richard1980

richard1980

SICU/CVICU

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All Content by richard1980

  1. Am I qualified? I need your inputs

    richard1980 replied to ucdmc's topic in Student Registered Nurse Anesthetist

    Take graduate level courses and get A's in them. From what I've heard, it's 'what have you done lately'. Admissions committees may overlook a low GPA from a decade ago if you've take multiple years...

  2. Does a hospital new grad fellowship/residency ICU program count?

    richard1980 replied to pamchris's topic in Student Registered Nurse Anesthetist

    The question I have is how could you possibly be ready for anesthesia school if you're a new grad and have one year of nursing experience? You probably don't even take care of the sickest patients in...

  3. Whats the most blood products you've given in a shift?

    richard1980 posted a topic in MICU, SICU

    Just wondering... I'd say probably around 30+ for me but I'm curious if someone has a ridiculous story to

  4. IABP removal

    richard1980 replied to SLP12's topic in CCU, Coronary, Cardiac

    What a dumba**! Good for you for standing your ground and trying to go above him. All you can do at that point is document what you did and what he said. Kudos to

  5. Precedex

    richard1980 replied to Stlcardsrock's topic in CCU, Coronary, Cardiac

    It's useful if it's started in surgery and used as a bridge to extubation, its usually not started correctly. The patient needs to be kept in a dim quiet room without a lot of stimulation and usually...

  6. Levo and pH

    richard1980 replied to Maevish's topic in CCU, Coronary, Cardiac

    Absolutely levophed is the first drug of choice but if she's further decompensating perhaps its cardiogenic and epi and perhaps a swan would be indicated. We uses swans every day in my unit....

  7. Levo and pH

    richard1980 replied to Maevish's topic in CCU, Coronary, Cardiac

    I disagree, I think a swan would be indicated as she appears to be in severely decomponsated shock of some sort and doesn't appear to be responding to the treatment they were giving her, a continuous...

  8. Milking chest tubes

    richard1980 replied to CleioRN's topic in CCU, Coronary, Cardiac

    Addendum: In 6 plus years of taking care of heart patients I have never had or seen a negative outcome from keeping the tubes patent...only from letting them occlude by not being aggressive

  9. Milking chest tubes

    richard1980 replied to CleioRN's topic in CCU, Coronary, Cardiac

    I will continue to strip chest tubes as needed as I have been instructed by my surgeon and are written into our post op heart orders. I think if theres any question, ask the surgeon what he or she...

  10. Hospital paying for NTI? Really?

    richard1980 replied to NightAngelle's topic in Critical Care

    ....Weird.........

  11. Sedation..Your thoughts?

    richard1980 replied to Da_Milk_of_Amnesia's topic in MICU, SICU

    It's our facilities policy that we cannot bolus propofol in a syringe but we can use the bolus feature on a pump and give them a few ml's at a rapid rate. I guess the highest rates of propofol I've...

  12. can ICU nurse handle 2 pts on the levophed same time

    richard1980 replied to Snoopy54321's topic in CCU, Coronary, Cardiac

    You got punked by a lazy

  13. Ambulate with Femoral Lines

    richard1980 replied to Ruby Vee's topic in CCU, Coronary, Cardiac

    Me too... yikes... In a couple words.. ABSOLUTELY NOT ARE YOU OUT OF YOUR FREAKING

  14. Milking chest tubes

    richard1980 replied to CleioRN's topic in CCU, Coronary, Cardiac

    "A class at Stanford" eh? When did they become the authority on CT management...? Just kidding. :-P All sarcasm aside, the competent nurse should use his or her judgement on the selection of...

  15. Levo and pH

    richard1980 replied to Maevish's topic in CCU, Coronary, Cardiac

    If she was that sick she needed a swan... and from the sounds of it tons and tons and tons of volume. How much volume is tons? Give it on pressure bags or with a Level one rapid infuser/warmer until...

  16. Whats the most blood products you've given in a shift?

    richard1980 replied to richard1980's topic in MICU, SICU

    You get a good sick open chest with a BiVad and DIC and it can be a long

  17. Whats the most blood products you've given in a shift?

    richard1980 replied to richard1980's topic in MICU, SICU

    Haha... Good times... We don't really let residents in patients rooms that are that sick. Hopefully their "pocket cheat sheets" were

  18. Milking chest tubes

    richard1980 replied to CleioRN's topic in CCU, Coronary, Cardiac

    As long as we're on the subject.... whats the most output you've seen in the shortest period of time out of a mediastinal chest tube? Couple years ago I had a guy come up and dump 3+L in the first...

  19. Milking chest tubes

    richard1980 replied to CleioRN's topic in CCU, Coronary, Cardiac

    Depends if they are bleeding or not. I always strip my chest tubes on CT surgery pts. Sometimes its only a couple times the first shift they come up from the OR...other times you're stripping until...

  20. pressors and sepsis

    richard1980 replied to diosadelsol's topic in MICU, SICU

    Levophed does increase heart rate some as it's a potent alpha AND beta adrenergic inotropic-vasopressor. Every patient will respond differently, but there is a breaking point where the chronotropic...

  21. How much lorazepam have you given....

    richard1980 replied to sassyrn333's topic in MICU, SICU

    I've had a ETOH patient on a Ativan drip at 20mg/hr with them still moving around, although intubated. I think he drank something like a 1.75 of vodka a day. As far as Ativan pushes? I've given...

  22. CVP's before x-ray line confirmation

    richard1980 replied to JayVArn's topic in MICU, SICU

    You'd be fine to hook up the pressure line. The doc will flush it with a hell of a lot more than the mL of 0.9 you'll be giving the patient by hooking up their line. You'll be able to tell right...

  23. CABG

    richard1980 posted a topic in MICU, SICU

    I've got a question for you all. Do most hospitals have a seperate CVS ICU or do the post CAB pts come from OR to your SICU. The latter is what happens at my facility. I guess I'm interested in...

  24. Dealing with ICU visitors

    richard1980 replied to leesespieces's topic in MICU, SICU

    We have a locked unit so I don't have to deal with people coming in when I'm not expecting, etc. If we don't want company we simply say "not right now." They really don't have a choice. There's a...

  25. TNCC

    richard1980 replied to gypsyeyes's topic in General Nursing

    I think they've changed it within the last year. I took it about 2 months