ernurse93

I work in the ED at my hospital, so I have actually encountered this. Our policy states any patient from 20 weeks gestation to 4 weeks postpartum presenting with symptoms of pre-eclampsia or eclampsia should be evaluated in L&D unless they are critical (hypertensive crisis, altered LOC, or actively seizing). If they must come through the ER we transfer them to a hospital with neurology coverage. I have found that most of these patients usually are sent to the OB centers at the receiving facility. I think you did the right thing. I am by no means an OB nurse (I admire OB nurse :bowingpur), but I actually was on a Mg++ drip for eclampsia, and it made me feel horrible. I wasn't even allowed to get out of bed. I had to have neuro checks every hour. The patient would need 1:1 care for sure. You are a great nurse for standing up for what you believed was safe for your patient.

I was always afraid of levophed, because we have to mix our own cardiac drips. That made me nervous. Now I'm glad we do. That is scary. Glad your patient survived.

i bought my sister this book. it has information on everything. she loves it. she is starting school in the fall. [color=#003399]how to survive, & maybe even love nursing school: a guide for students by students by kelli s. dunham i really like the weekend idea, too, as well as the gift card to the school bookstore. a giftcard to staples or best buy would be nice, too. i go through a lot of printer ink and paper. if your friend has children, you could give her homemade coupons for babysitting provided by you. i know it helps me when my sister takes my son for a couple hours so i can do homework. you are a really good friend.

These are all so true and very funny!! :chuckle

Congrats!! Your almost finished!! I have precepted many of the new graduations hired in our ER. The most important thing to remember go in with a positive attitude. Let your preceptor know what you need the most help with. I always ask my orientees/students what they need or want our of their orientation, afterall, this is their time to learn. Always try to observe any new procedures, patient types (peds, OB, older adutl, etc), watch codes or traumas. Take it all in. Don't be suprised if you don't become addicted, ER is a great place to work. As far as preparing, really brush up on your rythm identification skills. Review peds, cardiac diseases, neuro assessments(really important), and assessment skills. If you can review any protocols your ER will have that may be helpful. The main medications we give in my ER is toradol, morphine, demerol, phenergan, lasix, insulin, iv antibiotics, cardiac drips (Cardizem, Lidocaine, Cordarone, Dopamine, Nitoglycerin) and a ton more. Try to learn something new everyday. I have been in the ER for 11 years, and I still learn something new almost everyday! Have fun!! Good Luck!!

Here are some really good articles that answer most of the questions you have including use of a pain scale related to GCS score. Pretty interesting. http://www.docseducation.com/docs_ezio/red_disk_files/Clinical%20Trial%20Result.pdf http://www.vidacare.com/reports/Military%20040007.pdf This article discusses some of the complications related to IO, but does not give any real stats in regards to infection rates. http://www.emedicine.com/ped/topic2557.htm

I have been an ER nurse for 11 years. I can not begin to count how many times the IO has come to the rescue. Our EMS uses the IO frequently in codes especially, but also diabetic emergencies. Our hospital uses the EZ IO which is awesome.:redpinkhe It is amazingly easy to insert, you just drill it in. We have both the adult and peds set up. Our physicians use it often as an alternative to central lines, especially in pediatric emergencies. The only problems we have encountered was a few of the set ups had leaks in the plastic phlange due to cracks in the plastic. I am not sure if they were faulty or if the physician may have drilled them too much resulting in cracks in the plastic. Another problem I have observed is if you do not hold the drill at the proper angle the skin can begin to twist with the drill, which looks extremely painful. I have only seen it used once on a conscious patient, and they said it was not very painful. In the in-service video made by the company, there are doctors and nurses who volunteer to have one inserted on them. One guy said "ouch" otherwise no one really complained. I have used the old IO systems and the EZ IO and the EZ IO is definitely better. It rocks. Hope this helps.