A CT to make you feel sick

Specialties Neuro

Published

Weeel, a couple of these are cringe-worthy but the all time "My god wouldn't you just feel sick if you saw this" award goes to the CT second from the end.

http://www.trauma.org/imagebank/imagebank.html

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Awake trachs, soon as i heard those words, i get chills.

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Ouch.

As a new NICU nurse, lots of questions/doubts go through my head all day long. Have to admit though, never stopped to wonder, 'Is my NG tube in the abdominal cavity or the cranial cavity?'

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Ouch.

As a new NICU nurse, lots of questions/doubts go through my head all day long. Have to admit though, never stopped to wonder, 'Is my NG tube in the abdominal cavity or the cranial cavity?'

Generally you don't have to worry about that unless your pt has a basilar skull fracture, which is why you don't drop NGs in those pts. Otherwise, you should be good. Can't imagine if that was my pt with an NG showing up on head CT...DOH ain't the word! ;)

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Generally you don't have to worry about that unless your pt has a basilar skull fracture, which is why you don't drop NGs in those pts.

Yeah. This would be a good teaching slide to illustrate that point.

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Specializes in ICU, Education.

This is interesting that this just came on the forum. I am new to neuro icu (but not ICU in general). However, i knew that you should never insert an NG (or any tube) nasally with basilar skull fx, or potential there of. I just got a head injury in last week who was bleeding from his ear. The trauma team in mexico placed an NG and then our ER trauma nurse told me in report it was not positioned correctly so SHE pulled it back and repostioned it. She knew nothing about the scans the patient had except that he had several SDHs. When i mentioioned to the nurses on my floor that i didn't think you were supposed to put an NG tube in a head trauma patient, several of them didn't think anything of it and one (seasoned) nurse told me , quote: "If they don't have a fx right in the front here (indicated her forehead,orbits & nasal area), I place NG's all the time." I told her that basiler skull fx's could easily have sinus fx and that there have been xrays showing NG's in the cranium. She just rolled her eyes at me. Then my friend who is also new to neuro, just told me this am that her patient last night had a duo tube placed by the prior shift nasally, & it was specifically ordered to be place orally as the patient had a nasal fx. All this scares me, because I am seeing that my resources are not necessarily trust worthy. I have asked different nurses the same question and gotten several different answers. Or i have had one nurse tell me one thing when asked, and then received unsolicitated advice from others condescendingly stating the opposite. I have decided to keep reading reading reading, and when I follow advice, it will be the more cautious advice. I have such a fear of doing harm. Lots of nurses are so layed back & don't seem to worry about anything. Wish I was a little more like that I guess , but when I'm dealing with teenagers and young adults i tend to worry about ----ing them up. also it is hard because when you ask questions, everyone starts to treat you like you're an idiot about everything, and i could probably teach them everything about ventilatros , swans, sepsis, ARDS, DIC,MSOF etc. But then it has always been more important to me that I think I am doing my job well, than the fact that others think I am doing my job well. So i will continue to speak up when i don't know things (which turns out to be a lot lately)

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Specializes in ICU.

Sounds like you have a bit of a toxic work environment. Been there dealt with that. Best you can do is ensure your work is the best you can do and make plans NOW to deal with bullying because I will gaurantee that it will come.

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Specializes in ICU, Education.

Thanks Gwenith, but honestly, the bullying doesn't scare me as much as getting the wrong info might. Usually after I have been anywhere for any length of time I earn the respect I deserve. I am just concerned I am not learning the appropriate information. At least i have a written resource, as I bought that Joanne HIckey book you recommended and have been reading non- stop. I am also thankful to have you all on this site to run things by as well (as theory cannot touch practice in many cases).

Doris

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First, do no harm.

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