SRNA312

wow!!

Congrats!

Without expounding too much, what you say is pretty much how it is in a nutshell. People have very strong opinions about these two professions but the bottom line is, there is no research to prove that in the long run, one profession is better or safer than the other. It's all a matter of opinion. They both/all (MDA's too) exist because there is a shortage of anesthesia providers. History has proven that when there is a shortage of a type of service, society will create other ways to help fill the need.

Very true and very good point. Other things are definitely happening. If, during a difficult intubation or whatever, your denitrogenated patient with 100% sats hasn't had a breath in a bit, you may want to consider giving breaths, if for nothing else, to blow off C02.

The pillow doesn't have anything to do with the nitrogen washout. That is for obtaining a "sniffing" position that aligns the oral, pharyngeal, and laryngeal axis in an anatomically optimal manner to ease intubation. Whether you leave the pillow or not is strictly a preference of the endoscopist. Nitrogen washout, also referred to as pre-oxygenation or denitrogenation, is for maximizing the time you have to intubate. As you know, the air you breathe is 21% O2 and 78-79% Nitrogen, 1% other gases. With that being said, at the end of a normal expiration, each person still has more air they can forcefully expire.........this is the expiratory reserve volume (avg =1100cc). Even when you have seemingly blown all the air from your lungs, there is still air in there or they would collapse. This is the residual volume (avg=1200cc). These two volumes together = the Functional Residual Capacity (or FRC). The average FRC is all together is about 2300cc or so give or take, depening on the size, sex, and sicknesses of the patient. Out of that 2300cc, at least 78% of it is Nitrogen. The goal of denitrogenation is to make the FRC be 100% O2. This is done with 3-5 minutes of breathing 100% O2 (there HAS to be a good seal.....no entrained room air allowed!) or sometimes people do it with 4 vital capacity breaths of 100% O2. Depending on what book you read, the avg human consumes O2 at a rate of about 250cc/min. If your FRC is 2300cc, then if it was filled with 100% O2, that would give you about (2300/250=) 9 minutes or so before the patient would desaturate. That would be for a healthy person.Now you must understand that "sick" people usually consume O2 at a lot faster pace so you wouldn't have as much time to intubate but just understand that denitrogenation is to buy you time and the above is a detailed explanation as to how it buys you time. I have seen dentritrogenated patients maintain a 100% saturation for what seems like an eternity with absolutely no ventilation at all.

For me, actually being at valley did NOTHING for me except get me a few days off of clinical and a decent road trip with classmates. I DEFINITELY could have gone without it. But that's just me. The material, including the memory master is worth the purchase, if for nothing else, the organization of the material. I wouldn't use it as your sole source for studying, but it's very nice to have when you're trying to filter the BS.

It DOES make it a lot more difficult but it can be done. 3.32 here. As you can imagine, the application pool is a very competetive one. With that GPA you will need something else to make you stand out because when they are selecting for interviews, all they have to look at are numbers and you better believe there will be more than enough numbers higher than that. Most schools also look at last 60 hours. You will need things such as a superb GRE score, great experience, Great recommendations (and I mean GREAT...because who can't find 3 people to write good things about them?). Also, taking various classes over to improve the GPA. Asking the various schools what you can do to improve your chances and then doing it shows initiative, which is a good thing. I had the GRE and 8yrs experience going for me. In my humble opinion, the lower your GPA, the longer you may have to wait to get in so you can build up years of knowledge. A low GPA and minimal experience isn't a good match.

The whole point is to accept individuals who have knowledge about and experience with controlling people's hemodynamics with vasoactive drugs and measuring their hemodynamics with things such as Art lines, CVP lines, and SWANs. In addition, knowledge and experience with ventilated patients and preferably knowing how to run a code. With that being said, whether you work in PACU, ER, or ICU....if you don't have experience with and know how to do these things, you are not a good applicant to CRNA school. If you wish to bypass this, you have a much better chance of getting in AA school.

You only have to take it once. It does not matter what state you take it in. The difficulty does not change per state. All that matters is that you have a nursing license and/or advanced practictioner nursing licence in whatever state you want to work in.

Thank you for your responses. Can you reference this somewhere?

Can someone please provide me with a pediatric Succs dose for laryngospasm with a respectable reference? I can't seem to find it. I know what normal peds succs doses are and I also know that 2mg/kg IV and 4mg/kg IM should definitely cover it if these doses are enough to intubate with, however I want to see the peds succs larygospasm dose in writing if it is anywhere. All I can find is "treat with Succinnylcholine". Appreciate it....