spot

What are you scrubbing with? What kind of reaction are you having?

I have been tasked with the purchase of a biphasic defibrillator for my department. I am looking for some input. What manufacturer do you use? What do you like and why? What don't you like and why? Thank you for your comments!!

Dear Hissythecat, Find cardiologist that is board certified, and has been in practice at least 5-10 years. Transthoracic echo is a good place to start, especially if they have a machine that is capable of 3D imaging. As unsavory as it may sound, a TEE (transesophageal echo) will give BETTER images than transthoracic depending on your body habitus (if you are thick or thin will determine quality of images from a transthoracic study). Better still would be a cardiac MR. This diagnostic modality is giving exquisite images of cardiac anatomy. It is not, however, widely available. I've just recently returned from conference that was dedicated to cardiac MR and cardiac CT. WOW!! I do not know if anyone/place in TN has this capability. But, to be honest, I haven't looked. My suggestion would be to go online to some of the bigger hospitals (UT, Vandy, St Thomas, Erlanger, etc.) and see if one of them has cardiac MR. Cardiac echo is a very good diagnostic tool, please don't misunderstand. However, it is dependent on the skill and experience of the echo tech. So, another piece of advice is to investigate the experience of the echo techs, and find out if the echo department is accredited by the IACVL. To achieve and maintain the accreditation, they must meet rather stringent requirements. Hope this is helpful -- Take care -- Spot.

I graduated from nursing school 18 yrs ago. For me, nursing school was, at once, horrible and insipiring. Horrible in the sense that all of my instructors, save one, felt it inappropriate for me to be in the program. Inspiring in the sense that all of my classmate "family" and the lone instructor rallyed round me at the unfair treatment I'd been given. I was the only guy in a class of 100. Don't misunderstand, I was not coddled, or pampered by the women in my class. Ocassionally, I was the recipient of "tuff love" so to speak. We studied together, worked together, socialized together. We all worked hard for our degrees. I was given nothing but love and encouragement from my "siblings." I count myself a better man for it. Mr-D, you need to get over yourself, grow up, and get a grip. If you are so concerned about, as you say, "sexual tension" then you are obviously not very secure in your own masculinity. I have only ever treated my collegues with respect, and only ever received the same in return. As a result, I have a large extended family. It seems to me, that is the kind of relationship you should seek to foster with your nursing collegues, and nothing more. My wife of 18 years feels the same. So strongly, in fact, that we named one of my "sisters" to be gaurdian of our three children should we pre-decease them. Three things come to mind at this point: 1) What would Jesus do? Read the Book!! 2) Do unto others as you would have them do unto you. Think about that next time you want to sneak a peek!! 3) When in doubt, see number 1.

Theoretically, EF can be 100 %. Though, after 17 years in the cath lab, I've never seen such. However, in some patients, the LV cavity will nearly obliterate. These cases would be those patients with LVH, and/or a hyper-dynamic ventricle. I have seen patients with an EF of >75%. This is atypical. Luvbabies, I would encourage you to spend some time in the cath lab. After observing several caths, it will all make more sense to you. I have never met any cath lab staff that wasn't eager to share their knowledge and experience, not to mention show off their cath lab!

It was my first job as a new grad. I was working telemetry nights. Often I would sit next to the monitor tech and watch and learn. "What's wrong with that one," I said. "She's dying!" the tech replied as he vaulted over the desk into the patient's room. Naturally, I followed. Patient is asystolic by now. I began doing chest compressions. This was a sixty something female, s/p ventral hernia repair. It was my very first code!!! After about 30 seconds of compressions, her suture line split, and her entrails spilled all over her lap!! Now, that's what I call a code!