MegNeoNurse

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 illicit acceptable sedation. The unit I work in h...

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 often times.

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

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. Dilaudid is wonderful!!! As is morphine (but you sai...

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 in house. I'm pretty sure any attending who was ac...

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 now.. he lived but isn't "right"

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 unit, that's the type of floor I would try to get a p...

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 from a biased background. I've always been told ...

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 bowel) and the team would flip!

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 and interventions ( and RN signs off on), assist ...

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 propofol regularly.

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, clamp, access using needleless device at hub to draw sp...

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!) to decrease risk of right main stemming and associa...

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 often run peripherally. I would NEVER have TPN, bica...

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 drips, and we can give additional blouses from the pu...

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, instilling 3ml NS, withdrawing 5ml waste, drawing blood nee...

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 in a preemie is even more immature than that of a...

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 NICU.

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 denim? Should I wear khakis? Dress pants? There ...

I currently work in PICU, and have worked in ICUs my entire nursing career. All of our TPN and IL run on an IV pump, never piggybacked as you described. So IMO everything is wrong with that picture! With all of the additives and electrolytes in T...

Yes, that exactly.

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 calcium infusion going into a port directly to the pati...

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 far less difficulty in general with Citrate SLED. ...

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, vecuromium or ketamine gtt as well. I would of cour...

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 poster who gets to bring a doc with to MRI... I w...