Tenesma

Tenesma

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All Content by Tenesma

  1. Could an FPNP start an operate a "cash only" walk in...

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

    i figured since most posters aren't NPs that i could throw in my 2 cents as well ---- sorry if i intruded. by the way, MD terminator --- why the handle, if you are planning on becoming a doctor? any...

  2. Could an FPNP start an operate a "cash only" walk in...

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

    how about we compare the death rates with western medicine and without western medicine: 1) a patient comes in with dense hemiplegia and a history of a-fib... do we treat him with western medicine...

  3. OR Nurses Giving Conscious Sedation--WHY SHOULD WE?

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

    phenylephrine is a way better choice than dopamine for this situation, because the issue is tone and nothing else - phenylephrine hits the tone directly - whereas with dopamine you need a decent dose...

  4. ASN -> CRNA? NP? MD?

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

    a few reasons: - research - teaching - no malpractice insurance - no lawsuits - no pressure to be productive - tolerates eccentric personalities - cheap tuition for children at that institution - a...

  5. ASN -> CRNA? NP? MD?

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

    academic/university centers usually pay 1/2 of what private practice partners

  6. OR Nurses Giving Conscious Sedation--WHY SHOULD WE?

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

    like you said... giving fluid and t-burg is the first intervention, if you need to add a drug ephedrine/phenylephrine would be a better choice than atropine (for vaso-vagal). symptomatic bradycardia...

  7. OR Nurses Giving Conscious Sedation--WHY SHOULD WE?

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

    vaso-vagal is due to a high vagal tone (hence the name)... the reason the blood pressure drops and they feel nauseated is because the vagus will shunt most of the blood volume into the splanchnic...

  8. OR Nurses Giving Conscious Sedation--WHY SHOULD WE?

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

    don't mean to be a stickler but you don't treat true vaso-vagals with atropine... wrong

  9. Medical School after NP?

    Tenesma replied to Dave ARNP's topic in Nurse Practitioners, NP

    interesting... MD terminator wants to be a doctor... hmmm? time to change your handle

  10. flumazenil

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    now you know why tylenol is not a good choice for a

  11. How many patients (if any) have you had code during your watch...

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

    a code - in the OR should always be run by the anesthetist... for two reasons 1) if the patient is coding during the case the surgeon needs to finish up their surgery or help out by doing CPR or...

  12. flumazenil

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    i wrote my thesis on cytochrome p450 - it just takes a few hours... it is a post-transcriptional mrna mediated

  13. flumazenil

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    increasing IVF per say wouldn't increase clearance of versed... it is primarily metabolized in the liver (so is flumazenil by the way), and therefore if you want to increase clearance you will have to...

  14. flumazenil

    Tenesma replied to New CCU RN's topic in Certified Registered Nurse Anesthetist, CRNA

    i wouldn't give flumazenil either ... for two reasons... 1) old ladies for some reason always have an endless stash of valium that they take for sleeping and they never tell you about it... so there...

  15. simple mortality question

    Tenesma replied to Rhon1991's topic in Certified Registered Nurse Anesthetist, CRNA

    while that is the rough estimate for all-comers - what is the percentage risk of anesthesia related mortality in a 26 year old with diabetes for an elective knee arthroscopy??? there are no numbers -...

  16. simple mortality question

    Tenesma replied to Rhon1991's topic in Certified Registered Nurse Anesthetist, CRNA

    for full legal consent you need to make them aware of the risk of MI/stroke/etc... but if you quote some statistic and you go to court then what are you referencing??? where did those percentages come...

  17. simple mortality question

    Tenesma replied to Rhon1991's topic in Certified Registered Nurse Anesthetist, CRNA

    i never quote any percentages ever - for two reasons: 1) for most cases that you do there are no intra-mortality rates, and therefore you are only freaking out the patient 2) there are no good...

  18. Did anyone else see the show on Anesthesia Awareness on Discovery Health tonight?

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

    all the most recent studies regarding depth of anesthesia as far as awareness and mortality rates have been sponsored by Aspect Medical (the manufacturer of the BIS monitor)... so the news they are...

  19. PONV- use of decadron and zofran

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

    scopolamine is great too: 100mcq subcutaneous or 40mcg IM does the trick

  20. PONV- use of decadron and zofran

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

    0.2 to 1mg IV post-op only if pt. is nauseated - great

  21. PONV- use of decadron and zofran

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

    you aren't going to believe this - but we are studying low-dose haldol for PONV instead of phenergan or zofran (not prophylactically but in the recovery room) - and so far the FDA in their "infinite"...

  22. Pacemakers

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

    jebain - i stand corrected.... however, pacemakers are not the initial treatment modality for atrial fibrillation and when they are implanted they are usually not for the atrial fibrillation but...

  23. Pacemakers

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

    qwigley: 1) pacemakers are not inserted for A-fib, primarily because with a-fib you just have an irregular rhythm and that isn't the issue.... more than likely that person had a pacer placed for sick...

  24. few ??'s for CRNA's

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

    deepz... 1) i am impressed that you have been a CRNA since the age of 20 2) i feel bad that over the past 40 years you were exposed to anesthesiologists who would read in the OR at my institution...

  25. Ethical/Legal question

    Tenesma replied to Sis123's topic in Certified Registered Nurse Anesthetist, CRNA

    this is an interesting thread -- i had a patient the other day that insisted that she is allergic to benzodiazepines (they make her feel drunk and drowsy - that is her stated allergic reaction) - and...