) was the result of using a liter bag of fluid to draw flushes. The reuse of syringes or tubing or needles is indefensible because the CDC and OSHA specifically disband this practice. The best rational not to...

8. CRNA Debate from www.studentdoctor.net

   keermie replied to meandragonbrett's topic in CRNA

   All of you have inspired me to post because you have all done a remarkable job maintaining your professionalism. I would like to redirect a lot of the focus on what else can be done. I was recently at the Mid Year in D.C. I was thrilled to meet an...

9. dexmetatomadine

   keermie replied to jbro's topic in CRNA

   Dr. Ramsey (ala the Ramsey sedation scale) came and spoke about Precedex. Amongst his lecture was an open heart, who woke up from surgery and promptly walked out of the room on his hemodynamic drips and precedex infusing when prompted by voice. (A ...

10. charting...dialed in or end tidal?

    keermie replied to mbrian46's topic in CRNA

    End tidal is the most accurate method; however, the dialed in will be more easily defended in a lawsuit. An example is an end tidal of 2.5 and the patient's CO drops from 5.0 to 1.2. You want to lighten the anesthetic immediatly, but because of the ...

11. What would happen if someone accepted an offer from a hospital, anesthesia groups ect

    keermie replied to Roland's topic in CRNA

    ENOUGH! Here is the answer you are looking for. . . it is acceptable to use a stipend and default on it. It really is alright because you worked hard becoming a CRNA. People have done it before under extrenuating circumstances, or just for their pe...

12. Hemodynamics

    keermie replied to BDD's topic in CRNA

    Of the four interviews I went to, one asked clinical questions. That one gave you a piece of paper with values on it and asked, "what is happening based on these values and what are you going to do about it?"

13. Clinical Question

    keermie replied to WntrMute2's topic in CRNA

    I did attempt to look it up, and was surprised to find limited literature on the subject. What a great thesis project!

14. Clinical Question

    keermie replied to WntrMute2's topic in CRNA

    I did attempt to look it up, and was surprised to find limited literature on the subject. What a great thesis project!

15. Clinical Question

    keermie replied to WntrMute2's topic in CRNA

    I second this. It is a primary reason I usually choose an oral airway vs nasal airway, as I have seen this numerous times. The population, a young athletic male, is especially predisposed due to wild wake ups and strength. In my experience, CPAP or...