TopherSRN

TopherSRN

Member

  • Content

    126

  • Visitors

    2,572

  • Followers

    0

  • Likes

    0

All Content by TopherSRN

  1. Teaching vs. Non-teaching hospital

    TopherSRN replied to ericdb68's topic in MICU, SICU

    I say private, because you'll actually learn how to think critically and not just page the resident/intern. Also often times the residents/interns are just as clueless as you, or even

  2. Am I ready?

    TopherSRN replied to blackIrish's topic in CCU, Coronary, Cardiac

    This will probably be a unpopular opinion but w/e. Yes you are ready, you were ready as soon as you graduated. Your med/surg experience while nice, might handicap you the first year or so. You have to...

  3. Concerns: Actions outside of scope of practice

    TopherSRN replied to tigermonkey's topic in CCU, Coronary, Cardiac

    Basically Yes. Open heart is a entirely different environment. Once you've been there awhile and know what your surgeons want they will expect you to be more autonomous. If you actually did call for...

  4. Ok, please give me the bonehead version

    TopherSRN replied to sharann's topic in CCU, Coronary, Cardiac

    It's typically .5-10 mcg/kg/min, though I usually start at .2-.3 and go up from there. Most of are patients have a-lines, but I've used in patients who don't. Just be conservative, it has a very short...

  5. What Stethoscope to use

    TopherSRN replied to leesespieces's topic in CCU, Coronary, Cardiac

    you just graduated and are starting brand new? Just get a higher end littman Card 3, master card. I'd advise against an electronic for many reasons. The most important is that you don't want to be...

  6. Ok, please give me the bonehead version

    TopherSRN replied to sharann's topic in CCU, Coronary, Cardiac

    Nipride is usually 50/250, and thus would be calculated the same as single strength NTG. I really don't understand what the question is. Do you want to know specifically about Nipride dosing or do you...

  7. iabp

    TopherSRN replied to Feldner's topic in CCU, Coronary, Cardiac

    It takes me maaaaybe 5-7 mins to do the hourly balloon stuff (check pulses real fast, eyeball/assess site/catherter, record IABP numbers [either by printing a strip or just pausing waveform and...

  8. iabp

    TopherSRN replied to Feldner's topic in CCU, Coronary, Cardiac

    Ours are typically 1:1 DOS depending on staffing. Our hearts are also typically 1:1 until extubated, yet I've double admitted 2 stable ones 30 mins apart. A lot of it depends on the patients. Pre-op...

  9. What do you never leave home without?

    TopherSRN replied to RNCRNA2BE's topic in CCU, Coronary, Cardiac

    I bring a backpack to work and the only pertinent work related item in it is a stethoscope. I do have a small version of Dr. Cusicks's ACCRS sheet with gtt info on it, but it typically stays at the...

  10. What do you never leave home without?

    TopherSRN replied to RNCRNA2BE's topic in CCU, Coronary, Cardiac

    Mine helps me to drowned out all those annoying alarms so I can concentrate on my

  11. map & dbp question

    TopherSRN replied to chaosRN's topic in CCU, Coronary, Cardiac

    To the graft comment,I was talking with one of our surgeons who fellowed under one of the most renowned CV surgeons when a Precedex rep approached us trying to sell him on it. He said something along...

  12. Which pressor to use???

    TopherSRN replied to cardiacRN2006's topic in MICU, SICU

    sounds like you need some autonomy as well. If you paged a physician, and they said 'What his CVP?' would you really respond with "i dont have an order to xduce one'? I get all the information I...

  13. advandced monitoring in the ER

    TopherSRN replied to phiposurde's topic in Emergency

    Last I checked ER Attendings can put in CVLs as can residents and interns.. It takes a tech to hold the saline flush or not depending on how creative the physician is. Wha? People with CVLs goto CT...

  14. What holster do you use??

    TopherSRN replied to InmyblooD's topic in Emergency

    I wear the following and wouldn't goto the hospital without it!!! http://media.popularmechanics.com/images/tb_toolbeltlead-lg.jpg I get compliments from the hotties all the

  15. STAT intubation advice PLEASE!!!!!!!!!!

    TopherSRN replied to miloisstinky's topic in Certified Registered Nurse Anesthetist, CRNA

    That would work if CRNA's could write sedation orders. In our unit we have the autonomy to start precedex or propofol, though I usually get sedation orders when I call the surgeon for intubation...

  16. TEXAS CRNA's Call to action. Stop the potential AA bill!

    TopherSRN replied to Outdoor1's topic in Certified Registered Nurse Anesthetist, CRNA

    (edited by moderator for TOS)..What's it like to live in your world? So are all PAs/SAs/AAs just med school flunkies, yet NPs/CRNAs are not? You have a amazingly twisted view of midlevels and their...

  17. Does time pass slow in the OR?

    TopherSRN replied to Chip_04's topic in Certified Registered Nurse Anesthetist, CRNA

    I thought twice about reading gossip magazines during cases when I first started too. I thought it would be hard to concentrate with all the alarms beeping. But then I just started silencing them and...

  18. dobutamine

    TopherSRN replied to samaletta's topic in Cardiac

    CI would be ideal for titration of dobutrex. in the absence of a swan sbp, uop, and cvp would be next best. The OP said pt was on 10 mcgs and the mar simply said titrate. Typically you have...

  19. Does time pass slow in the OR?

    TopherSRN replied to Chip_04's topic in Certified Registered Nurse Anesthetist, CRNA

    Bring a few magazines to the OR with you. They always help time pass

  20. Question on Certification

    TopherSRN replied to AcosmicRN's topic in CCU, Coronary, Cardiac

    PCCN != CCRN. No clue why you cut/pasted from AACN site and then told me you sat for the PCCN because you wourk on step downs. Vent management and hemodynamic monitoring are the essence of an ICU....

  21. Arterial Cath Placement

    TopherSRN replied to Cik's topic in MICU, SICU

    PAs and perfusionists do as

  22. please help with these ABG's

    TopherSRN replied to emmycRN's topic in MICU, SICU

    those always make me laugh. Catecholamines do no good sitting in a periphreal or the svc. PO2 isnt horrible considering his Hx. You would be surprised at the PO2 some people walk around with though, I...

  23. Dumb Question?

    TopherSRN replied to WeakAnkles's topic in MICU, SICU

    Ever hard flush an A-line or IABP? Ever push thru a CVP line? Same way, just connect at the

  24. Ventilators

    TopherSRN replied to krzysiu's topic in Student Registered Nurse Anesthetist

    you should know vent management in and out before you are sitting for a CRNA interview. That is, unless you worked in an icu that never handled

  25. hemodynamic monitering cold or room temp?

    TopherSRN replied to AJACKSON1048's topic in MICU, SICU

    Your post is very confusing, but my suggestion is a CCO swan. Only time I've used non CCOs are from xfers. Used iced injectate and left it connected. Thankfully we don't even have setups where I'm at...