pm80

Just wanted to get some opinions/thoughts from any ECRNs out there. I've heard some grumblings of late from some medics regarding some suspicious sounding diversions. Apparently an ECRN (or ECRNs?) has diverted several crews with signed refusals to go to the closest by pt's who were A/Ox3 but who had unstable vitals( one had a HR in the 150's and I think the other had a BP 220/110 ) . Obviously these were sick pt's and their desire to go to hospitals other than the closest was questionable. The issue however is if a person can be forced to go to the closest hospital ( which they may or may not have very valid reasons for not wanting to go to) after they have signed an informed consent and are A/Ox3. I know protocols vary from region to region but this still just seems odd to me . Any thoughts?

Yeah. That sounds about right. I've only seen it once and I was the only one in the room who thought it was significant that the guy was in IVR.

I'm also starting the BSN program this fall . Your GPA is good but you should keep in mind that the majority of applicants will have comparable GPAs. What I think you should focus on at this point is writing a really strong essay for yourself. This will be a much more effective way to distinguish yourself from the pack. Paint them a picture not just of why you think you should be in a nursing program, but why you think you should be in their nursing program. Keep in mind that they are a large research focused university program. I don't think they are really interested in just cranking out floor nurses. Rather they are more interested in individuals who want to pursue advanced degrees and who will function not just as clinicians , but as researchers, leaders, and educators as well. I don't think you neccessarily have to make that a focus of your essay to get in, just be aware that those are the types of individuals that they likely prefer. Just my:twocents: Good luck!

Maybe I should've elaborated better. ASA is a part of the AHA/ACLS standard for ACS pt's . It is used to inhibit platelet aggregation in the hope that this will prevent the thrombus from becoming any larger. This is what I've always been taught. He was saying that it also acts as a vasodilator and would have similar beneficial effects to NTG. I've never heard of that before and frankly have a hard time believing it's true based on the manner in which we give it. So basically I just wanted to make sure I didn't miss something. Thanks again

I was talking to a recently graduated paramedic student the other day and he told me that they were being taught that you gave ASA to chest pain pt's for both anti platelet aggregation and vasodilation purposes . Is this something new? I definitely was not taught this. I looked it up in my drug reference and it did say that its analgesic effects were due to vasodilation but this can't seriously be a major systemic effect. If it was then it would be contraindicated for already hypotensive pt's. I think he's confused and/or overanalyzing . But then again I've been wrong once or twice myself.. Thanks for any input

I once had a trauma transfer pt who had to be intubated because he couldn't tolerate being placed on the backboard. He had been hit in the head ( I don't remember with what) but was completely stable when we arrived; A/Ox3 ,no distress, stable v/s , cooperative. I don't remember if he had a bleed or not. We explained what we were going to have to do in regards to boarding and collaring him and he seemed to be OK with it. He changed his tune pretty quick when it came time to actually place him on the board though. He just started screaming and fighting and he had that panicked animal type look in his eyes . It was a bizarre transformation. It took 4-5 people to hold him down and we all were taking turns trying to explain to him what we were doing and why but he just didn't seem to be processing anything we were telling him . After a couple minutes of this it was decided that we were just going to have to tube him. It was an unfortunate thing but in this case it was more or less indicated.

While talking to a coworker the other day the subject of starting a peripheral IV on the same extremity as a dialysis pts fistula or shunt came up. We know it's not allowed but we were not sure why exactly. I guess we mustve missed that day of class. I know it would be less than optimal. I can understand how a fistula could alter the pathway of a med push but the blood would still get back to the heart to be redistributed. So , other then for a drug like adenosine, why would it be banned outright? What about a pt. in arrest? If the only descent vein you can find is in the same extremity as their port then why couldn't you use it? Thanks for your help and sorry if this is a dumb question.

I found out the other day that I have been accepted to UICs BSN program for fall 08 and I was wondering if anybody could answer some questions I have. The thing I'm most concerned with at the moment is the 300 level science class I still need to take as a pre-req. Does anybody know exactly what classes are included in this? Are there going to be any available over the summer? I was also wondering what to expect for the first semester, what does the class time/ clinical rotation schedule look like esp.