WolfpackRed

this is a bunch of crap. in looking at the FDA statement FDA Safety Communication: Boxed Warning on increased mortality and severe renal injury, and additional warning on risk of bleeding, for use of hydroxyethyl starch solutions in some settings regarding this issue, i felt that the populations studied are already at increased risk for renal damage (critically ill requiring ICU admission and septic) and the volumes used (>2L in over each of the studies cited) are a tad excessive. Also, the FDA warning states that "Renal injury was not evident in a review of 59 RCTs in which HES products were administered in the operating room to adult and pediatric patients who were undergoing surgery and were followed for a short period of time, the facility I work in withdrew all HES products from the pharmacy after this warning was issued. I am concerned that it limits may fluid options for patients in the OR (Jehovah's Witnesses who elect to not receive albumin come to mind). Also, the cost of albumin is a concern. However, given the FDA warning and the European warning, perhaps I should consider investing in albumin manufacturers.

According to the AANA, yes burn ICU would count. HOWEVER, you should contact potential programs and inquire how they view your ICU experience

i prefer words with friends

My ICU experience was medical for ~2yrs followed by neuro ICU ~18months (both adult) prior to starting anesthesia school. You will hear and see many opinions on which is the "best" ICU to get experience in. in my class we have a good mix from every ICU background: trauma, surgical, medical, CV, cardiac, and neuro.

Anesthesia Board Question of the Day from Core Concepts Daily Free Board Question

i have the sweat book and flash cards from friends and did not attend the actual course. I have used the Prodigy system and find it more to my learning style - the computerized questions and practice tests are very convenient.

the "sweat book" contains all the info that you will cover in the review course; you should receive it a couple of weeks prior to the live course. the memory master is the same as the flash cards, except the MM has all the questions printed out on 8x11 pages instead of "flash cards"

"Watchful Care" by Marianne Bankert would be a good start. Also any book from here: Books

as you are asking for ways to INCREASE you chances of being accepted, the best thing you should do is speak to the director of any program you are interested in attending. the standards set forth by the AANA are purely minimal, and your BA GPA needs some improvement. as Skip said prior, you will probably need your BSN (I am ~99.9% certain that you will need it). while you can take grad level courses to demonstrate you can handle the work, it may not replace your grades in your undergrad; again a good discussion for the program director However, any adult ICU experience will suffice; I know the AANA states "acute care" and that is left up to the admissions committee. There are programs that will consider pediatric experience and other "acute" areas, but adult ICU should have you covered. Certainly, many people have a preference of CVICU being "better" than anything else, but any ICU experience counts and have more than one year helps. Get your CCRN. Don't forget about the GRE. Focus on shadowing CRNAs. If you want to do committee work, stay involved once you are working; school committees look good, but (again my opinion) work committees demonstrate professional involvement. you can try to volunteer in an ICU as a way to get you foot in the door for a job, but in my experience, there is little place for volunteers. to get your foot in the door you may consider a nurse assistant/PCT position

what does Barry recommend? also, I would contact the financial aid office to see what the requirements are to qualify for financial assistance/reimbursement on your computer purchase. to answer you original question, I bought a Dell Inspiron 17in screen laptop with i5 processor and 4Gb RAM/ 400 Gb hard drive. I am more comfortable with a Windows OS; further I felt that I would be able to keep this laptop for personal use after school is complete. Some people have Apple/Macs, but the biggest problems that many run into is the occasional problems when these students try to do presentations from their MACs onto the school's Windows based presentation software/hardware.

Benzyl alcohol, a component of this product, has been associated with serious adverse events and death, particularly in pediatric patients. The "gasping syndrome," (characterized by central nervous system depression, metabolic acidosis, gasping respirations, and high levels of benzyl alcohol and its metabolites found in the blood and urine) has been associated with benzyl alcohol dosages >99 mg/kg/day in neonates and low-birth weight neonates. Additional symptoms may include gradual neurological deterioration, seizures, intracranial hemorrhage, hematologic abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia, and cardiovascular collapse. Although normal therapeutic doses of this product deliver amounts of benzyl alcohol that are substantially lower than those reported in association with the "gasping syndrome," the minimum amount of benzyl alcohol at which toxicity may occur is not known. Premature and low-birth weight infants, as well as patients receiving high dosages, may be more likely to develop toxicity. Practitioners administering this and other medications containing benzyl alcohol should consider the combined daily metabolic load of benzyl alcohol from all sources. from the hospira package insert for its formulation of propofol

according to the AANA "The requirements for becoming a Certified Registered Nurse Anesthetist (CRNA) mainly include having a bachelor's degree in nursing (or other appropriate baccalaureate degree), Registered Nurse licensure, a minimum of one year acute care experience (for example, ICU or ER), and the successful completion of both an accredited nurse anesthesia educational program and the national certification examination." it is left up to the program on defining the acute care experience and other admissions requirements.

