loriaz

I have been working in the ICU for many years we have had an increase in the number of ARDS patients in the US. We start out using the CLRT funtion on beds to rotate patients for lung reasons. However, we are still required to turn patients with a pillow to offload pressure in coccyx area. What is the practice in your hospitals. The CLRT function can only be set for 30 mins hold at a time. Are you turning and removing pillows every 30mins? DO you use pillows to turn them when using this function? Do you worry about the impact of skin when patients lungs are compromised? If this CLRT doesn't help we will use the rotoprone bed which is horrible for skin. Do you have certain protocols for the ARDS patients related to turning and skin impact?

In the hospital I work at we have a resource pool . I float to ICU and ER and med surg. Get the best of all the worlds and it changes daily.

Have you seen a difference with the use of vitamin C/thiamine/steroid protocol? Are patients getting out of ICU quicker?

I am curious what other hospitals are seeing. I am a resource nurse and float to many different ICU in our hospitals. We are seeing more and more sepsis. What are you guys seeing as the cause of Sepsis???? We have seen pneumonia, post C-sections, surgical site infections and post op surgery as some of the causes. What is everyone seeing. I also seen an article about giving vitamin c for sepsis and patients recovering from sepsis quicker. Our doctors aren't using this yet are your docs using this???? I have been doing my own research to enquire about sepsis. This is kind of a personal mission I lost someone close to me due to sepsis. Just wanting to see what is happening around other hospitals today.

What kind of dressing changes is everyone doing on their knees and hips? Does the MD do the first dressing change? Just curious. We have a couple docs putting wound vacs over stapled incisions is anyone else seeing this?

Just training a new nurse and want to make sure I cover the important stuff. It is hard to explain gut feeling any thoughts?

Just seeing if there is anything I might be missing. I work in a trauma unit and with trauma it is hard to tell sometimes if it is because of the trauma or if it is an infection starting. Traumas are usually dirty so didn't know if there is something else to help differentiate. It is interesting to me that even with some of our trauma patients they don't continue antibiotics. Usually only three doses. Is this normal practice? Sometimes my gut tells me this is going to be a bad outcome but didn't know how to explain it to a newer nurse any suggestions? It is hard to explain gut feelings to a new grad. I told her all the signs to watch for but sometimes you forget so that is why I am asking.

Just wanted to see if nurses that deal with surgery patients can explain how they know when an infection might be starting in the surgical site? Nurses Gut feeling? Smell? Redness? Copius drainage? What are some of the things you notice first? How long after surgery do you notice it? Is it immediate within 24 hours or longer? Are patients being prescribed antibiotics after surgery? Who does the first dressing change nurse or surgeon? What kind of surgeries are you seeing with infections?

They are placing wound vacs on closed incisions. Staples usually in place. Any rationale behind this?

is there a trend in using wound vacs for surgeries? The hospital I work at some docs are using wound vacs on hips and open hearts. Is anyone else seeing this trend. Just curious?????