Latest Comments by MunoRN

Latest Comments by MunoRN

MunoRN 27,573 Views

Joined Nov 18, '10. Posts: 7,345 (68% Liked) Likes: 17,579

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  • 0

    So in general, do you support Trump because of his personality or his policies, what particular policies do you like?

  • 4

    Quote from tntrn
    It makes sense to me that the Brits who voted to leave might be extremely worried about what seems to be uncontolled immigration into their country. Resources have to be strained, British law is reported to be nonexistent in some areas and Sharia law has taken its place. I'd vote to leave, too.
    There don't appear to be places in Britain where "British law is reported to be nonexistent in some areas and Sharia law has taken its place". Debunking the Muslim No-Go Zone Myth - Bloomberg

  • 0

    Quote from azhiker96
    Seems strange that the pound and stocks are taking such a hit. It is stranger still that German stocks saw a huge drop. The only reason I can imagine is that with this vote, the U.K. Will not be funding more bailouts. That leaves more for Germany and other successful EU states to shoulder in future bailouts.

    I have heard about how immigration has strained resources. Were EU bailouts also part of the pre-vote discussion?
    There seems to be widely varying reasons why businesses and speculators are concerned about the effect of increased UK isolation on their economy and others, but I don't think I've heard that mentioned. Decreasing immigration is predicted to limit the overall growth of their economy, for instance, and there has been a lot of growth that is dependent on the open environment they are now closing, such as Airbus.

  • 5

    Quote from azhiker96
    Ask and yea shall receive.
    [IMG]http://allnurses-breakroom.com/attachment.php?attachmentid=22517&stc=1[/IMG]

    The AR-15 was released for sale to the public in 1960.

    The full automatic version known as the M-16 started production in 1963.
    They are actually excellent hunting weapons, although not for hunting deer, elk, bear, or fowl (not as accurate as you want for deer and elk, smaller caliber than what you want for bear, doesn't leave much to eat in the case of fowl), but for hunting humans, particularly in confined spaces, they are ideal.

  • 2
    toomuchbaloney and herring_RN like this.

    Crashing economies can make for a great home buying market, 2008/2009 was an ideal time to buy a house, that doesn't mean it's overall a good thing.

  • 1
    canoehead likes this.

    Benzo's should be avoided as much as possible, particularly versed, so that' usually last on my list. Generally you should provide analgesia as part of sedation, which means usually starting with fentanyl. We usually use either propofol or conservative amounts of ativan for sedation in addition to analgesia. Although sometimes you're using as much fentanyl/propofol/benzo as you can get in 'em.

  • 2

    Quote from offlabel
    Sounds like insurance fraud to me. Risky business for the docs and the hospital if complicit.
    Unfortunately providing services, medications, etc that are aren't well justified is pretty common, this is an area where nursing could do a better job of questioning these orders and determining if it's appropriate to initiate them. Because of bundled billing on the inpatient side, instances of fraudulent billing for unnecessary services is much more common in EDs and outpatient services where services are billed individually.

  • 1
    NotAllWhoWandeRN likes this.

    Quote from hawaiicarl
    I think someone may not be familiar with central line policies. Manufacturers for years have said that only 10 ml syringes or greater should be used for injections on central lines. The rational being that the smaller diameter syringes generate far more PSI than the larger ones, increasing risk for line rupture, and if a thrombus is occluding the line, blasting that thrombus straight into the patient.

    Cheers

    PS - Personally I feel this is an out of date practice, and with the new lines someone should design a research study, and get some grant money to disprove it.
    You can actually generate the same PSI with any size syringe, the difference is how a single force applied to the plunger translates to PSI. More force=same PSI in a larger bore syringe.

    A larger bore syringe (10 ml size or above) should be used per manufacturers recommendation until the patency of the line is assessed. Imagine a garden hose with an open end, no matter how much PSI you apply to one end it will not exert excessive pressure on the interior of the hose.

    This is why multiple practice groups clarify that a 10ml syringe is only necessary to assess for patency, from ISMP for instance:
    5.4 Assess central line patency using at a minimum, a 10 mL diameter-sized syringe filled with preservative- free 0.9% sodium chloride. Once patency has been confirmed, IV push administration of the medication
    can be given in a syringe appropriately sized to measure and administer the required dose.
    Discussion: Care should be taken when assessing for central line patency to avoid possible catheter rupture.
    Manufacturers recommend using at a minimum, a 10 mL diameter-sized syringe for assessing patency because a
    syringe of this size generates lower injection pressure. After patency has been established, however, medications
    can be administered in a syringe appropriately sized for the dose of the IV push medication required.18 Many
    facilities have created policies stipulating that a 10 mL syringe be used for all procedures involving a central line,
    when in fact, it is not necessary to introduce risk through a syringe-to-syringe transfer in order to administer
    medications.
    http://www.ismp.org/Tools/guidelines...guidelines.pdf

  • 2
    vintagemother and SeattleJess like this.

