jewelcutt

There probably isn't one around the area because georgia has i believe two AA schools and a high number of practicing AAs there.

EtCO2 monitoring on vented patients is crucial, how else will you know you are ventilating the patient adequately? the once every few hours ABG?

You could get the bilevel vent, whose goal is ultimate alveolar recruitment. functions on the concept of constant high peep (~ 30) that allows spont ventilation over by the patient. it sounds weird but has proven miraculous in many patients. you should look up the lecture series by michael mitton.

It is a great drug for sedation for vented patients. Of course you have to be careful with the cardiac depression, and long term administration can lead to acidosis in children. Some of the other positives include bronchodilation and antiemetic properties (but we really don't worry about that for vented patients). It is known as a very clean drug, however, it is only good for six hours from opening, many studies have shown bacterial contamination after that expiration. So if you're running it at a very low rate (10-20 mcg/kg/min) with a very large bottle remember to change it. It can also be very irritating to the vein, but should not be mixed with lidocaine in the bottle. Long term administration may cause a longer awakening than you expect too.

It is a great drug for sedation for vented patients. Of course you have to be careful with the cardiac depression, and long term administration can lead to acidosis in children. Some of the other positives include bronchodilation and antiemetic properties (but we really don't worry about that for vented patients). It is known as a very clean drug, however, it is only good for six hours from opening, many studies have shown bacterial contamination after that expiration. So if you're running it at a very low rate (10-20 mcg/kg/min) with a very large bottle remember to change it. It can also be very irritating to the vein, but should not be mixed with lidocaine in the bottle. Long term administration may cause a longer awakening than you expect too.

the first thing i do is ask what's going on as i visualize the patient, i get a brief synopsis (allergies, events leading to) of the situation as i'm looking to see if there is already a blade, tube, and working suction at the head of the bead. I then visualize the effect of whoever is bagging the patient and see if the belly is distended and what the sat is. i take my place at the head of the bed and always ask for on ORAL AIRWAY. i usually place it and try to bag the patient to 100 with their effort or not if there isn't any. if needed ill have them give a little versed and/or etomidate before intubating. if someone automatically gives cric pressure i ask them to let up because they're usually placing too much.

Okay, I have to say it. So as an ER nurse you're taking care of a balloon pump patient, do you actually know how to adjust it and what you're looking at and why you should adjust it? ICU nurses have to take classes and be oriented on the unit for a ocuple of days before taking them on their own. I just find some things that are said here very arrogant. Everyone likes to think they're so smart that they can take anything, it would take someone a very long time to become extremely proficient in all areas and maintain that proficiency by doing it frequently. So how do you manage a balloon pump on a patient fresh out of a mitral valve repair? aortic valve repair? massive MI? the point is that critical care nurses have the title because that's the area they work in, you don't see them wanting to be called emergency nurses just because they have to deal with emergencies also. Anesthesia more frequently is looking for candidates that deal with critical care nursing daily, because that's what we do in the OR. We put patients to sleep, monitor hemodynamics, keep them alive, and deal with the effects of surgery. Many SICU nurses have to deal with the effects of surgery, do you as an ER nurse know how to take care of a whipple? We all have our specialties, just because you've taken care of a certain type of patient or are forced to do it in non-ideal situations doesn't make it right. Why in the world would i want someone taking care of me in a critical status when you have to take care of seven other patients. it seems that the attention and care wouldn't be ideally what the patient needs. it is great that you can deal with emergencies and stablilize and handle all of those patients, but our purpose is to have the patient stay alive and actually walk out of the hospital. let's not let our pride get in the way of the patient's best interest.

I have done both ways. With it deflated i find it folds back easily and usually requires use of the second hand to reposition the tip. With it partially filled it can be difficult to get in the mouth past the tongue but overall easier to insert.

My statement is not a mockery, it wasn't meant to insult. I was basically clarifying for an above poster about the cost of training a resident versus srna for the hospital alone. Nothing at all to do with the amount of debt a person ends up in, rather how much the hospital pays. I didn't think residents got "paid very little", I've talked to many that make the same amount as nurses.

Cost of education is the cost that the hospital pays not what you pay. SRNAs don't get paid, in fact they pay to learn. MDA residents get paid, in addition to all of their food and some get help with housing, in addition to the cost of training them.

I had a short rotation in a place I absolutely hated, I realized that I did become a little depressed during that time. Keep your head up, I think antidepressants might actually be a good idea. There are many people on antihypertensives, antireflux, and antidepressants during school that weren't on them before. Don't give up, go in everyday and try your hardest, just tell the CRNA that this is what you want to do and ask them to help you become better. Don't get upset in front of them, just be very pursuant in the fact that you want to do this. They will see your effort. You will have ups and downs during school, some where you think you're terrible and stupid and everyone must think of you like that, but it's not true. You also have to understand that you are new, and first years need a lot of direction, just try to build on what you are doing everyday.

I wouldn't call it necessarily boring, maybe sometimes lonely because your always someplace different. We have our busy times, beginning of a case, end of a case, in between cases. So I actually welcome the chance to sit for a while and catchup on my charting and stuff. There are days you have 5-10 patients a day and no time at all to even sit. what I think you are referring to is the long cases in which everyone sees us just sitting there watching the screen or surgery. Well, that can be a little tedious, but like the above poster said, i don't mind it. i don't at all think its 99% boredom 1% panic, those numbers are exaggerated quite a bit. i will take "boredom" anyday over the excitement of cleaning someone's pee in the ER or listening to families complain in the ICU, the real exciting times.

What i meant by plain NICU was that without post cardiac surgery. My classmates had experience in post cardiac surgery, ecmo etc. If you have anything other than that, then the anesthesia school may suggest you get adult experience or some sort of icu experience that involves gtt management.

Must be nice to get lunch and 3-4 breaks per shift. As a student I used to get lunch, and hopefully a morning break if my case wasn't just starting or ending. I also remember plenty of 12-16 hours days that were supposed to be 8. I find the work comparable to when I was an RN. The busy times and quick turnovers in the OR are comparable to the admits in the ICU physically to me.

I had two classmates in my class that worked in a cardiac NICU/PICU withou adult experience. It is excellent experience in that environment. However, I also know of someone who didn't get in the first time with plain NICU experience until they got adult cvicu experience. I would suggest getting some adult experience, that way you'll be more marketable with both nicu and adult icu.