IDoNotGiveOut replied to twinkletoes53's topic in CCU
I get the feeling that you are concerned about the activity level as well as the pain meds. When I worked in the other part of the surgical ICU that didn't get the cardiothoracic patients, it always used to seem crazy to me too that the open heart p...
IDoNotGiveOut replied to elizabells's topic in PICU
Where I work, ECMO specialists (specially trained and certified RNs/RTs) run the pump, and then there is the bedside nurse who is the nurse for the patient. It is never the same person doing both. I agree having one nurse do two jobs would be unsaf...
I am an ECMO specialist but my day job is being an ICU nurse, and I can tell you it is not even close. Let's be honest, when we have a balloon pump or VAD, mostly we just write down numbers, we had to learn a few assessments/checks to do and a fe...
IDoNotGiveOut replied to thelema13's topic in Emergency
I don't know about the laws by state, but logically I don't think the time frame of the charting should matter. It's fradulent if it's fradulent, regardless of when charted, and if someone is telling you to chart something that is intentionally not ...
I'm wondering if some of the people with the absolutely shocked and horrified responses have ever worked in an ICU???? If so, on what planet was it located? Sarcasm aside, I agree that there is an issue here, but it is an issue of informatics, phys...
IDoNotGiveOut replied to eftgirl's topic in Safety
We use alaris pumps and this has happened to me twice. A white screen with red bars at the top and bottom popped up along with a different-sounding beep and then the entire brain shut completely off stopping all four modules from infusing. I work I...
IDoNotGiveOut replied to bellehill's topic in Neuro
I also work in a teaching hospital and we don't use any of that stuff! Triple H patients get a high hourly fluids rate and keep MAP >80 or 90. They don't even get a central line unless they need more than phenylephrine and fluid to keep their MA...
Where I work we have had a many adult patients on ECMO awake, ambulating, talking, eating. I admit it is a bit disconcerting at first to see a VV ECMO patient with central cyanosis and giant blood filled tubes sticking out of her neck sitting in a c...
IDoNotGiveOut replied to nursingdude78's topic in CCU
Dex drops BP and HR just as much as propofol and ativan. Was the patient too sedated? Some places seem to like patients near comatose, others want them more awake. If you want them totally snowed you will most likely have to use pressors. I could ...
IDoNotGiveOut replied to sunnycalifRN's topic in MICU
Lol so true. You can always tell that's the case when the patient is getting admitted for "respiratory distress" because their PaO2 is 60 on 2 L NC satting 95% (hmmm maybe you can turn it up to 4 L and treat that hemoglobin of 7.2? Yes this really ...
IDoNotGiveOut replied to jimmy_hat's topic in Neuro
Yeah, we have the monitor and drain open simultaneously, but that's the open ICP, and then we close it and the closed ICP is the "real" one. As you know they're way way different. The reason I asked is because one of the nurses I work with said som...
IDoNotGiveOut replied to jimmy_hat's topic in Neuro
About 7.5%, I was referring to hypertonic saline which we use for ICP >20, I assume everybody does this? Or do you use mannitol or something? So, for CPP of 60 all we need is MAP of 60-80 depending on closed ICP, and if CPP is low d/t high ICP w...