modern day vaporizers can maintain volatile agent concentrations over a range of temperatures and fresh gas flows the des vaporizer differs in that it keeps a higher temperature and pressure since des can boil away at STP; also des is ~5x less potent than iso and sevo and thus very high fresh gas flows would be needed to dilute the agent to safe levels 4 methods - landmarks/ paraesthesia, field blocks, nerve stimulation and U/S guided IV, tracheal, intercostal, cervical, epidural, brachial plexus, sciatic, and SQ propofol can have EDTA and Na metabisulfite, the bisulfite preservative can cause problems in ICU/ARDS pts. on a side note, in the institution I train, we have seen benzyl alcohol as a preservative and had alerts against using this formulation in the peds pts. finally, NO state (unless you count a state of delusion) requires CRNA supervision for practice

in my opinion, you should look into another area besides CRNA. the process of ICU preparation and an anesthesia program may be very difficult if you are not motivated to do it. i enjoyed the ICU; i worked MICU and Neuro ICU. I also worked part time in an ER. perhaps you should look into that.

the pt's use of these drugs would modify the plan as cogentin will antagonize the ACh and histamine receptors, selegine is an MAOI and therefore ephedrine should be avoided but small doses of direct acting alpha agonist (neo) can be used for hypotension. sinemet increases the amount of dopamine available. other antiemetics to use include decadron and I forgot to mention the use of 80-100% oxygen. antiemetics to avoid: butyrophenones (droperidol), metoclopramide, and phenothiazines (phenergan and compazine) as these can increase the extrapyramidal side effects

Rx4zzzz, I sent you a PM, let me know if you received it.

scop patch, H2, blocker, TIVA with propofol, maintain normotensive state (ephedrine preferably or neo), adequate hydration; ondansetron can be used for rescue N/V. avoid droperidol

I suggest you get Morgan And Mikhail "Clinical Anesthesiology"

I can only relate my experiences, first as an interviewee and second as a SRNA on an interview committee. during my interview for school, the interview was going well (in my opinion) then someone asked "what I would do if I was not selected for admissions?" as I laid out a plan, the interviewed asked straight out "do you plan to get your CCRN?" and I responded that I had it and I apologized as the certificate should have been in my application ( I had taken the CCRN exam months prior to the application deadline). Upon hearing that answer, there was a little scurrying as the committee updated my application. as some back ground (not bragging), prior to applying to the nurse anesthesia program, I had been a MICU and NSICU nurse at major urban teaching hospitals for a total of 3 years, had CCRN, TNCC, BLS, ACLS, and PALS, prior military experience, a BS in biochemistry with a minor in genetics, and a GRE of 1180. as an SRNA on an interview committee, I feel that having your CCRN demonstrates that you are motivated and dedicated to your profession. you have also shown the ability to apply a high level of critical thinking skills. on the interviews I have seen a range of nurses with little experience having their CCRN as well as seasoned nurses without it. under the pressure of the interview, I have seen both sets freeze up on clinically related questions. final thoughts - on paper, I think the CCRN can set a candidate apart, as griffenchet stated, once you make it to the interview stage other factors can set you apart. p.s. if the committee asks if you plan to obtain your CCRN, please answer "yes" or "no". one candidate said it was not worth their time, they did not do so well

good luck

last interview session was this past weekend, the program interviewed ~36 applicants for ~6 slots; the entire class size starting in August will be 24

there is a dress code. think business casual. definitely no jeans/t-shirt. you should receive an electronic version of the student handbook ~1 month prior to starting the program. the handbook will detail all the policies, including dress code.

wow - this was difficult. i spent about 30 minutes researching this answer: methylene blue great question

ephedrine?

I found Princeton Review's book extremly helpful; you can register on their site and get access to tutorials and practice exams.