ShaunES

ShaunES

ICU

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All Content by ShaunES

  1. Therapuetic Hypothermia

    ShaunES replied to kaiser0926's topic in MICU, SICU

    We cool for ~24 hours, then passive rewarm with space blanket aiming for 0.5 degree celcius/hour. We remove blankets and recommence cooling if they exceed this. We've had several successful cases, but...

  2. Cath Lab

    ShaunES replied to wrenRN06's topic in Cardiac

    If you're applying to ICUs why are you getting nervous about going into the cath lab? Just go, it sounds like a good job with a good orientation and it will certainly get you in the

  3. Temperature. Where do you go?

    ShaunES replied to MLB55's topic in Critical Care

    Bottom is worst. Properly positioned esophageal probe (at the aortic arch) will give you the closest match and the fastest response to blood temperature

  4. Multiple drip administration

    ShaunES replied to Sugarcoma's topic in CCU, Coronary, Cardiac

    cvp is useless to assess volume status and you should ignore it; better yet, put your vasoactive medications on the distal lumen and you have another free lumen. last or first it doesn't matter,...

  5. Multiple drip administration

    ShaunES replied to Sugarcoma's topic in CCU, Coronary, Cardiac

    Seems much simpler to just use a bag and then you never have to stop

  6. Should CVVHD be 1:1

    ShaunES replied to kristenallene40's topic in Critical Care

    If the argument is that it's time consuming, then I agree, it can be time consuming. On the other hand, changing bags takes a minute or two at most, and fluid removal is simple. As for charting, I'm...

  7. Should CVVHD be 1:1

    ShaunES replied to kristenallene40's topic in Critical Care

    That's why they're 1:1. What's the difference between an intubated patient and someone on CRRT? If you lose an airway that's a lot bigger deal than your circuit clotting. I don't

  8. Nitro vs Morphine

    ShaunES replied to moidla's topic in CCU, Coronary, Cardiac

    CRUSADE is demonstrating that those treated with Morphine have double the mortality rate than those not given morphine. If one were to use opiates/opioids, I would suggest fentanyl - faster, nicer and...

  9. Do you get a lunch break?

    ShaunES replied to beccainabox's topic in Critical Care

    I work in a large ICU in Australia. We're 1:1, and work 12 hour shifts. We get a 20 min morning tea, 30 min lunch, 20 min afternoon tea, 30 min dinner. We do break with our neighbour; our bedspaces...

  10. Intubated Pt's Using Bedside Comodes

    ShaunES replied to EDrunnerRN's topic in Critical Care

    I've walked intubated patients around the unit with a transport ventilator, so no, using a bedside comode isn't that crazy an idea. Not every intubated is unstable, if you have the resources and time...

  11. Sedation..Your thoughts?

    ShaunES replied to Da_Milk_of_Amnesia's topic in MICU, SICU

    I just use the bolus feature in our pumps, saves me having to baby sit the pump, and I don't accidentally leave it infusing at

  12. Scrotal Edema leading to Breakdown

    ShaunES replied to dtbrn09's topic in Critical Care

    Our hospital has occupational therapists who do all our splints/etc, they provide scrotal slings to assist with reducing pressure, seems to

  13. Moving Too Slowly in Emergent Situations

    ShaunES replied to LaurenBoog's topic in Critical Care

    Sounds like a problem with the system, not with you. In my ICU, all orders are entered onto our electronic system by the doctor requesting them, and show up instantly on our bedside computer....

  14. When to call in sick to the SICU

    ShaunES replied to DuluthMike's topic in MICU, SICU

    When you're

  15. Vasopressin- Usage and dosing

    ShaunES replied to trvlnurs's topic in MICU, SICU

    http://www.srlf.org/data/Upload/Consensus/pdf/50.pdf This study has the patients in severe sepsis on an average of 0.45mcg/kg/min of noradrenaline, with a maximum of 1.06mcg/kg/min. While there is...

  16. Vasopressin- Usage and dosing

    ShaunES replied to trvlnurs's topic in MICU, SICU

    Our septic patients start on noradrenaline (nor-epi/levophed), once they hit about 30-40mcg/min, we start vasopressin at 0.04units/min, and from there we can wean the noradrenaline down, but keep the...

  17. Palp pressure traumatic hypotension

    ShaunES replied to dudemursestudent's topic in MICU, SICU

    Any trauma like that should score an art-line anyway, so the noise of a trauma bay is irrelevant after that goes in (usually one of the first

  18. Any ICUs or critical care settings where the standard ratio is 1:1?

    ShaunES replied to edogs334's topic in MICU, SICU

    Australian ICUs are 1:1 for ventilated patients, and 99% of patients are 1:1 anyway. Come on

  19. How often do you take a vacation?

    ShaunES replied to PAERRN20's topic in General Nursing

    I get six weeks a year of paid leave, or 12 at half pay, enough time to relax, dont have to use it all at once, or at all (so can have massive holidays every few years etc), it's

  20. New RN with Question

    ShaunES replied to RNwithpassion's topic in General Nursing

    Since we've covered the easy stuff, how about something way out of left field? Paroxysmal Nocturnal

  21. ICU Ratios in the US

    ShaunES posted a topic in MICU, SICU

    Hey, I'm in ICU here in Australia, and I've noticed that you guys in the states seem to have 1:2, even with stuff like vents and CRRT. I'm just wondering about the practical aspects of this; what...

  22. Over riding a resident?

    ShaunES replied to beeble's topic in General Nursing

    An ECG takes 30 seconds, and pulling bloods takes 2 minutes. I don't understand why you would spend time trying to get the order changed when you could have done in the time you spent

  23. Should CVVHD be 1:1

    ShaunES replied to kristenallene40's topic in Critical Care

    Vents are 1:1 here, CRRT is 1:1. 95% of our patients are 1:1, even the people waiting to go to the

  24. How do I protect airway when trach gets pulled out?

    ShaunES replied to ahicks's topic in CCU, Coronary, Cardiac

    In our hospitals ICU it is policy that nurses do not reinsert airways (how often do you actually get to use it, and do you want to stuff it up and make further reinsertion more difficult?), nor do we...

  25. What's your favorite computer charting program?

    ShaunES replied to TDCHIM's topic in General Nursing

    We use ICIP, from Phillips. It's great, I haven't had a problem at all, and it integrates with everything so