GilaRRT

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All Content by GilaRRT

  1. GilaRRT

    STEMI and Dopamine

    GilaRRT replied to MikeyBSN's topic in General Nursing

    Peripheral edema may not be appreciated in the acute setting of right ventricular failure. JVD may be appreciated; however, with all of the other things going on, it would be an easy sign to miss. CVP...
  2. GilaRRT

    STEMI and Dopamine

    GilaRRT replied to MikeyBSN's topic in General Nursing

    I cannot disagree with the fact that the patient requires interventions other than PO meds; however, let us look at the possible physiology behind this patients condition. If we are in fact talking...
  3. GilaRRT

    STEMI and Dopamine

    GilaRRT replied to MikeyBSN's topic in General Nursing

    This is how I see the situation of a pump problem. You have a couple of ways of looking at this regarding cause and treatment. We need to ask ourselves is this diastolic or systolic failure? Systolic...
  4. GilaRRT

    STEMI and Dopamine

    GilaRRT replied to MikeyBSN's topic in General Nursing

    I would hesitate to use either agent. Both agents can have beta 1 effectes (depending on the dose) and will increase heart rate, thus increasing myocardial oxygen demand. I would avoid norepinephrine...
  5. GilaRRT

    STEMI and Dopamine

    GilaRRT replied to MikeyBSN's topic in General Nursing

    Without looking at a 12 lead, I may have to disagree with you at this point. With a RV infarct, preload is compromised and "priming" the system with fluids will significantly assist with cardiac...
  6. GilaRRT

    STEMI and Dopamine

    GilaRRT replied to MikeyBSN's topic in General Nursing

    What wall was involved? With a low B/P and bradycardia, I would bet money on an inferior wall MI. I would also guess that the RCA had a more proximal occlusion and the right ventricle was involved....
  7. GilaRRT

    Truth or Myth: dairy increases mucus?

    GilaRRT replied to RNsRWe's topic in General Nursing

    This is a myth that refuses to die. The myth can be dated back to at least the middle ages. Many double blind studies have been perfomed and all have indicated that milk does not cause increased mucus...
  8. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    Yep, in the world of defensive medicine, the art of the physical exam is dead. While I understand and support diagnostic imaging, the importance of a good H&P has all but been replaced by...
  9. GilaRRT

    Cholinergic agents (drugs)

    GilaRRT replied to Epona's topic in General Nursing

    I think instructors sometimes use oversimplified terms to describe the physiology behind our job. I never agreed with the whole speed up or slow down paradigm of explaining the nervous system. For...
  10. GilaRRT

    How lengthy is your commute?

    GilaRRT replied to RNOTODAY's topic in General Nursing

    Currently, I am looking at about 54 miles. This can take 45 mintes to over an hour depending on traffic. Next month, I am looking at approx 110 miles, or just over two hours depending on traffic....
  11. GilaRRT

    What does an RN do in pre-hospital EMS?

    GilaRRT replied to CNAinNeb's topic in Flight, Surface Transport

    I work a dual provider platform. (RN/Paramedic) The differences in practice between providers is limited and the roles each provider fills are essentially interchangeable. With that, the paramedics...
  12. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    i am not sure i agree. the op went so far as to name the thread "a prime lawsuit." so, at this point i can only guess that the op feels differently. however, the op may post additional information...
  13. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    In addition, the surgeon had to at least agree with the ER assessment. Nearly every surgical case I have seen in the ER, had the surgeon come in and look at the patient, in some cases perform tests,...
  14. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    Talking about nurses and doctors supporting each other. Yeah, the off topic police are on the way to lock me up. I simply want people to stop for a moment and consider the thought that we may not have...
  15. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    I agree. I remember when I was a new grad RN in the ER. Thr rumor mill was out of control. First, my fellow nurses started talking about how my pay was several dollars an hour more than the most...
  16. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    We have two docs who thought this was a hot appy. A surgeon and an ER doc. There is more to the story than we know at this point and callng poopoo on the docs involved at this point is simply going...
  17. GilaRRT

    A prime lawsuit

    GilaRRT replied to xoemmylouox's topic in General Nursing

    Agreed. I cannot speak for the ER Doc; however, he must appreciated some pretty significant evidence from the history and exam to suspect a hot appy. I would want a doc to error on the side of caution...
  18. GilaRRT

    O2 Sats..bad if 100%..?

    GilaRRT replied to featherzwolfcloud's topic in General Nursing

    Remember, the pulse oximeter is a calculated measurement and not exact. To actually have 100% of your HGB bound by O2 would be a feat on room air. We see 100% readings frequently; however, if I...
  19. GilaRRT

    O2 Sats..bad if 100%..?

    GilaRRT replied to featherzwolfcloud's topic in General Nursing

    I understand. It can be hard to guess at intent on forums, so it is better to ask and find out the meaning behind the
  20. GilaRRT

    O2 Sats..bad if 100%..?

    GilaRRT replied to featherzwolfcloud's topic in General Nursing

    Yeah, I saw a couple of typos in my post. I could tell a sob story about having to type on a tiny PDA and so on, but the typos are my fault in any event. However, we are talking about the Bohr effect....
  21. GilaRRT

    Ec 135

    GilaRRT replied to FlyingScot's topic in Flight, Surface Transport

    Yikes, what a PIA. Anytime an isolette is needed, the King air from Albuquerque flies in to save the day. Nice motorized ramp, lots of space, fast turboprops, the way to go IMHO. I fly in A-stars and...
  22. GilaRRT

    O2 Sats..bad if 100%..?

    GilaRRT replied to featherzwolfcloud's topic in General Nursing

    DaMale Nurse: Good thinking. Allow me to expand on the Bohr Effect? The Bohr effect is the primary mechanism which prompts the movement of oxygen from the RBC into the body tissue. The Bohr effect is...
  23. GilaRRT

    Question for the experienced ER RNs

    GilaRRT replied to nursemommyof3's topic in Emergency

    I disagree. A busy tele unit can be just as bad if not worse. In many ways the ER is actually a better place IMHO. MAR's, chart checks, etc. I dump my patient off on the tele foor and say "thak God I...
  24. GilaRRT

    Wilderness/expedition nursing

    GilaRRT replied to wildernessgal's topic in General Nursing

    Check the dive medicine and hyperbaric specialties as well. Very specialized areas. Mixed gas diving, saturation diving, and decompression is a very specialized field. In addition, many of these jobs...
  25. GilaRRT

    Intubation

    GilaRRT replied to rnwithtof's topic in General Nursing

    That's pretty funny. It's all about the drama. Yeah, I am a