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Search Results Type: Posts; User: Dodongo

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  1. How critical is your ICU?
    It depends for us. I work in a large MICU - level 1 trauma, tertiary care center. Generally during the summer we have a lower acuity, while the trauma ICU has higher acuity. Then it switches...
    Aug 19, '13
    Forum: MICU / SICU Nursing
  2. Failure to maintain sats on ventilator
    Wrong. All the most recent studies on proning show a reduction in morbidity and mortality of more than 50 percent when patients are proned for ARDS. You need to look at the P/F ratio. My ICU uses...
    Aug 13, '13
    Forum: MICU / SICU Nursing
  3. ICU RNs running CRRT?
    In our entire system the ICU nurses run CRRT. The assignment is made 1:1.
    Aug 5, '13
    Forum: MICU / SICU Nursing
  4. 5% dextrose and cardiac outputs with a swan ganz catheter
    We use NS in my ICU. I would think the major problem with a solution containing dextrose would be the possible raise in blood sugar.
    Aug 2, '13
    Forum: CCU Nursing / Coronary / Cardiac
  5. Easy, dumb, common new grad mistakes
    You are definitely going to make mistakes. Even seasoned nurses make mistakes. It's inevitable. We're all people. However, a new grad should, theoretically, make a few more. Haha. I think it...
    Jul 30, '13
    Forum: First Year After Nursing Licensure
  6. Leaving Phenylephrine on with an Epi Drip?
    Ok, so I talked to the pharmd at work and here's what he had to say about it. He said, I general, at high doses of epi, it's redundant to have neo, because the epi is exhibiting alpha stimulation....
    Jul 30, '13
    Forum: CCU Nursing / Coronary / Cardiac
  7. Max on Levophed?
    Our hospital policy has us max levo at 1mcg/kg/min - which is obviously silly. Epi is supposed to max at .15 mcg/kg/min but we can go as far above that as we need to go. It doesn't make any sense to...
    Jul 25, '13
    Forum: CCU Nursing / Coronary / Cardiac
  8. Leaving Phenylephrine on with an Epi Drip?
    Crnahopeful, you're going off on tangents. I'm sure everyone reading this knows what receptors they both act upon and how they influence CO, SVR, etc. The point I'm making is that having neo with epi...
    Jul 24, '13
    Forum: CCU Nursing / Coronary / Cardiac
  9. medication mismanagement?
    In my ICU we frequently modify orders in the computer to suit our needs. If it were me I would have changed the order, taken out the 10/650, given it and then let pharmacy (we have our own satellite...
    Jul 24, '13
    Forum: Nursing and Patient Medications
  10. Help! I don't "get" vents!!!
    Do you work in a teaching ICU with residents? At the beginning of every month the pulmonologist/intensivist will go over every aspect of the vent during rounds with the new interns. The experienced...
    Jul 24, '13
    Forum: MICU / SICU Nursing
  11. Leaving Phenylephrine on with an Epi Drip?
    I just want to get a feel for what you guys do in your ICUs. A lot - a lot - of the nurses in the main ICU I work at (MICU/CCU) leave the neo drips on with an epi drip. The ICU I float to (trauma)...
    Jul 24, '13
    Forum: CCU Nursing / Coronary / Cardiac
  12. What type of device goes in the ankle during cardiac arrest??
    IO for sure. Weird place though. Our ED and EMS providers loooove IOs. We keep them for the 1st 24 hours just in case. Even after they're lined. If it was the intensivist working down near the foot I...
    Jul 19, '13
    Forum: CCU Nursing / Coronary / Cardiac
  13. What would you do?
    I've had a lady code in a chair. Luckily she was little so we grabbed the sheet underneath of her, threw her back on the bed and started compressions. It was way more stressful than a normal code...
    Jul 18, '13
    Forum: CCU Nursing / Coronary / Cardiac
  14. Nurse's Role in Therapeutic Hypothermia
    I don't know about any research publications, but we use either the arctic sun hypothermia machine or the blanketrol. Both are pretty similar. We put the temp probe in their esophagus or rectum, wrap...
    Jul 18, '13
    Forum: Nursing Student Assistance
  15. Beta Blocker OD
    Insulin has positive inotropic effects - as does glucagon, which is great for countering the negative effects of a BB overdose.
    Jul 12, '13
    Forum: Critical Care Nursing
  16. Proper disposal in the SICU
    The ultrafiltrate line from our CRRT goes into the sink or toilet. Just like urine or feces (if you have a flexiseal/rectal trumpet). Diprivan isn't a controlled substance in the same way benzos or...
    Jul 12, '13
    Forum: MICU / SICU Nursing
  17. Looking for some insight from seasoned CCU nurses :]
    Wait - so you're not an ICU nurse? But you were hired as a float RN for an ICU? How? Do you have an orientation? I hope you do. How else would you know how to manage the MI, arrests, drips, invasive...
    Jun 28, '13
    Forum: CCU Nursing / Coronary / Cardiac
  18. Sepsis Questions
    "Never use vasopressin for sepsis" You're kidding right? You're scaring me if this is not a joke. MunoRN is absolutely correct. Someone needs to do a little book learning.
    Jun 24, '13
    Forum: MICU / SICU Nursing
  19. Consolidation vs Infiltrate vs Opacity on CXR
    Infiltrate is when your alveolar spaces are filled with some sort of fluid, i.e. transudate, exudate. Consolidation is more of a measure of the texture and hardening of the lungs. But on a CXR you...
    Jun 13, '13
    Forum: MICU / SICU Nursing
  20. ARDS: Should we be prone to prone?
    My MICU uses rotaprone beds pretty frequently with ARDS patients. Our intensivists do not use ECMO and I think the literature at this point favors proning. Good article.
    Jun 13, '13
    Forum: MICU / SICU Nursing
  21. PAWP
    It depends on the physician who puts the orders in. I've had some MDs that order the wedge once a shift and some that want it only sometimes and they'll ask for it. But, yes, we do wedge in my ICU....
    Jun 11, '13
    Forum: CCU Nursing / Coronary / Cardiac
  22. Sepsis Questions
    Low white count can occur early on in an infection because the leukocytes will extravasate at first making it seem as though absolute counts are low when in fact the circulating levels of WBCs are...
    Jun 5, '13
    Forum: Critical Care Nursing
  23. Sepsis Questions
    What else did you try for the fever? Take the blankets off, make the room cool, etc. Tylenol would be my next choice. And no patient that is awake and alert is going to take the cooling blanket. ...
    May 23, '13
    Forum: MICU / SICU Nursing
  24. ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping?
    "Slamming a liter of epi" means nothing. If you don't know the concentration then you have no idea what the patient is actually getting. Was it 16mg/1000ml? 32mg/1000ml? 64mg/1000ml? If you don't...
    Apr 30, '13
    Forum: MICU / SICU Nursing
  25. No rapid response for a DNR?
    When the family fills out a code sheet the provider should also discuss other treatment options such as intubation, blood products, pressors, Abx, etc. We have plenty of patients in the ICU who are...
    Apr 18, '13
    Forum: General Nursing Discussion


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