rnguy25

Check into primary amebic meningoencephalitis (PAM), particularly Naegleria Fowleri. Over a year ago, we had a case with similar presentation as you described and usual work up showing nothing. It turned out to be PAM.

We use Toradol post-op for several our patients, excluding those at risk as janfrn has mentioned. We typically schedule the toradol for three doses then make it prn thereafter and have opiods for breakthrough pain. I have not read the article above (I sure will tho), but toradol use as an adjunct in controlling post-op pain also decreases the use of opioids in the long run as well, thus preventing other complications typical of opiod use. It works beutifully!

I can too share your sense of being "called" to a nurse in a PICU. I felt the same way during my clinicals as an undergrad as well. Peds is what led me to becoming a nurse in the first place, but never thought about the PICU until our critical care and peds clinical rotations. I was a pharmacy tech at the hospital I worked at, and every time I delivered meds to the PICU I could not help but get a feeling of belonging to this unit. I was offered a job there after graduation and never have left. Hopefully after NP school, I can stay there as a practitioner or be close to it as I possibly can. As far as experience needed for CRNA programs, you should get the experience needed from working at one of the nation's top children's hospital. After all, there are CRNAs who specialize in children. Good luck.

Our unit typically uses fentanyl, versed, and rocuronium. Atropine prior to intubation is used for the neos and infants. As others have said, it is physician pref, as etomidate and vecuronium is also used, but not as frequent as the three listed above. Roc has a much quicker onset of action and a shorter half-life than vec, so that's why our intensivist choose roc.

We collect our EVD cultures or samples from the sample port that is proximal to the patient using sterile technique. RNs are allowed to collect CSF samples, but not allowed to infuse any meds or flush the EVD tubing. If there is a known infection, we typically send daily cultures until negative for a given number of days. We'll send cultures as needed only to rule out infection if an indication is given, such as a spike in temp.

Congratulations sicushells!!! Kick butt!!! janfrn, I know this is off topic, but I have to say that I admire what you write and what you do for this forum in many ways. You give hope, inspiration, knowledge, comfort, confidence, support, and much much more. I've been a PICU nurse for 6 years, haven't been a member of allnurses that long, nor do I post much, but being a lurker of these forums, I notice what you provide for this community and nurses all around. You rock!

Sorry to comment on an old thread. Deleted.

gab.rielle, Hi. I say go for it. I started my career and life as a nurse in the PICU and have loved every bit of it (still do too). You seem to already have a special connection with the PICU life from your experience in one. Many new grads are hired onto our unit now and have grown and developed into wonderful nurses. Care of children, in a PICU especially, is a wonderful specialty. Hope the best to you and I'm sure you'll choose what is best for you. -T

Hi Anna, Bagging during suctioning is needed to maintain adequate arterial oxygenation levels and to maintain adequate lung volumes, especially for those patients who require a high PEEP. All of which, if lost, can induce hypoxia. Since you don't use in-line suction catheters on your unit, bagging will help those babies maintain good lung volumes while off the vent. It'll cut down even more time away from their needed pressures and oxygen as you were already doing. -T