I'm about to graduate in 2 months and I know there are things that are different in the real world than "textbook." I see nurses on the floor do so many things differently than what I'm taught and lately I've been struggling with figuring out which things are okay to do a different way and which are just nurses taking unsafe shortcuts. One of my issues lately is the use of filter needles. I always use filter needles when administering meds from ampules. Nurses will kind of snicker and make comments about me using them because I'm a student. Do you use them? I was taught that shards of glass can be injected into the vein if the filter needles aren't used. Is this true or is this just in theory and the filter needles aren't actually necessary?
Also, if you have time...can you mention some things off the top of your head that really are okay to do differently than what is taught textbook.
It's happened maybe 3-4x's in the past almost 3 years. We use a larger needle (16g I believe) to draw up our meds, so maybe that is why. But I always look to make sure my syringe is clear. And...of course I use the filter when using a glass ampule. Sometimes we are lucky enough to get fentanyl in glass bottles with rubber tops, but mostly the ampules. I work on a trauma unit and we use TONS of ativan & fentanyl.
yeah, I work at a level 1 also - so lots of Ativan, Fentanyl, god you name it. I've never encountered issues with the rubber portion of the top... but watch, now that I've written that, I'm sure I'll notice something now....
I have to go back and change my answer :o:o as AirforceRN has provided us with incredibly odds-defying instances of people surviving falls of between 18,000 and 22,000 feet! Does anyone remember if DB Cooper's remains were found? Maybe he really is living it up in Rio or somesuch.
Hate to hijack this thread but with PALS. Yes we know about the color coded tape and pre-packaged packs. However we were told they cannot pre-package medication in these packs because it would be very expensive and the drugs would, could, expire. The epinephrine we practiced with comes in a pre-filled 10ml syringe that has a needless tip. Do you have access to pre-filled epi syringes that already have 1.0 - 1.2 - 1.3 - 1.4 - etc epi syringes in them????? If so, where did you get them???? Don't they expire unless you run a lot of codes? If you don't have pre-filled syringes how do you inject 1.2 ml of epi from a 10 ml syringe? Isn't it hard to push that exact amount especially in a code?????
I have to say, the meds are locked (we check locks and chart on that daily) and restocked by a refilling department. I will double check on our infant epi/atropine on my next shift as to the amount/dose. It's a lot smaller than our adult, in our trauma rooms, they're in our Pyxus next to our adult doses, but they're the same manufacturer. I'll get back to you on that one. I would imagine as the meds come due on the peds code carts (that are stocked by a seperate department, even when the locks are popped open) they are checked by this stocking department and they know when they come due.
As a sidenote - I have pushed only the amount of epi required based on their color code on the braslow for a pt. I just looked at the color and pushed, for instance, 1.3 of epi, from our syringe. Where I work now, I haven't been in on a pedi code yet. I hate to even add that yet, but I know it happens. I can't crack our pedi crash carts, but I'll look into what dosages are stocked in there and get back to ya.
:o:o as AirforceRN has provided us with incredibly odds-defying instances of people surviving falls of between 18,000 and 22,000 feet! Does anyone remember if DB Cooper's remains were found? Maybe he really is living it up in Rio or somesuch.
Deb123j
305 Posts
Hmmmm...never thought about that. It would save the hospital some $$$ (maybe we'd even get a raise this year).