bellehill

bellehill RN

Neuro Critical Care

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All Content by bellehill

  1. Advanced Stroke Life Support

    bellehill posted a topic in Neuro Intensive Care, ICU

    I work in a 20 bed Neuro ICU. Our Quality Outcomes Manager came across this Advanced Stroke Life Support training from our EMS contact. We are a TJC certified stroke center now, has anyone heard of or...

  2. Pupillometer guideline

    bellehill replied to kdneal's topic in Neuro Intensive Care, ICU

    We obtain a pupillometer reading on admission for all our neuro patients. Our protocol is to call the MD for: NPi CV %change >1mm difference between pupils We also trend the NPi and if there is a...

  3. Flotrac for Triple H therapy

    bellehill posted a topic in Neuro Intensive Care, ICU

    We recently started using the Edwards FloTrac for our Triple H patients. The first round went really well, the second round did not go as well. The problem we are having is the variability with the...

  4. "One Born Every Minute"

    bellehill posted a topic in Ohio Nursing

    Is anyone watching "One Born Every Minute" on Lifetime? It was taped at Riverside Methodist Hospital in Columbus. I work there (not L&D) and I love to see the exposure. Even if you don't work at...

  5. TIA PRESENTATION

    bellehill replied to ducky82's topic in General Nursing

    We treat any stroke symptoms the same with the standard benchmark goals. Door to doc in 10 minutes, door to CT in 20 minutes, door to CT read in 45 minutes and door to TPA in 60 minutes if applicable....

  6. Neuroscience - I need some help in Cerebral Circulation

    bellehill replied to ratine's topic in Neuro Intensive Care, ICU

    Grab a textbook, preferably by Hickey and look at it then draw it. I always learned better when I drew the subject (like the Circle of Willis). I think I drew the COW a million times when I was...

  7. Flotrac for Triple H therapy

    bellehill replied to bellehill's topic in Neuro Intensive Care, ICU

    An update: we are seeing great success using the Flotrac. Our goal is SVV40 and CVP>8 for non-vented and >12 for vented patients. If two of the three parameters are not in range we bolus the...

  8. Levophed shortage

    bellehill replied to silentRN's topic in General Nursing

    We have a Neo shortage as well, anyone else? We have been using Dopamine and

  9. Problems with shift to shift report

    bellehill replied to pumpkin's topic in MICU, SICU

    Have you tried a bedside report? If you are having trouble remembering what happened during the day go in the room and talk about the patient. Chances are you will remember and the patient will...

  10. Shared Governance

    bellehill replied to ICURN13's topic in MICU, SICU

    Our unit has a shared governance with 4 different quadrants: customer service, quality of worklife, practice and research, and education. Each quadrant has a chair and co-chair as well as the chair...

  11. Need some Precedex advise

    bellehill replied to EyeSeeYouRnOhio's topic in MICU, SICU

    In our neuro patients it seems to work very sporadically. We were just inserviced on Precedex and it is not to be used for the patient when they are wild. Ideally, you would get the patient calm with...

  12. Pregnant in Neuro ICU?

    bellehill replied to natters1980's topic in Neuro Intensive Care, ICU

    I worked in a busy Neuro ICU my entire pregnancy. I was supposed to work the night I had my child. It is like any nursing job. You take normal precautions just like you would with any patient, even if...

  13. Flotrac for Triple H therapy

    bellehill replied to bellehill's topic in Neuro Intensive Care, ICU

    Thanks. We are going to be looking at the SVV, SVI and CVP. If 2 of the 3 numbers are below the parameters the patient will be bolused. This has worked well so

  14. cscc or mount carmel

    bellehill replied to Selhadi7's topic in General Nursing

    I agree with birdie22, go with the BSN and work as a tech. Nursing jobs are very competitive in

  15. Thoughts on/advice for new grads in Neuro ICU please...

    bellehill replied to AJ BSN 2008's topic in Neuro Intensive Care, ICU

    One thing I see in new nurses on our neuro ICU is they do not understand the emotional toll they will encounter everyday. The neuro ICU is a sad place to work. We do have those cases that really lift...

  16. Flotrac for Triple H therapy

    bellehill replied to bellehill's topic in Neuro Intensive Care, ICU

    So what are you using to monitor fluid status and cardiac output? I certainly don't miss the swans, what a pain they

  17. need some encouragement

    bellehill replied to link51411's topic in Neuro Intensive Care, ICU

    You did nothing wrong. I agree with the previous posters, 0.5mg of Ativan is like spitting on the problem. Neuro changes happen in seconds and you did everything you could for this young man. We...

  18. What are you using for sedation?

    bellehill replied to kgriffiRN's topic in MICU, SICU

    We use Propofol in our neuro ICU simply because it wears off so quickly for our hourly assessments. Precedex is tried and we have seen that it tends to work better on some than others (not sure if it...

  19. Bedside report in the ICU setting

    bellehill replied to squirtle's topic in MICU, SICU

    In our neuro ICU we do a neuro assessment together at the end of the shift. We are supposed to be going to full bedside reporting and I really don't see the harm. Of course there are some items that...

  20. How many committees do you serve on?

    bellehill replied to bookwormom's topic in Nursing Educators, Faculty

    I am on 8 committees plus teaching classes to our med-surg nurses, CC nurses and EMS occassionally. Plus, I am supposed to do bedside hours each week to stay clinical. Sometimes I feel like I am being...

  21. Bed Bugs

    bellehill replied to Prissilla1484's topic in Patient Safety Issues

    If you put your clothes in the dryer on high for 30 minutes you will kill the bed bugs from clothing and linen. I would do this automatically for your own safety, especially working in home health....

  22. A few questions for those experience in the Neuro ICU

    bellehill replied to StudentICUhopeful's topic in Neuro Intensive Care, ICU

    My hospital has a Critical Care Fellowship for new nurses and this is the only way we will hire new nurses to the NICU. I think the fellowship is a great way to experience every aspect of critical...

  23. As a nurse, how do you tell your PCP you want anti-anxiety meds?

    bellehill replied to squatmunkie_RN's topic in Health, Stress Management

    Walk in, tell the doctor your symptoms and how you feel. There is nothing more to it. What would someone who isn't a nurse tell their doctor? You are human and

  24. Survey regarding tube feedings

    bellehill replied to cruisin_woodward's topic in CCU, Coronary, Cardiac

    1)c 2)e...if the patient is mechanically ventilated we do oral, non-vented we do nasal 3)a 4)e...enteral feeding should be started as soon as possible, it is best practice for the patient 5)a 6)a 7)d...

  25. ICU visiting hours.. What is reasonable?

    bellehill replied to TigerGalLE's topic in MICU, SICU

    Our unit is open except for 6:30-8:30 and 1830-2030. This gives the shift coming in time to get report and an assessment done. I have mixed thoughts about open visitation, however, everyone has to...