Tenesma

Tenesma

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All Content by Tenesma

  1. DO (school) in anesthesiology or CRNA school

    Tenesma replied to Mantibob's topic in Certified Registered Nurse Anesthetist, CRNA

    $87,000 per year for MDA

  2. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    sorry about my response regarding nitric oxide... but in truth, you wouldn't use nitric oxide for bronchospasm.... but you would use

  3. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    nitric oxide??? what does that have to do with

  4. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    law of fives: time for a new

  5. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    low dose epinephrine is actually B2 selective to a certain

  6. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    exact same mechanism of action... the description of "total" is mine entirely!!! bronchospasm is bronchospasm is bronchospasm... the one thing that is important in pedi is how quickly they can...

  7. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    law of fives: there are different types of bronchospasm: there is reactive airway that responds nicely to aerosolized meds (albuterol, etc..), and then there is total bronchospasm where the lungs...

  8. Primacor question

    Tenesma replied to chaosRN's topic in Certified Registered Nurse Anesthetist, CRNA

    it isn't often that you need milrinone to come off pump --- usually it is a volume/tone thing way before it is a contractility

  9. Question about Pulse Oximetry

    Tenesma replied to DustinRN's topic in Nurse Practitioners, NP

    ignore the post about the concern regarding starting CPAP at a young age... there is nothing wrong with starting CPAP at any age... I have prescribed it for 14 year olds... of course the ideal...

  10. Question about Pulse Oximetry

    Tenesma replied to DustinRN's topic in Nurse Practitioners, NP

    dustin... everybody is atelectatic to one degree or another, in fact it is very rare to see a sat greater than 97-98 on room air... the more overweight or the more restricted your chest is, the worse...

  11. Primacor question

    Tenesma replied to chaosRN's topic in Certified Registered Nurse Anesthetist, CRNA

    i don't want to give the whole answer away (cause i think this is an important thing for you to know, and the best way to learn is to look it up in any up-to-date critical care textbook in the chapter...

  12. Question about Pulse Oximetry

    Tenesma replied to DustinRN's topic in Nurse Practitioners, NP

    1) atelectasis 2) possible right to left shunt due to PFO in the setting of pulmonary hypertension due to chronic obstructive sleep apnea due to your weight just a few

  13. Potential for Air Embolism (clinical discussion)

    Tenesma replied to yoga crna's topic in Certified Registered Nurse Anesthetist, CRNA

    1) agreed: the gasp reflex is a true phenomenon, however it is very rarely seen under general anesthesia - even in a spontaneously breathing patient... 2) i misspoke: when i wrote compressible, I...

  14. Potential for Air Embolism (clinical discussion)

    Tenesma replied to yoga crna's topic in Certified Registered Nurse Anesthetist, CRNA

    air embolisms usually don't make you buck - you will see a drastic drop off in ETCO2 however... i suspect light anesthesia might be the cause for the bucking.... and it is very difficult to entrain...

  15. Renal protection during aortic clamping

    Tenesma replied to gotosleep's topic in Certified Registered Nurse Anesthetist, CRNA

    the only thing that has preliminary good signs for renal protection is fenoldapam... everything else is voodoo - but we use it all the same :) i find the best indicator for good outcome is who the...

  16. do you fight a V/Q mismatch

    Tenesma replied to alansmith52's topic in Certified Registered Nurse Anesthetist, CRNA

    close but no cigar... pulmonary wise it is PDE-5 all the way - in fact the lung is the main place for PDE-5, and that is why viagra is so perfect for the lung... it is working great so far in studies...

  17. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    sorry i fixed my post... i meant 1mcg/cc so i only give 1 or 2mcg at a time total -- so about 1/100 of a cardiac dose... you don't need very much to help with

  18. do you fight a V/Q mismatch

    Tenesma replied to alansmith52's topic in Certified Registered Nurse Anesthetist, CRNA

    well theoretically there are systemic effects, but we don't really see them... of interest, you will soon be seeing nebulized or IV Viagra to augment the effects of NO on the lungs... i am

  19. Train of Four

    Tenesma replied to Kason's topic in Certified Registered Nurse Anesthetist, CRNA

    if somebody is 0/4 then how long do you think before they become 4/4 (and remember that 4/4 initially only means 75-80% of initial strength) ... depending on the drug it could be a long time......

  20. Treatment for Pediatric bronchospasm

    Tenesma replied to Brenna's Dad's topic in Certified Registered Nurse Anesthetist, CRNA

    brenna's dad meant 10-20 mcg instead of 100mcg (as would be the dose for 10mcg/kg)... anyway, brenna's dad... i often draw up a syringe with 1mcg/cc and give 1 to 2 mcg at a time if it is severe, if...

  21. do you fight a V/Q mismatch

    Tenesma replied to alansmith52's topic in Certified Registered Nurse Anesthetist, CRNA

    that's right... NO only causes vasodilation in ventilated

  22. Is there something comparable to Toradol that can be given IV for pain?

    Tenesma replied to bellehill's topic in Pain Management

    don't get me wrong i think the Nursing Drug Handbook is a great resource for a quick check to look up a med or a dose... but when the finer points are being discussed it is often in error or vague or...

  23. do you fight a V/Q mismatch

    Tenesma replied to alansmith52's topic in Certified Registered Nurse Anesthetist, CRNA

    now let's say for some reason you can't oxygenate the collapsed lung and for some reason the surgeon can't clamp the PA feeding the collapsed lung - what are the things that will improve V/Q in the...

  24. Is there something comparable to Toradol that can be given IV for pain?

    Tenesma replied to bellehill's topic in Pain Management

    you have to be careful how you describe things.... and I wouldn't reference a Nursing Drug Handbook when discussing the intricacies of pharmacology. There is a huge difference between saying "toradol...

  25. do you fight a V/Q mismatch

    Tenesma replied to alansmith52's topic in Certified Registered Nurse Anesthetist, CRNA

    nitric oxide will improve your V/Q mismatch... don't worry about HPV so much... just use what makes sense physiologically, and by the way TNG would be fine as