zzyzx

zzyzx

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All Content by zzyzx

  1. B52 cocktail

    zzyzx posted a topic in General Nursing

    I understand that Benadryl, Ativan, and Haldol are not compatible when given in the same syringe IV push. However, is it safe to give when they are mixed in the same syringe and given

  2. plasma compatibility

    zzyzx posted a topic in Critical Care

    I've always thought that with a plasma transfusion, blood type is critical, just as with PRBC's, and that therefore a Type A patient, for example, must get only Type A or AB plasma. However,...

  3. plasma compatibility

    zzyzx replied to zzyzx's topic in Critical Care

    Cool, thanks for the link! I did a whole bunch of Googling and couldn't find an

  4. Blood pressure goals in traumatic brain injuries

    zzyzx posted a topic in Neuro Intensive Care, ICU

    I know that the recommendation for treating hypertension in a subarachnoid bleed is to keep the BP below 140, but is there any accepted recommendation for traumatic subarachnoid bleeds? Would you...

  5. Brain bleeds: prophylactic care

    zzyzx posted a topic in Neuro Intensive Care, ICU

    I'm wondering what protocols/decisions strategies the neurologists in your ICU/ER use for deciding to use Keppra prophylacticaly for seizures, and mannitol/hypertonic saline? I ask the question...

  6. capnography

    zzyzx posted a topic in NICU, Neonatal

    For a neonate, can waveform capnography be used for ET tube confirmation (post intubation and during transport)? I guess I don't see why it shouldn't be, but I don't see any reference to waveform...

  7. capnography

    zzyzx replied to zzyzx's topic in NICU, Neonatal

    Thanks for your responses! What do you guys think is the best way to monitor tube placement during transport of a neonate? In adults waveform capnography is great because you get an immediate alert if...

  8. Pedal pulses and posterior tibial

    zzyzx posted a topic in CCU, Coronary, Cardiac

    If you can feel or Doppler a pedal pulse, is there really any need to find a posterior tibial pulse? Likewise, if you can get a posterior tibial pulse, any need to feel for a pedal

  9. Pedal pulses and posterior tibial

    zzyzx replied to zzyzx's topic in CCU, Coronary, Cardiac

    I get that, but my understand is that an arterial occlusion of the leg is going to happen in the femoral artery, or in the popliteal artery proximal to the knee. In either case, you'd have no...

  10. Pedal pulses and posterior tibial

    zzyzx replied to zzyzx's topic in CCU, Coronary, Cardiac

    Thanks for the reply. My understanding is that we are mainly checking pedal or posterior tibial pulses to make sure the patient hasn't developed an arterial clot higher up in the leg, in which case we...

  11. hyponatremic seizure

    zzyzx posted a topic in Emergency

    Has anyone ever seen a hyponatremic seizure in the ER? I'm just curious on how the patient presented, how long the seizure lasted, if you saw immediate relief from treatments, etc.

  12. hyponatremic seizure

    zzyzx replied to zzyzx's topic in Emergency

    Thanks for your replies. I didn't realize I had gotten any messages, hence this late reply. I've worked in the ER for many years, but I've never seen a seizure due to hyponatremia. We're always ready...

  13. What have you heard about Creighton University's RN to Paramedic Program?

    zzyzx replied to Kareegasee's topic in Flight, Surface Transport

    Taking a two-week paramedic course may certify you on paper, but it will not make you a competent paramedic. You need a bunch of experience working as a medic, not just a little bit of classroom time....

  14. AF RVR + levophed

    zzyzx posted a topic in CCU, Coronary, Cardiac

    How would you treat this patient in regards to rate control: Pt has been going in AF for a few days, and now they are in AF RVR with a rate of 130. The patient is also on Levophed at 5 mcg/min. BP is...

  15. AF RVR + levophed

    zzyzx replied to zzyzx's topic in CCU, Coronary, Cardiac

    Thanks for your responses. We didn't want to do amio because she wasn't anticoagulated yet. The obvious thing to me was to do rate control, but I wasn't sure if Cardizem was the right thing to use...

  16. ARDS patient, dialysis

    zzyzx posted a topic in Critical Care

    I had a patient with severe ARDS who had been anuric for 24 hours. She was in a respiratory acidosis, with a PaCO2 of 75 and a bicarb of 18. Her pH was 7.20. The fellow ordered CRRT, but the next day...

  17. Hemiplegia after BP reduction

    zzyzx posted a topic in Emergency

    I recently heard of a case (if I remember it was the EmCrit podcast, but it may have been another) where a patient with asymptomatic HTN was given hydralazine IVP for a BP of 175/90 in the ED. The...

  18. ARDS patient, dialysis

    zzyzx replied to zzyzx's topic in Critical Care

    Ok, got it. Thanks for all the responses. I realize now that the dialysis could not have made a significant impact on reducing the respiratory acidosis. Makes sense. At one point after she was...

  19. ARDS patient, dialysis

    zzyzx replied to zzyzx's topic in Critical Care

    The patient was perhaps hypotensive due to sepsis, though she could also have been volume down. She initially came in for chronic pancreatitis, then developed a GI bleed, then came to the ICU because...

  20. Droplet precautions on intubated patients

    zzyzx posted a topic in Critical Care

    What is the point of wearing a mask if you have a patient who is intubated and not coughing anyhow? Is it that you could touch something that has their respiratory secretions on it, and then touch...

  21. albumin and hypotension

    zzyzx posted a topic in Critical Care

    I have always thought that with hypotensive liver patients who also have low albumin levels, the correct treatment is to give albumin. This seems to make sense since they need the protein to maintain...

  22. albumin and hypotension

    zzyzx replied to zzyzx's topic in Critical Care

    Thanks. The fact that albumin does not stay in the vasculature makes it much easier to understand some of the other processes involved. I'm half way through the article now. Very interesting so

  23. albumin and hypotension

    zzyzx replied to zzyzx's topic in Critical Care

    Thanks for all the responses so far. One thing I don't understand is how the albumin gets out of the vasculature. Probably I'm forgetting something from physiology class. I understand how the water...

  24. sodium amount in sodium bicarb

    zzyzx posted a topic in Critical Care

    How much sodium is in one amp (50 ml) of sodium bicarb? Is it 3735

  25. sodium amount in sodium bicarb

    zzyzx replied to zzyzx's topic in Critical Care

    Thanks for your reply. Since the sodium is not free but bound up with the bicarb, does it have the same effect as if you gave the patient 1150 of sodium only? In other words, would it immediately...