donnuchi

How frequently is your tubing changed for TPN? If you change it every 24 hours, is your lipids mixed in with the TPN? We currently change our tubing every 72 hours. The lipids are separate and we change that tubing every 24 hours. Thanks for your input!

Why allow the blood to drip out and risk possible exposure? Why not draw back your discard?

We are looking for new syringe pumps for our hospital. Can you suggest one that you really like, is easy to set up, can deliver as low as 0.01ml per hour and is not prone to error? It seems there are a few that have been recalled lately and I have heard that not many companies are making syringe pumps anymore. Thanks!

Do you know of any evidenced-based research on this or is this "just what we do"?

What type of method do you use to draw blood from a peripheral arterial line? Do you use the "drip" method or do you draw back with a syringe? Is there any evidence-based research on this? Thanks!

Our NICU is looking for new emergency evacuation aprons that have four pockets in the front of the apron. Any recommendations out there? Thanks!

For those using the PIPP for Pain Assessment, do you score using gestational age at birth or corrected gestational age? Thanks!

How would you set those up for your maintenance fluids? Do you have a bag hanging that you draw fluid from?

Thanks! I totally agree!

Currently our practice is to use a buretrol/soluset for IV administration and to drop 2 hours worth of fluid in case of a pump issue. We are changing to new pumps next month and are looking at our tubing use. Upper administration found out that the solusets are costly and want to stop using them. I need to know what the standard is in other NICUs. Thanks!

Actually, I am an NICU RN. The patient with Amiodorone toxicity is my Dad. He has been in the ICU for nearly 5 weeks. He was on the drug for 10 months. I guess he had developed a dry cough over 2 months and then on New Year's Eve started feeling sick. We thought he was getting the flu. Over the next few days he was feeling worse and then on 1/3 woke up very short of breath. He went to the doctor and the x-ray looked like bilateral pneumonia. His sats were in the low 80s so he was admitted into the hospital. He was on a non-rebreather mask for 2 weeks. After the first week they did a lung biopsy showing diffuse alveolar damage. After the second week, he was so tired out that his CO2s started to climb and he was intubated. He was on high pressures and developed subcutaneous emphysema, pneumoperitoneum and pneumopericardium. They changed him to a low tidal volume protocol that was developed by the ARDS Network and he hung in there! They had to paralyze him because he could not tolerate a rate of 35. That was 2 1/2 weeks ago. He made it down to 50% and a PEEP of 5 and last night took him off the vecuronium. He is just starting to move a bit, so I guess we will see what happens over the next few days. What do you think are his chances of getting off the ventilator? How can the doctors tell how much fibrosis is there if the x-ray continues to say bilateral infiltrates? Thanks for the information.

Has anybody had experience with a patient with Amiodorone lung toxicity? How were they treated and what was the outcome? Thanks!

What is your usual routine for changing dressings for peripherally inserted central catheters? Do you change on a PRN basis or weekly or some other frequency? Thanks for your information!

If anyone is cobedding twins/multiples in California, could you please send me the name of your hospital? We are trying to convince our doctors to start this practice for our patients and families. We usually have 5-7 sets of multiples at a time. Thanks!