athomas91

i also had stopped posting here for similar reasons to yoga - however - i did want to comment on this particular thread... i like droperidol - mostly because it worked for me when i had PONV - but yoga is absolutely right - i was off for over 24 hours due to the dysphoria. droperidol was blackboxed - and is still out of most pharmacys - HOWEVER it can be used (but the warning labels state) you must use a 5 lead ecg to monitor for QRS changes - so if you are using it w/ a 3 lead or no lead - you are wide open to that lawsuit coming your way.

- you are right - this is obviously no site for those who have an opinion to post... if you read my origional post - it was quite benign and just an observation - not even directed at the OP - i didn't become irritated until this as far as tooting horns - i don't - and if i wanted to - i could with substance. thank you to allnurses for the early days when professionals could share opinions and learn - this has however become a site (that like many others) has not become useful or beneficial. good luck to those of you think you know it all.

edited out flaming post

it is amazing how many people are asking "how fast can i get in..." instead of what experience will make me the best provider.

amen, amen and amen.

i believe in my post i clearly stated that the program needs evaluated - ...but i stand by my other statements. it has nothing to do w/ dog eat dog or nurse..whatever... there is a reason behind standard and expectations, and if they aren't met - there should be no "ok...let em by..." that IS the problem with nursing in general - there either aren't standards for what is acceptable (as far as programs) or they aren't adhered to. i am all about giving whatever support i can to help anyone along - but i am not going to pretend that i support lower standards. again - if the facts the OP stated are factual - i completely support someone looking into that - it doesn't sound like it is treating students fairly - however ... if it were looked into and found to be sound in its decisions - then i would say - good for them for adhering to tough standards.

not only do nurses do plenty of research... but i can't recall a research nursing project being in legal trouble for "padding numbers" but there are quite a few MD research areas that have been in hot water plenty of times... so i will take quality over quantity thank you.

many programs have a baseline avg that must be achieved to continue - i think NOT having one is sub-par .. now - if 8 people were kicked out of one program in a year - does that need evaluated - yes... but... if you aren't making the grades- you shouldn't be there - my classmates as well as myself were made aware from the get go that we needed to know it all - and saying "i wasn't taught that...or it wasn't covered" is no excuse and will get you into trouble fast. i hate to be hard-lined here - but it is an elite profession for a reason.

yoga- i look forward to seeing those "bleeps" in the OR and showing them how real anesthesia is done... they sounded like a bunch of 15y/o boys calling names and making statements they obviously have no facts to back them up... i guess they are too lazy to look up the hx of anesthesia - ... lazy....ologist...hmmm...

good question- and from your post i am confident it comes from a sincere desire to learn ..there are multiple posts debating this same subject - many RN's feel it is fine for them to use propofol in non-intubated patients as long as an MD is there or there is an airway cart bedside. those TRAINED in anesthesia don't agree - the manufacturers of propofol don't agree - so there is your answer... it is funny how those of us who know the drug intimately continue to argue this with some who feel they are more than qualified ... good luck.

that is funny...i read all the same books that the ologists i work with read... hmmm...

yes- they use lma's on neonates - personally anything smaller than a 2, i feel, doesn't do the job - so they buy tubes... but to answer your question - yes - LMA's are used.

actually - if the record is sealed or expunged you should be ok... because they ask if you have ever been convicted of a felony - the answer to that is not - and if they looked (and it was sealed or expunged) technically noone should be able to find any record of it ever happening... i would talk to someone with some legal background and see what you need to do.

i agree - the mhaus site will be your best option..but halothane like all triggers of MH cause an inappropriate release of calcium from the sarcoplasmic reticulum - specifically the ryanodine receptor is believed to be the problem site - good luck.

thta brings me to another question - do you all defasiculate prior to giving sux - why or why not.

No - you are right - it isn't an abortion thread - and it isn't a debate on whether you support the death penalty or not - but it seems ok to shout from the rooftops if one doesn't support it. the actual thread related to the the question IF the anesthesia community provided anesthesia for the death penalty - would you be a part of it... so - if everyone wants to stay on thread then great - but let up on RN for giving an opinion as everyone seems able to.

sux increases gastric pressure - from what yoga saw- i guess even small doses can do it.

first of all we are talking about an Anesthesia program... as far as i am concerned apples and oranges as far as professional demeanor and hearsay being plausible to exit someone from a program. i do agree w/ zinobile - there are multiple factors in letting someone go - but generally in anesthesia school it is one of two reasons - they aren't making the grade either didactically or clinically and as a fellow student you may not be privy to that information...ie - they tell you they are doing great... when really they are not ... and some are not good at playing the game... if you can't hack it ...you can't hack it... it is as simple as that ...and it is why CRNA's ARE the cream of the crop.

soliant - i see your issue - you (like jwk stated) cannot at this point argue your point.. but i wholeheartedly agree - LMA's are (in this region) utilized when no muscle paralysis is indicated - the gases cause some muscle relaxation and this is sufficient. i am aware that in europe - paralytics are used w/ lma's as well as PPV - but... the public isn't sue-happy as in the u.s - and unfortunately this must be taken into consideration. i am gathering that they are using it for jaw relaxation for insertion - but if a proper/sufficient dose of propofol is utlized - it shouldn't be needed. etomidate can be used - but it can cause myoclonus and make your life more difficult... i would say that if someone isn't stable enough for a big slug of propofol - they need a tube. i personally use versed and propofol for insertion and turn gases on then titrate fentanyl to respiratory rate - this way they are pretty much self ventilating just after insertion. good luck.

the previous posts are correct - a little propofol or deepening via gases will help IF the patient is truly not paralyzed - but remember a 2/4 TOF is sufficient relaxation for any surgical procedure - i have surgeons all the time say - are there any twitches - ... again - as a previous poster stated - sometimes they are just having a hard time and want to blame it on something.

i agree with brian - the topic tracked off a bit... let's face it - ER and ICU are different beasts..i have done both - and I happen to agree with Mike - ER is more challenging. that is my personal opinion - just as those who debate ICU is more challenging happens to be their personal opinion. the AANA requires 1 yr of acute care setting - this requirement is decifered by each individual school and some do accept ER/trauma as an acute care setting. I for one am happy that i had experience in both areas- as both of them added to my skills and knowledge as a nurse...

the places i have been ask if you would perform such a procedure...and then keep it on record - that way they know who and who not to assign to such things.

ok - so it varies state to state - is it the state you work in or the state you work in ... because your CRNA lic. isn't state specific and i carry a lic. that covers 5 states and also hold a PA lic.

ok... so a nursing STUDENT just came on a CRNA specified board and decided to make a completely idiotic statement about a specific and valid question.... forgive me but .... give me your opinion when you have some education to back it up please. there are plenty of APN's who DO prescribe medications on a daily basis - that DO NOT need a doctor's cosign.... my question to those who i believe will have some professionally backed imput... (but thank you to those of you who tried to be helpful... ) is... do CRNA's have this authority, do they have to register ect... and no...i don't want to prescribe meds for myself..