chani

greetings from Down under As some of you may know we dont have RTs in ICU in Australia so the nurses are responsible for most respiratory care including ETT management. At present I am reviewing the evidence for ETT cuff pressure management. I would ...

there appears to be little difference between OZ and NZ from above. What happens in OZ is how differ area health services (in NSW) interpret the nurses & midwifery act and then how this translates into actual practice. As an ICU nurse we continue...

As always if you dont know what to do DONT. Unfortunately as a new grad you are in an unequal power relationship however you will need to stand your ground. Explain politely you are unsure of what to do however are happy to do so with instruction.

Dear all on aussie forum we have also been discussing CVP. Below is a posting from a senior ICU specialist about the physiology of CVP. CVP Measurement This is the Achilles heel of the CVP. Like all intravascular measurements the baseline MUST be ...

putting aside my misgivings for patient being treated. Patient needs appropriate investigation to identify reasons for low BP and urine output. That means ECG and cardiac echo to rule out intra-op infarction or perhaps another cause. Agree that norma...

many oz docs refer to CVP as a random number generator and many posters have identified all the things (abdominal ascites, ventilation, PEEP) which interfere with a 'correct' reading. Additionally this patient is losing protein into the abdomen so NS...

There are many interesting and thought provoking posts in this thread. As an ozzie I have lived with some aspects of socialised medicine plus private cover all of my life. Not sure if we have the right balance and ofcourse our current government is p...

"clinical practice and evidence based practice, knowledge versus reality of practice." while you are working over the next couple of shifts see if you can identify something that seems contrary to what you were taught at uni. as you are in a neuro w...

I was asked the comment on something the other day which initially made me go YUCK and then I thought am I just being precious and not keeping up with the times. I was asked whether sterile gloves were still the recommendation for CVC line and dressi...

I have to say I am torn regarding the evidence regarding the efficacy of chlor hex bag baths. From a nursing perspective regarding time and efficiency I love the product however I am yet to find more than 2 well designed studies conducted in ICU and ...

In NSW & Victoria Australia we have had large numbers of both H1N1 and influenza A as well as non-specific flu-like patients admitted, who then crash & burn within 24 hrs. Both states are over the worst (Victoria was the first state in Austra...

I would have to agree with both sides of the debate here. I am concerned over the dilution of nursing degrees away from an applied science degree and do feel that there is a lack of certain somethings. But who is to blame? Well all of us. Can we all ...

Inotropes/pressors = A line. this is standard practice in Australia also. I would only use CVC/Picc for bloods as a last resort and that is ususally a long term patient who is stable & not on haemodynamic support. Remember any breaks into a CVC i...

:banghead:this is me after 20 years. The basic problem is that they are brought up to think its womens work and need to be thanked profusely if they do anything. Now my hubby does alot compared to some and not so much compared to others. He aske wehn...

http://intensivecare.hsnet.nsw.gov.au this is a comprehensive aussie website

well done for focussing on the many items that needed to be done and not getting caught up in the emergency. Too often I see the outgoing shift running around finishing their work while the oncoming shift is sitting at the desk chatting about the la...

Early in my ICU career I learnt to plan so I knew when items such as meds and obs needed to be done, so that then I could slot in bigger items such as dressings and line changes. One of the biggest lessons I have learnt over my 20+ years is to compl...

I must say I am dismayed by the tone of most of the emails in this discussion thread. I'm afraid that most of you are appear as though you have absolutely no idea or compassion for what the families of critically ill patients are going through. Now a...

As a general rule vital signs q1h for stable ICU patients and q2h for non-intubated patients. Vital signs are HR, BP, RR, O2 Sats and pain When titrating meds - 1/4 hrly when changing (any more frequent is not useful) and you can go back and look at ...

the short answer is too much! At a hospital where I used to work we had 'hover matts' however not sure they are still used. They were great for lifting in that they created a cushion of air enabling three people (one for tube and two for lift) to mo...

This question troubles us in Australia. When we looked for evidence we couldn't find it. And considering how essential the practice is in intensive care this is appalling. I'm used to either 1"wide cotton tape or 1" wide adhesive medical tape. Compan...

The NHS infection control e-learning package is being trialled in NSW (Australia). Love to here from NHS staff who have experienced this package. All the gory details please!!!!!!!!!!

Hey jttweedie what a great post. You have highlighted something very important but not highly valued, that is the need to experience different healthcare cultures, which could be another ward, hospital or country. It is only then that we can apprecia...

Is the package graded for different levels of clinicians and other workers in health care?

So this CAS test. When was it implemented in QLD and are you aware of the background behind it? What support does the hospital give to you to complete and how does it map to across different nursing specialties. from south of the border