Adult and pediatric emergency and critical care
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PeakRN specializes in Adult and pediatric emergency and critical care.

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  1. Blood pressure in peds patients

    Just for perspective I have found essential hypertension in otherwise healthy 2 and 3 year olds several times in the ED. While the ED is not the kid's primary care, that may be the only medical provider they see for months or years. These kids could ...
  2. When we hire in my center we typically favor critical care over floor pediatric experience. Unfortunately adult med/surg is unlikely to give you either experience, but you also have to start with the job you can get. If you are willing to relocate th...
  3. The ICU book. The Ventilator book.
  4. Paramedics in the ED

    Query: Professionalism.
  5. What is your "favorite" procedure?

    One of our PICU intensivists loves giving haircuts to the long term kids.
  6. What is your "favorite" procedure?

    Reducing dislocations. Instantaneous gratification.
  7. Paramedics in the ED

    While I agee with some of this I would like to clarify a bit. I was a messy medic. The floor and bench of my bus were a disaster by the end of my call. That was because we thoroughly cleaned the back after every call. Also since we only us a few call...
  8. Paramedics in the ED

    You seem to have a bit of a chip on your shoulder. Why did EDs start hiring paramedics? Simply put they are cheaper labor than registered nurses. Paramedic and nursing education is not the same, I’ve done both. Paramedics are taught the technic...
  9. In my opinion your ED has not provided adequate training. All of our new grads must have ACLS, PALS, TNCC, ENPC, NIHSS as well as complete their online ED modules and all of their staged orientation (which would include things like gastric tube place...
  10. NGT policies about days until removal for Neonates

    If they are in the NICU: 28 days unless ordered otherwise (typically for surgery or other complex placement). In the PICU or Cardiac ICU they stay until they go bad, we don’t have a policy on rotating them.
  11. Peds Nurse Furloughed During Pandemic

    We never furloughed anyone, but we did cancel every traveler and PRNs have been removed from the schedule. We did rotate a lot of nurses with adult experience back to the adult world. PICU nurses back to adult ICU, peds onc to adult onc, peds floor t...
  12. Famous person as patient?

    I’ve taken care of more famous people and their families than I can count. Professional athletes, national media reporters, politicians, several heirs to european monarchies, CEOs who’s names are nationally known, and so on. We are a bit well known a...
  13. Feeling Bored

    No offense but if you have nothing to do as a nurse on a peds unit for several hour you aren't really a peds nurse. There is always a kid that needs help with homework, another disease to be studied, an infant that would benefit from holding, and so ...
  14. Finger Stick in Arm Alert AV Fistula

    For something like a glucose check I don't understand why you would really need to use the limb alert arm. In the unit we stick patients every hour when on IV insulin, often (repeatedly) on the finger of their choosing.
  15. Coping with death and bad outcomes

    I'm fortunate to have the perspective of having worked with adults and peds in EDs and the units. Life is unpredictable, it isn't fair, and not everyone gets dealt a good hand. I've had plenty of kids with poor outcomes from heart disease, the flu, a...