nursemoons14

BNP is a waste of money, CHF in the ED can be done by doing simple chest xray and going on your clinical assessment. The only ED docs i see using a bnp in the emerg are ones that are very unsure of their dx's and are not confident. Its an expensive blood test that is pretty much useless. Someone has swelling in their ankles, sob on exertion crackles in lungs, hmmmm lets do a bnp just to be sure. Not really relivant to an ER setting, up for debate i guess

Oh im in no way expecting a ride in the park ahah. Things must be a little wild if they can't staff a small unit like that. Shoudl be interesting and im looking forward to it. I like a challenge

Lucky for me I'm an Emerg nurse, im going to abbotsford ER. And It sounds like they areally have a hard time staffing their ER. probably since its only n 8 bed unit with 1 trauma bay. If I can do magnet hospital ER, hopefully it shouldn't be an issue, my fear is getting pulled into med/surg. I hate that floor crap ahah

Actually I'm starting my first assignment in Abbotsford, BC in 2 weeks time. 8 week contract, it sounds almost too good to be true, I know the hospital is small but thats what I wanted, busy, and be able to do more clinically compared to a magnet hospital that I'm at now. Where did you go for Solutions and how did you find it?

I read it fast, my mind processed dilaudid ahah, thats one hell of a medication error, luckily it was on a board not in the hospital. Don't report me goldstein

Like we don't have enough problem with addicts, good idea drug company

you got problems, peg lyte smells better then lactulose.

I wrote my post after working a 12 hour night and unfortunately didn't get across what i was meaning to get across, i didn't mena we were bolusing her, she was on a pump but she didn't tell us her arm was blowing up so it kept pumping in, nevertheless we still run potassium without a pump. 20kcl with 1L. So its either put it to that or ask another nurse if i can steal her pump for her nitro drip so i can run my maintenance fluid.

hahaha, thats priceless, im sorry

Thank you, some back up

GingerSue, you forgot to add a reference from Jarvis inc. for that detailed explanation ahah, kidding. I would accuse you of copyright if you hadn't have spelled fillup as one word

I too had a very hard time differentiating between lung sounds. I would hear things nobody else would, and was the only thing i really struggled with when i started. A good way to help you would be get someone else to listen too, determine what you think you heard.. chf, usually crackly and wet sounding, sometimes you won't hear any air movement if they are totally full. Try some online sites as well, there are a few out there that have sound files that you can listen too. here's a decent site, there are more out there http://www.stethographics.com/main/physiology_ls_introduction.html

Well boss, at our hospital it is not protocol to run a ba of 1000ml nacl with 20kcl on a pump. Bolus yes, pump no, so I shall continue to do so. Its recommended, but nowhere does it say you have to. when you have a 42 bed emerg with 35 admitted pt's and most of those pt's requiring a pump, and all you need it is for maintenance IV, sorry to break it to you but its the only thing you have to use. What do you think they used before pumps?

def. no tourniquet for ABG's. Lactate doesn't go on ice at our hospital, ABG's and ammonia do tho And our protocol for a stemi is to give "clot busters" we use TNK,unless contraindicated, then start on Nitro drip/heparin gtt.

alright guys i think we all know K can cause arrythmia's I don' think 9 posts saying the same thing is really necessary.