haji

haji

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About haji

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  1. Ativan IVP vs Propofol gtt

    Propofol is a great drug for quick weaning. It has an extremely short half life. There is absolutely no reason to leave a patient on psv overnight when they are clearly failing. With a respiratory rate in the 40s tachycardia and hypertension you need...
  2. Vasopressor and Inotrope Titration Orders

    This just came up in my unit recently. Its absurd. I guess next time I start norepi on a crashing patient I will start at 0.5mike and then wait 5 min to increase by another 0.5 ARRRRGGGG stop the madness Is JCAHO run by nursing theorists?
  3. Respiratory Therapists Stingy with o2?

    My belief system? The cascade of the dying process? Is this about nursing theory? Are any of you icu nurses?
  4. Critical care book help

    This isn't a nursing book, but I liked it better than all the critical care books I read. It covers lots of physiology that's relevant to icu work. Clinical Anesthesiology by Morgan/Mikhail/Murray Also check out emcrit.org and lifeinthefastlane.com
  5. Respiratory Therapists Stingy with o2?

    Wow, I guess I should just start a morphine drip the next time I respond to an Rapid Response call on the floor for a DNR or Limited code patient. Or maybe just refuse to treat them and go back to the unit. And never give anyone 100% fio2 because it...
  6. Respiratory Therapists Stingy with o2?

    One patient was DNR but we were trying to keep him going until his family got there. The next was a meds only code. So in both cases I had an intensivist in the room and we were giving pressors and code drugs. I don't like it when really sick DNR pat...
  7. This has happened to me twice recently. I have had some very sick patients on bipap (DNR) who were near death. When the patients desaturated, and I suggested to the respiratory therapist (both times already at the bedside with me) to turn the fio2 up...
  8. Titrating Multiple Pressors

    I agree that more volume (dry?) and maybe blood (low hct?) might be good options when you are on multiple pressors. Steroids might help also. Lots of people think bicarb helps, but after reading lots of books I'm not sure its a good idea. I have give...
  9. Trouble with understanding pH-related death

    I think you would need to know a lot about physiology to understand why a low pH kills patients. I don't understand it really, but from what I've read at some point your body cannot carry out the cellular functions necessary to sustain life once your...
  10. CCRN testing help

    Do the Pass CCRN practice questions like crazy and if you can do well on the practice test you're good to go for the real one.
  11. Cardiac gtts???

    wow i have never heard or read anywhere that levophed dilates the coronary arteries. it might increase coronary perfusion by increasing diastolic arterial pressure. maybe you are thinking of nitroglycerin? levophed has some effect on beta receptors ...
  12. yeah i agree don't bring a bunch of stuff into the room. if the patient is sick the last thing you want is a bunch of cleaning supplies getting in the way. you can get that stuff when you need it.. i don't like to wait until the patient is throwing ...
  13. Not feeling it...

    I think experience is the best teacher but here are some good resources for learning outside of the icu: Pass CCRN (throw the book out but do the practice questions on the cd) Emergency Management of the Coding Patient (its going to happen sooner or ...
  14. Great Podcasts

    I just want to recommend to everybody to check out some of the great resources on the internet, especially if you are relatively new to the icu. Some of the info is over my pay grade (c-spine clearance, PE risk stratification, etc.) but lots of it ha...
  15. Studying for CCRN... question regarding test plan

    I studied for several months before I took ccrn and passed. I read a lot of medical stuff on my own (especially relevant topics in Anesthesia books like physiology and meds). I watched the gasparis videos and they were ok but not that useful in my op...