    There are certainly patients coming to the ED that need IV fluids, but a lot of it seems to come from the old ED wisdom that IV fluids and O2 can cure just about anything.

    I have worked with an ED physician who claimed they get pressured by the inpatient docs to order IV fluids since that helps justify them ordering IV fluids which is one way to bump a patient's status from observation to full inpatient (so long as the fluids are ordered to run at 100 ml/hr or greater). Basically, this means that the physician who has to do the same H&P either way, can significantly increase what they get reimbursed for that H&P by justifying inpatient status instead of observation.

  • 4

    Quote from tntrn
    I know I will get scolded again, but at the very least we should have the correct information when making arguments. The AR-15 (which stands for Armalite Rifle not assault rifle) and the Sig-Sauer which the Orlando shooter used are not weapons of war or used by police. They might be high capacity, but they are do not use ammo as big and hefty as many handguns do.

    A soldier handed an AR-15 or the Sig would probably be like, "really? you want me to fight war with this?"

    The fact that mass murderers use them does not make them weapons of wars. And taking them away from law-abiding citizens will ensure that murderers will find a different weapon for their evil doings.
    (Bolding mine) That's the argument that's been made for a while now, that while AR-15 variants and other high capacity semi-automatics can be fun, they're also a bit too perfectly suited to mass murderers, so increasing the chances they'll have to find something that gives them less of an advantage would seem to be a good thing.

    In the Orlando shooting, Omar Mateen began shooting at 1:58 AM, a police officer at the club engaged the shooter only 4 minutes later, but decided he was "outgunned" and retreated from the club. I'm all for the "good guy with a gun" method of dealing with these situations, but the good guy with the gun has to have a sporting chance halt a shooting spree for that plan to work.

  • 10
    dexm, madricka, poppycat, and 7 others like this.

    A 10 ml size plunger is only required when assessing patency, once patency has been established any size syringe can be used.

  • 0

    I've never worked anywhere that the facility initiated any nurses week activities, it's always been something that nurses do for themselves, usually organized by a nursing based committee.

  • 5
    herring_RN, BCgradnurse, Ted, and 2 others like this.

    Quote from tntrn
    For two years Obama had both houses in his pocket. So I do not see how the Republicans can be blamed for anything that happened during that time, but nice try. Obamacare was rambodded in, strictly partisan voting.

    Race relations are certainly far worse than they have been in years. ISIS has proven to NOT be a "JV" team. I don't see the economy as improving.....I know too many small business owners who are fixing to close because of increasing regs.......and the list is long.
    He never actually "had both houses in his pocket" thanks to how republicans redefined the use of the filibuster at the beginning of his first term, he never had a filibuster proof majority.

    Obamacare was basically a summary of the republican healthcare reform platform, and still is to this day. Anything in Obamacare that republicans opposed was removed under a filibuster threat, which is why all that was left was republican healthcare reform principles.

    Despite all the rhetoric, republicans have yet to come up with a replacement that isn't essentially repealing Obamacare and replacing it with something that is no different than Obamacare, Cruz for instance had a healthcare platform that offered nothing that wasn't already in Obamacare.

    I'm a small business owner and there's been nothing that's caused me to think of closing from the executive branch in the last 8 years, what are you referring to?

    Considering Obama has been bombing ISIL(S) far more than republicans say is acceptable, I'm not sure how Obama is to blame for being too aggressive against them, according to republicans we should be far less aggressive against ISIL.

  • 4

    While David Daleiden was initially described as a "whistelblower", the full tapes which he had deceptively edited eventually came out, at which point there was really no arguing that his claims were fraudulent, maybe you could clarify why you don't see it that way.

    Of the two charges against him, only the misdemeanor has been dropped (due to a procedural error in the indictment), the felony charge still stands. The remaining felony charge was brought by a strongly conservative county's grand jury.

  • 1
    herring_RN likes this.

    You've repeatedly suggested that snopes is presenting false information but have never offered any evidence to support that. The facts may not always agree with what you want to hear, which is all you've offered to support the idea that snopes is unreliable. Snopes response to the disgruntled writer you posted a link to:
    Failed Daily Caller 'Writer' Throws Temper Tantrum About Being Debunked by snopes.com : snopes.com


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