Inquisitivewon

Hi Indy: You need more data. What happens with the P wave at the pause, if it remains normal it sounds like normal sinus bradycardia with a RBBB and escape beats. The question is why so slow? Is there SA disease? What about your PMH? Meds? etc. Prior CAD could be the cause for the RBB and perhaps Sick sinus syndrome. Is there any other variation other than brady with ectopy? Is there hypotension associated with the bradycardia. Do the ectopic beats perfuse? (pulse with ectopy) Inquisitivewon:cool:

I understand the concern for patients with regard to sinusitis, but oral suctioning can only get the upper airway. Deep suctioning by the oral route is contraindicated because of the risk of introducing the oral flora to the lungs. My concern is for non-intubated patients who require deep suctioning. The benefit should always outweigh the risks. What about your policy? Does it call for an MD order?

Great advice that is very practical. So few female patients have text book anatomy. It has been my experience that the meatus is often located in the proximal upper lady partsl wall. This is a great technique to improve on catheter insertion.

Thanks for sharing your experience. We all come to work and care for others often with so much already on our plates. Faith is a wonderful comfort. Grace only can bring us through those most challenging times that we are responsible for caring for others in the midst of our own personal turmoil. Don't be afraid to talk to others. Colleagues and or employee assistance teams can make difficult times more manageable. Non-health care providers just don't have a clue. Sincerely, carrmichael3

:typingHi there: I agree that Littmann is the best. The bottom line Littmans are expensive when compared to other brands but are more duarble and dependable. They are unquestionably the best. If I were you I would buy one middle of the road Littmann and take care of it. Skip buying two-you don't need to. However, engrave your name on the bell, and don't leave it around as someone, notoriously docs will pick it up to "borrow it" and you will never see it again. Keep it with you, and be very selective when it comes to lending it out. I am partial to the Littmann Cardiology Scope. It is expensive but not that much more then the basic and a much higher quality instrument. It's great for Critical Care users. For Med-Surg., a basic Littmann is just fine. See the Link above the forums to buy direct from Littmann and skip the $ that goes to a middle man such as a uniform or eqiuipment store. Good Luck! carrmichael3

I was trained as a student that maintaining a clear airway is one of the most primary of all nursing priorities. It has come to my attention that some facilities require an MD order for suctioning via the NP route. I have two questions to contemplate. 1.) Does your institution require and MD order to suction by NP route? 2.) Was nursing involved in drafting your Institutional policy on NP suctioning? Please feel free to add what type of institution you work in.