CathRNCA

The thick, smelly, (sputum like) oral secretions that head injury patients all seem to produce. The sound of suctioning them out is just as bad. Working in trauma the an RT friend knew that that would get me out of the room instantly if he started to suction out the patients mouth.

We are no longer allowed to use the line "continue previous meds". JCAHO? I am not sure, the solution is for all patients who have invasive procedures a re-order med sheet is printed for MD review and signature. (only exception is invasive radiology ie pic line, angio,graft declot etc). Saves lots of time and errors basically this sheet is a slimed down copy of the computer generated MAR.

My lab has seen both ends of the spectrium. Last year during a staffing crunch I took call 12-15 days month, currently take 7-8. Remember with call it can go a month with no call back or come in every time for a week. Also our call means that anything not finished durng the day (ten hour shift) gets finished by the call crew. RN's circulate, monitor, and scrub here.

Have not used Aggrastat for at least 4 years, mostly based on the the studys. Bwick, a few years ago we changed the policy regarding Reopro from all pts to ICU to may go to Tele with ration 1:4 or 5 but only after the 2 hr platlet count is back and reviewed and the goin site has adequate hemostasis. Any drop in platlet count requires the patient to stay in the post procedure unit (1:2 or 3), the 4 hour platlet count taken and reviewed. Any patients with significant drop must go to AMCU (stepdown 1:3) or ICU. Recently though the doc's tend to give more Integrilin or Angiomax.

All of our intervention (PTCA) :) patients stay overnight. Do not do ASD/PFO yet. All new device implants and upgrades (single to dual/ dual to bivent etc)stay overnight. Changeouts stay approx 4 hrs. We have 16 bed diagnostic pre/post unit. Hope this helps.