matt2401

matt2401 MSN, RN

ICU

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About matt2401

matt2401 has 21 years experience as a MSN, RN and specializes in ICU.


Latest Activity

  1. Assessing the hyperglycemic patient

    Other posters have left some great information so I will try not to re-post. Here are some highlights of things I believe are improtant: Almost every single patient that comes in with critical high BGL levels are severely dehydrated. Expect all the ...
  2. Need some Precedex advise

    Precedex for induction is just plain insane. I can't see how any doctor in his right mind would look at either 1) the FDA labelling, 2) the mechanism of action, 3) the literature available and say "hey I am going to use this to intubate a patient. St...
  3. DAMN STRAIGHT!!!
  4. So, I take it from your post that you are happy with your 3% pay raises while the management gets HUGE increases? Heck, that 3% will be eaten up from the massive insurance increases HCA is rolling out. "rumor has it they have a year to get a contract...
  5. Would you ever be a scab?

    These words are as true today as when Jack London wrote them: After God had finished the rattlesnake, the toad, and the vampire, He had some awful substance left with which He made a scab. A scab is a two-legged animal with a corkscrew soul, a waterl...
  6. Question for Jackstem..Suboxone

    Hi all, recovering RN here. 4+ yrs clean. I personally did not use suboxone for my detox (I detoxed myself) but I see no reason why it can not be employed as tool in detox/recovery. I have seen many people successfully use suboxone for an extended pe...
  7. I have been seeing ALOT of fairly health patients coming in with URI s/s then crashing HARD and ending up on a vent/oscillator, multi-pressors then dying (usually within 24 hours of admission but sometimes just languishing). They aren't technically f...
  8. Overdoses

    RSI is the best and safest way to go. I bring this expierence from my paramedic years of dealing with many, many ODs. Most are polysubstance and difficult to treat. If you give narcan you run the risk of reversing the narcotic component and causing v...
  9. ICU experiences: how do you know when to worry...

    First, with the SpO2 remember it is giving you insight into only one component of the respiratory status: Inferred PaO2. Basically the pulse ox will give you a (usually) very good indication of what the PaO2 is. The rest of the compenents are: PaCO2,...
  10. Neuro ICU - Do you talk to brain-dead patients?

    Hmmm, well the brain dead patients I have had were all organ donors and let me tell you....I was waaaaay too busy to sit and talk to them. Having said that I didn't have a desire or thought to talk to them. I did give a prayer of thanks for thier gif...
  11. VCC vs. SCC

    I went to Lake-Sumter on the Paramedic to RN bridge (which had us in with the LPNs so same program). AWESOME program, I can not say enough about it. I compared my expierence with people going to DBCC, SCC and VCC and I had it made. Send me a message ...
  12. Well the local nursing schools have FINALLY DONE IT

    First a couple of things to realize. In this area, at least at my hospital; Oct, Nov and Dec are traditionally low census months. It picks up around now until April or so. If the census is low, it makes it easier for managers to justify a hiring free...
  13. To suction the ETT, or not?

    The only patients I have refrained from suctioning are the patients that are requiring high PEEP levels to maintain minimal PaO2s. In those patients when you break the circuit (the suction is going to break the PEEP) it is going to take 30 mins or so...
  14. Things you'd like the ER to Know

    Wow, you get report? Lol, our hospital went to just faxing a report then the patient comes 15 mins later! Thats always awesome when a patient rolls in just as your other patient (or patients) are crashing. If it were me I would focus on what treatme...
  15. 44 year-old woman with DVT dies of PE--- ???

    Yes, the dosing schedule goes to 1mg/kg instead of 40mg (or 30mg with reduced CrCl). Still usually given SQ, although there is a dosing approved for IV in ACS. Lovenox has the benefit of no PTT monitoring required, and decreased risk of HIT. Back t...