richard1980

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 of graduate level science work and have a 4.0. Do...

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 your own unit yet. Get more experience and the w...

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

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 you!

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 helps if they're on a benzo and/or narcotic becau...

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. Vigileos are, imo, garbage. The pt can't be tachy or afi...

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 SvO2 monitor would be nice to see as well. (SvO2 ...

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 enough.

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 wants.

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

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 seen is around 100 mcg/kg/min or so but usually we'...

You got punked by a lazy nurse....

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

"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 gentle "milking" or aggressive "stripping." There is ...

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 you get to the downward trend of the starling cur...

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

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

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 hour and a half before going back to surgery.

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 you hands feel like they're gonna fall off. You r...

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 beta effect will kick in and you'll start to see an ...

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 about 14 mg an hour for a few hours to get someone un...

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 away if you're in the right spot by the waveform.

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 case I move somewhere else. I'd miss taking care of ...

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 lot of talk about "family oriented ICU care." I to...

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