simboka

Pt was SOB

Definitely not end-tidal co2. Yeah, everybody just always says "a-oh" and nobody seems to know what it means. Somebody ventured the guess airway output, but that seemed a bit far fetched. *shrug*

So no idea what "Ao" (That's big A, little letter o) stands for, and neither does anybody I've asked. It's sensor is attached to the the vent's tubing right before it hooks to the ett. It's a mostly flat line that has upward deflection in regards to breathing. We use it to determine where to average the CVP. I figured the descriptors would help incase it's not referred to "Ao" elsewhere. I must have my curiosity satisfied! Thanks in advance :)

I was talking with a coworker about charting. She recalled reading a book in nursing school a number of years before about charting with a title something along the lines of "Something like a nurse, chart like a lawyer". or some permutation along those lines. She said it was good, but couldn't remember the name. Anybody heard of it or have read it?

If they're in a shockable rhythm and the PM/AICD hasn't taken care of it, then it's not doing it's job and might be broken anyway. Now where it would be a little sketchy would be if the pt's rhythm was completely dependent on the PM.

I agree with you, but my thought is this: At that point, the patient's decision maker decided to refuse the treatment of being on the vent. Also, since I assume the doc would still have to come pronounce, the call would've needed to happen anyway. Crappy situation. Did anyone talk to the family about how they felt the nurse handled this? Probably not since I guess that's secondary.

You're thinking about it the wrong way. I'd be willing to bet it doesn't use anything different than adding, subtracting, multiplying and dividing, probably mostly multiplying and dividing if it's a lot of flow rates. The hard part is figuring out what you need to do when.

What gets me is the returning of parental rights when they were removed for completely legitiment reasons. Case in point, very dear family friends were fostering a child whose mother was jailed for drug offenses. Child was less than 1y/o when mom went to jail. Fast forward a couple of years, mom gets out, and I believe within 6 months has child back. Our friends were pretty much the only family that child knew up until then. Double standard? hopelessly optimistic in reform? too many cases and not enough workers/fosters? who knows? As with everything, probably a combination of everything.

lol love it

The highest I've seen was 220 or 240mg q8 or 12hrs (don't remember, it was probably 1-2yrs ago), in a pt who wasn't very responsive to lasix. Out policy is in the process of changing, but it used to be 10mg/min, now larger doses are going to be sent from pharm in a piggy back bag, but I'm not sure if the rate'll change with that or not.

I just did the online inservice on this last night, and they mentioned wiping the tops with alcohol. I'd never heard this before, and wasn't in the process of doing this with BCx or IV meds, but I guess I'll have to start. PITA but if it's true about not guaranteeing the sterility of the stopper, then there's no other choice, right?

Whenever I've heard that, it's been in the context of prostate issues. One of our nurses is starting a new inservice thing for us, educating on the "why"s of evidence based practice. They're specific to our policies, but some things she's looked at are: extended infusion of doripenem, why blood has to be done within 4 hours of leaving the blood bank.

I was thinking "q" anything isn't to be used anymore. But out computerized entry system has a "qpm 21". But I would suppose you could do a "qpm cc" for basically, "with dinner," makes sense to me

"Grab me, not the bedside table, I guarantee I'm stronger than it is."

I remember this quote from a nurse's blog I used to read, "Push it as fast as you want, the patient's dead". Now if they weren't dead, then 15+ min is the speed. (Can't help but say, "I'm not dead yet" in my head)