piper77

Latest Activity

1. Very Unhappy With My Career

   piper77 replied to Nupe4sleep's topic in CRNA

   Hi Nupe: First, let me say "i understand!" and can empathize with you...it is absolutely MISERABLE to feel stuck in a job that you hate, and feel as though you are stuck in and cannot leave. It sucks! A little about me so you know where I am coming f...

2. Coumadin prior to major surgery, your experience?

   piper77 replied to miloisstinky's topic in CRNA

   Yep, I agree with athomas; I would feel much more comfortable with an INR in the neighborhood of 1.5. I dislike the LMWH for this very reason. Post op is going to suck as well as intraop. Makes more sense to hospitalize, heparinize...can turn it on a...

3. Clinical Quiz: Bite Blocks

   piper77 posted a topic in CRNA

   Not so much of a quiz, really...perhaps a poll on practice. I was given a break by an MDA on an adult case; he said..."Oh..you nurses and your soft bite blocks..." then went on a mini-tirade about soft bite blocks being useless with ET's. I asked him...

4. physical demands-CRNA

   piper77 replied to 2ndChance's topic in CRNA

   You know, I think the physical demands on the CRNA are less than those of unit nursing, but I find myself pretty tired at the end of the day. I think there is something about being "hyper-vigilant" that tires you even though you may not be doing as m...

5. Anesthesia Care Plan Book/PDA Program?

   piper77 replied to MaleAPRN's topic in CRNA

   Lou, thanks for the link..interesting! Believe it or not, our program requires us to handwrite our care plans, every room's case, every night; we can't just write "Versed 1-2 mg" - we have to reason "Versed, 1-2 mg IV - anxiolytic, amnestic.." etc. F...

6. Clinical Quiz

   piper77 replied to piper77's topic in CRNA

   good catch guys....as deepz knows....it was the overwrap. Good lesson for all of us in the room. Situation was confusing in that the patient did indeed have some type of histaminic response...and of course, the history. First time I encountered this....

7. Clinical Quiz

   piper77 posted a topic in CRNA

   Thought I would add an experience that happened to me recently; after reading the "ventilate-or-not induction sequence" thread a few pages back. I enjoy reading other's experiences, and hope this one may offer some insight for future practice: Did a ...

8. BIS Monitor

   piper77 replied to sandman1914's topic in CRNA

   gaspassah...just a couple of things....I have never heard that the author of "Silenced Screams", Jeanette Liska, experienced her awareness because the ologist let the vaporizer run dry.....she does not say that in her book...is there another source? ...

9. Physostigmine + Neostigmine

   piper77 replied to devine1's topic in CRNA

   Well, jwk...jes take a peek at any good anesthesia reference, and there you will find it. Funny what a good read will do. Could be me, but you sound a little defensive. I think anybody would agree that good practice should have solid reasoning behin...

10. prone positioning and pt. blindness

    piper77 replied to EmeraldNYL's topic in CRNA

    Emerald, I would guess that the anesthesiologist was concerned about ischemic optic neuropathy secondary to hypotension; prone positioning has been widely implicated. Short prone cases (a couple of hours or less) are of less concern. ION is well repo...

11. BIS Monitor

    piper77 replied to sandman1914's topic in CRNA

    As always, an interesting discussion. Most of the experienced clinicians I work with do not use the BIS monitor, even though it may be available to them. I believe they operate on the same principles that Yoga just talked about. I also know one with ...

12. Physostigmine + Neostigmine

    piper77 replied to devine1's topic in CRNA

    Hate to disagree with you, jwk, but physostigmine is, of course, a cholinesterase inhibitor, and has LONG been used as a reversal agent - don't know where you came up with idea that it has no indications as one. That being said....I certainly don't s...

13. Beta Blockade during C-section

    piper77 replied to Brenna's Dad's topic in CRNA

    Good clinical scenario, Brenna's Dad. Thanks.... Just one perspective - there are many ways to skin a cat, as everybody knows. I probably would have done the exact same thing as you. By no means am I an expert (!) but it seems to me that we must be g...

14. Interesting case of hypothermia

    piper77 replied to yoga crna's topic in CRNA

    Thank God for a clinical post! ....VERY interesting...thanks Yoga, et al...........wish I had more to offer, but sure looks like its being covered. We don't talk enough about hypothermia.....

15. Washington Conference

    piper77 replied to piper77's topic in CRNA

    Ok, DNSC - you talked me into it! :) Thanks for the replies......