MegNeoNurse

MegNeoNurse

PICU, ICU, Transplant, Trauma, Surgical

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All Content by MegNeoNurse

  1. Sedation Woes...

    MegNeoNurse posted a topic in PICU, Pediatric

    What do you use routinely for sedation on patiently requiring mechanical ventilation? Our first line routine is fentanyl @ 1mcg/kg/hr and midazolam at 1mcg/kg/min and we increase as patient needs to...

  2. To Filter or Not to Filter

    MegNeoNurse replied to ScammRNC's topic in NICU, Neonatal

    The NICU I worked in didn't filter lipids. I now work PICU and we "Y" our lipids in above the filter. Keep in mind, kids that get TPN and Lipids at home get the TPN and Lipids mixed in the same bag...

  3. Sedation Woes...

    MegNeoNurse replied to MegNeoNurse's topic in PICU, Pediatric

    Yes, pentobarb for sedation. Works wonders for these kids who build up such tolerances to fentanyl and

  4. Pain management post open heart surgery?

    MegNeoNurse replied to twinkletoes53's topic in CCU, Coronary, Cardiac

    How frustrating to have a relative going through this and not receiving adequate pain control! It is SO important for post-op hearts to becomes extubated ASAP and ambulatory! As is pain control....

  5. BP Cuff Readings vs. Arterial BP

    MegNeoNurse replied to Zee_RN's topic in MICU, SICU

    Art line. It should be a WORKING art line if you have a pt on pressors. I am glad to work in a teaching hospital with residents available (although not always helpful) 24/7 if the attending is not...

  6. What is the highest temp you have seen?

    MegNeoNurse replied to momthenRN's topic in MICU, SICU

    Mid/High 41.0 (Celcius... in the US but our system uses Celcius kinda surprised more don't!). I take care of a lot of transplant and trauma patients. Closed head trauma is what comes to mind right...

  7. Best floor for experience prior to ICU

    MegNeoNurse replied to sedation_season's topic in MICU, SICU

    It sounds like you have a good path planned for jump starting your nursing career :). What type of ICU do you aspire to work in? Trauma/transplant, burn, neuro, cardiac? Depending on the type of...

  8. Computer linking

    MegNeoNurse replied to 4fill's topic in Critical Care

    I have always had computer charting, we were trained in this is nursing school. Our legal classes even discussed aspects of best charting practice in reference to computer charting. So I am speaking...

  9. Temperature. Where do you go?

    MegNeoNurse replied to MLB55's topic in Critical Care

    We take axillary on patients unable to otherwise take oral temps on (so pretty much everyone). Very rarely have esophageal probes. Never taken a rectal, but a lot of our patients are transplant (inc...

  10. Just got hired as a CNA in the ICU

    MegNeoNurse replied to Miash58's topic in Critical Care

    The CNAs in the unit I work in do a lot: vitals, baths, help with repositioning, blood glucoses, answer call lights, stock rooms, set up rooms for admissions, record vitals and notes during procedures...

  11. Sedation Woes...

    MegNeoNurse replied to MegNeoNurse's topic in PICU, Pediatric

    The only time we use propofol is SOMETIMES in the 12 or so hours prior to planned extubation since the half life is so short. I know the adult units use it more often, but our intensivists don't use...

  12. What do you guys use for art lines??

    MegNeoNurse replied to Nursemommi's topic in PICU, Pediatric

    We use an inline system as well for art lines. Transpac® Disposable Pressure Transducers by ICU medical. We put a T connector at the hub of the catheter, pull waste back through closed system,...

  13. Positioning for HFOV

    MegNeoNurse replied to menemsha's topic in NICU, Neonatal

    As long as baby is >28 weeks and a week old, midline positioning is not detrimental for prevention of IVH. If a pt is on HFOV the ETT is ideally a bit higher than normal (still below clavicles!)...

  14. Neonatal IV question

    MegNeoNurse replied to NickB's topic in NICU, Neonatal

    We never cover our IVs in NICU, in PICU yes as those kids actually realize they have an I'VE in their arm/hand and might pull it out. In NICU sometimes all you have for access is a PIV and TPN is...

  15. Hourly doses of vent sedation, is this common?

    MegNeoNurse replied to jkej's topic in MICU, SICU

    I had a trauma patient last week that the trauma team wrote for PRN dosing of meds to keep RAS at a certain level. Super annoying. Generally, vented patients in our unit are on pain and sedation...

  16. Drawing blood from central lines

    MegNeoNurse replied to Altra's topic in CCU, Coronary, Cardiac

    I work in a PICU and regardless of age or weight, we return the waste when drawing from a CVC, with the acception of heme/onc patients. I found the practice of vigorously scrubbing the hub,...

  17. Bilirubin levels ?

    MegNeoNurse replied to samiam4's topic in NICU, Neonatal

    7.0 and 6.3 is elevated for 24 hours of age, but phototherapy usually isn't started until 10.0 (in most cases, depending on the doc). Prematurity increases the risk of hyperbilirubinemia as the liver...

  18. How sad is the NICU? Is there a personality type best suited to it?

    MegNeoNurse replied to chunkiesundae's topic in NICU, Neonatal

    I've worked in NICU for over 7 years, and PICU for over a year now. PICU (at least the one I work in... Level I trauma center, transplants..) is by far MUCH sadder than the

  19. Nursing School Orientation. What to wear!?

    MegNeoNurse posted a topic in General Students

    Hey all :) Orientation for new nursing students is on Tuesday at my school. I don't know how to dress! How did you and others at your school's orientation dress? Is it okay to wear a nice top and...

  20. Zeroing the transducer...help?!

    MegNeoNurse replied to cwhitebn's topic in MICU, SICU

    Yes, that

  21. Alaris pumps

    MegNeoNurse replied to deanpicu's topic in PICU, Pediatric

    No this pt was on Heparin CRRT, so no calcium infusion. The port that had pressure issues was the "Pre-fluid" once the Arterial Pressure hit -300. But yes, when we run Citrate CRRT, we have the...

  22. Alaris pumps

    MegNeoNurse replied to deanpicu's topic in PICU, Pediatric

    The last kiddo I took care of was on Heparin SLED (CRRT). His pre and post fluids were connected in at a stopcock hooked up next to the respected arterial or venous port. I've found that I have had...

  23. Ativan IVP given undiluted into central line.

    MegNeoNurse replied to Septic Boy's topic in MICU, SICU

    If central line, I give it undiluted, and as generally my pt is intubated I give it over maybe 30 seconds. As my pt is intubated, they are also on a fentanyl gtt, versed gtt and possibly propofol,...

  24. Question for more experienced ICU RN's

    MegNeoNurse replied to Nurse1966's topic in MICU, SICU

    I agree with the air leak explanations above. It sounds like he had free air elsewhere (peritoneal.. mediastinal...) which may have caused the crepitus you felt during compressions. And to the above...

  25. Does NICU offer experience for other areas of nursing?

    MegNeoNurse replied to ijuanabhappy's topic in General Nursing

    NICU is really its own world compared to all other units in the hospital. I did NICU as a new grad for 2.5 yrs before getting bored and switching to PICU. I just didn't find NICU challenging anymore...