hotcoffee

hotcoffee

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All Content by hotcoffee

  1. RT focus on pao2?

    hotcoffee posted a topic in MICU, SICU

    Every once in a while this comes up and it bugs me. I have read in a few different studies that really high pao2 is harmful (after cardiac arrest, MI, etc). So to me it seems logical to try and...

  2. Ucsf commute + parking

    hotcoffee posted a topic in California Nursing

    I am going to be commuting from the peninsula to ucsf. What is the deal with parking? I checked out the website and the lots all have waitlists. Also it looks like the caltrain to N Judah is an option...

  3. Ucsf commute + parking

    hotcoffee replied to hotcoffee's topic in California Nursing

    I will be working at Mission Bay and

  4. Versed IV push or Ativan IVP

    hotcoffee replied to icumurse1122's topic in Critical Care

    It weird how everyone keeps using benzos even when there is evidence they are bad news. I have even had a hospitalist refuse to order precedex because she didnt want the patient "to get intubated"...

  5. Ucsf commute + parking

    hotcoffee replied to hotcoffee's topic in California Nursing

    Anybody?

  6. Finding a job WITH experience?

    hotcoffee replied to csj50's topic in California Nursing

    This is the highest-paying area for nurses, and we have unions so you almost always get to eat lunch (cheers for unions!). It is a hard place to get a job. Lots of new grads move out of town to get...

  7. PEEP and blood pressure/other hemodynamics

    hotcoffee replied to sunnybabe's topic in Critical Care

    Sounds like you know more than I do about hemodynamics. But my point was that I don't think it's clinically accurate to say that in all situations an increase in cvp = a drop in stroke volume. There...

  8. Clinical tidbits I wish someone would've told me.

    hotcoffee replied to Mully's topic in MICU, SICU

    Use a jaw thrust when bagging a patient, or on someone who is obstructing. most RTs and RNs I have seen bagging don't do it. Emergency Ventilation in 11 Minutes on

  9. Reflections after my first code

    hotcoffee replied to ilikesharpthings's topic in MICU, SICU

    One thing I have to add- obviously I was not there so I don't know what was happening- but i am reluctant to pull the plug on people who are fully functional prior to admission. Sounds like your...

  10. PEEP and blood pressure/other hemodynamics

    hotcoffee replied to sunnybabe's topic in Critical Care

    Regarding the first response- I don't think it's accurate to describe high cvp as an impediment to venous return. But I think I get your point. Cvp is often used as a measure of preload but lots of...

  11. Any sedation/intubation specialist here?

    hotcoffee replied to rearviewmirror's topic in Critical Care

    Wow that's a lot of questions. you need to look those meds up. sounds like you already have a handle on the clinical implications/applications it will help you if you understand the mechanisms of...

  12. Sodium bicarbonate push

    hotcoffee replied to lvcrn's topic in Critical Care

    Bicarb isn't in the ACLS algorithm. Does that mean the docs who wrote the guidelines don't know what they are doing too? im not saying we don't give it where I work. just saying that there is no...

  13. Sodium bicarbonate push

    hotcoffee replied to lvcrn's topic in Critical Care

    From what I have read there is no evidence that pushing bicarb is helpful. We do it at my job fairly often. I don't have a good grip on the physiology. After you inject the nahco3 you get h20 and co2...

  14. Grad courses before CRNA school

    hotcoffee replied to PositiveThinker :)'s topic in Student Registered Nurse Anesthetist

    I just started advanced Pathophysiology at umass Boston online no exams yet but it seems

  15. Good book to work in CCU

    hotcoffee replied to Plenur's topic in CCU, Coronary, Cardiac

    You can get lots of old editions used for cheap on Amazon. clinical anesthesia by Morgan, mikhail is really good. Covers lots of Icu info even though it's an anesthesia

  16. Failed CCRN again

    hotcoffee replied to Whitroth05's topic in Critical Care

    i think the pass ccrn questions are great. i think some of the questions on the test I took came from Morgan and mikhail clinical anesthesia. I learned a lot from reading that book. also maybe you...

  17. Pacer capture

    hotcoffee posted a topic in CCU, Coronary, Cardiac

    Took care of a CT surgery patient with an epicardial pacer connected but on backup rate of 35 VVI. She was alert and doing great. At shift change we check thresholds. The patients intrinsic rate was...

  18. Calibrating CVP/ART/etc

    hotcoffee replied to nurs1ng's topic in MICU, SICU

    Actually it does matter where it is positioned vertically when transducing but not

  19. Starting neuromuscular blockers

    hotcoffee replied to pharmd8888's topic in MICU, SICU

    Very interesting that BIS isn't useful. i read that somewhere else

  20. Pacer capture

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

    My patient's rhythm was juncitonal/3degree block so I doubt there was much atrial kick. I imagine VVI wouldn't cause a drop in output. thanks for the

  21. Pacer capture

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

    That's what I was saying! Thank you. so the capture threshold is the lowest possible mA at which you have capture. i think you need mechanical as well as electrical capture which can be verified via...

  22. ICU Nurses - IV Carrier Rate for Infusing Pressors

    hotcoffee replied to rebrrn's topic in Critical Care

    Why have a carrier fluid at 100? That doesn't make sense. i believe if you have a drip going slowly (less than 10) it makes sense to run it with a kvo (saline at 10). I don't know of any evidence for...

  23. Calibrating CVP/ART/etc

    hotcoffee replied to nurs1ng's topic in MICU, SICU

    Makes

  24. Calibrating CVP/ART/etc

    hotcoffee replied to nurs1ng's topic in MICU, SICU

    Yep you're right. You can zero close to the floor and it does t matter. weird how when you lower the transducer it reads a higher pressure. i do t understand the physics of

  25. Troponin Level Increase

    hotcoffee replied to OSUFan1's topic in CCU, Coronary, Cardiac

    Of course it depends on the patient. There are lots of conditions besides coronary occlusion that can cause trop elevation- PE, sepsis, other bad stuff. In my experience with a big Stemi you'll see it...