Elenaster

Latest Activity

1. Question about TBI w/ cranioectomy?

   Elenaster replied to jadespirro's topic in General Nursing

   If a bone flap was removed to allow more room for the brain to swell, it's very possible there is an area with no protection to the brain tissue itself. This procedure is often resevered as a "last ditch" measure for hydrocephalus refractory to other...

2. Barbiturates in Critical Care

   Elenaster replied to Vance's topic in Neuro

   I wasn't implying anything and my post certainly wasn't directed towards you. Just trying to add my perspective as an experienced neurosurgery nurse and educate those that are new or unfamiliar with that particular scenario. Additionally, the propofo...

3. Barbiturates in Critical Care

   Elenaster replied to Vance's topic in Neuro

   I agree that propofol is a far superior drug for providing sedation in ICU patients under most circumstances, however it should be noted that some patients experience a sustained drop in blood pressure that limits its use, particularly if they have i...

4. Barbiturates in Critical Care

   Elenaster replied to Vance's topic in Neuro

   In my experience, barbituate comas are still used, but only as a last ditch effort for cerebral hypertension (not hydrocephalus) refractory to other treatments, such as mannitol in addition to what Gwenith stated. Barbituate comas have some very nega...

5. Craniotomys in the PACU

   Elenaster replied to jayep99's topic in PACU

   As a former Neuro ICU nurse and a current PACU nurse, I hope I can offer some well-rounded advice: 1. Tell your staff that neuro patients and EVDs are not that scary and with a little training, they can care for this population with confidence. 2. Fi...

6. how hard is it for a RN to work weekends ONLY in ICU?

   Elenaster replied to a_clay's topic in MICU

   I've been working weekends only in ICU for close to 2 years now. The plan at my hospital pays us for 80 hours in 2 weeks when we only work 60 (3 days one week, 2 the next). The majority of people that do it are parents with young children and student...

7. Trouble on Night shift

   Elenaster replied to ErinRNBSN's topic in Neuro

   Erin, I had the exact same problems working nights that you described and after a year, I told my manager that I either had to get on days or I was going to have to leave. I just couldn't physically do it and I think that there are some of us whose b...

8. ICU gets differential and not ER??

   Elenaster replied to jentenrn's topic in Emergency

   Having worked both ER and ICU, I have to say that paying diff to ICU and not ED is certainly unfair. I also have to agree with the part of the argument that most all hospital nurses work very hard and each area has differing aspects of the job that a...

9. Nimodipine shortage

   Elenaster replied to bellehill's topic in Neuro

   We haven't experienced a shortage recently, but our peak aneurysm season is over and we've had far more crani for tumor and head injuries lately, so I haven't been giving as much Nimodipine. As for Nicardipine, I attended a presentation last summer b...

10. what does the patient experience when care is withdrawn while they're conscious?

    Elenaster replied to rach_nc_03's topic in Neuro

    Rach, Because this woman was still conscious, I would assume that she was put on a morphine gtt or some other comfort measures were taken to ensure that she would have as peaceful death as possible. I'm sorry you were so freaked out, but consider tha...

11. A few Neuro Q's....

    Elenaster replied to raindrop's topic in Neuro

    Good thinking NurseyBaby - that's why we make sure the EVD is leveled properly every hour and with any movement of the patient. Also you wouldn't want to LP a patient with a suspected or confirmed spinal cord injury because it's very important to mai...

12. Getting dumped on by resource nurse who doesn't like me... what can I do?

    Elenaster replied to bluesky's topic in MICU

    Bluesky, Sorry about the old bat projecting her misery onto you. Just ignore her as best you can and see if you can get one of your co-workers to swap assignments with you. Try to do it when you're going to be working several nights in a row so you c...

13. ICU nursing in USA ?

    Elenaster replied to Paul Mauer's topic in MICU

    Greetings Paul! Here in the USA, you can come right out of nursing school and work in the ICU, with a training period that varies from 3 to 6 months. ICU here is highly specialized and units are generally broken down by specialty like neurosurgery, c...

14. Maximum time on BiPap

    Elenaster replied to bluesky's topic in MICU

    I've seen DNI patients stay on Bipap as long as a week, but IMO it seems like torture. Just watching a tachypnic patient trying to blow off CO2 on one of those things is exhausting. Longer-term use of bipap also results in some freaky ABGs.

15. Nipride drip and no MRI/MRA?

    Elenaster replied to Kiwi's topic in MICU

    Great answer CritterLover! I might add that Nipride is extremely potent and any sort of "accidental" bolus, even a really small one, could bottom out the patient's pressure, and trust me, you do not want to ever have to code someone in the scanner.