dmc_rrt

dmc_rrt

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All Content by dmc_rrt

  1. Trach suctioning. Bullet vs. no bullet

    dmc_rrt replied to divaRN*'s topic in Pulmonary

    We teach all our long term trach pts to use these, or sterile saline through a syringe, when they need to clear their secretions. Its

  2. lung sounds with vent

    dmc_rrt replied to muffins20's topic in Pulmonary

    You can usually hear the different breath sounds with a vent. I don't know the circumstances, but rapid gunshots arn't normal vent sounds. I think you were probably hearing circuit noise. perhaps...

  3. respiratory distress vs respiraotry failure

    dmc_rrt replied to yatyu's topic in Pulmonary

    Simply put: Resp distress, which is increased WOB, will lead to resp failure when the muscles can no longer do the work. similar to untrained legs trying to run a marathon. ARDS is filling of the...

  4. respirator mask for copd patients

    dmc_rrt replied to nu2this's topic in Pulmonary

    If the Hypoxic Drive to Breath theory is correct, it should happen immediatly as soon as the PaO2 becomes greater then 60mmhg. When the PaO2 is less than 60mmhg the peripheral O2 recepters kick in. As...

  5. Questions on Mechanical Ventilators

    dmc_rrt replied to floridarose's topic in MICU, SICU

    I agree with you, that oxygen toxicity does not fit. How can you get oxygen toxicity if you ventilate your pt with high volumes or pressures on an FiO2 of .21? High pressures and volumes do release...

  6. Is a Bronchoscopy needed for pt who chokes on dinner?

    dmc_rrt replied to CrabbyPatty's topic in MICU, SICU

    They might do a pharynoscopy to assess to compentency of the Larynx. This looks like a small

  7. COPD & NRB your input please

    dmc_rrt replied to crb613's topic in Pulmonary

    As an RT I would definetly put the pt. on the NRB. Actually it sounds like the pt needed BiPap more then anything. I have never seen a COPDer stop breathing from too much O2, and if it does you remove...

  8. Danger to self? help!

    dmc_rrt replied to Trubie's topic in General Nursing

    I understand she was palliative, so the main objective here is to make the pt. and her family comfortable. The removal of O2 should not have been a problem, the lack of proper sedation is more of a...

  9. USE of PF Ratio with ARDS

    dmc_rrt replied to TennRN2004's topic in MICU, SICU

    Here is the ARDSnet protcol: NHLBI ARDS Network INCLUSION CRITERIA: Acute onset of ,Tahoma],Tahoma]1. PaO2/FiO2 ≤ 300 (corrected for altitude) ,Tahoma],Tahoma]2. Bilateral (patchy, diffuse, or...

  10. Central Line Insertion

    dmc_rrt replied to haji's topic in MICU, SICU

    I say the Doc's retty lucky to have you there. I place femoral Central Lines and Have to get my own stuff together, and I am usually left alone, unlesss someone wants to watch. Tell him to quit his...

  11. Dsitinguishing Breath Sounds

    dmc_rrt replied to TennRN2004's topic in Pulmonary

    Coorifice crackles on expiration are usually due to secretions. I find that most pleural effusions present as diminished breath sounds. Remember the fluid is gravity dependant and will usually collect...

  12. Increase of super morbidly obese patients?

    dmc_rrt replied to Hoozdo's topic in MICU, SICU

    Funny, an ER RN and myself were just talking about it this

  13. Ambu bags (inpt)

    dmc_rrt replied to LouisVRN's topic in General Nursing

    For cost effectiveness, my hospital has those mouth-to-mouth thingys, which to my own personal opinion are a joke. I have yet to see them used effectivly at the beggining of a code. The pt is blue, as...

  14. Hijab (headscarf) Nurses

    dmc_rrt replied to skybmonkey's topic in General Nursing

    I've seen quite a few Drs. wear them too. they are all respected Pts. and

  15. communicating w/ pts on ventilators

    dmc_rrt replied to turnforthenurse's topic in MICU, SICU

    I have one pt that uses his

  16. When to transition from non rebreather to bag valve mask?

    dmc_rrt replied to theodog's topic in MICU, SICU

    I agee with dano. Prior to intubation, if the pt can hold their sats close to 100% by breathing on their own, then use the NRBM. Bagging can cause increased anxiety, and gastric

  17. Need help on mark twain quote!

    dmc_rrt replied to TeeGuneys23's topic in General Nursing

    I think that it means to sort through the BS of what you're tought, and find out for yourself what is real. Just because a teacher or a book tells you something doesn't make it true. This is why it is...

  18. Facilitating intubations

    dmc_rrt replied to poppy07's topic in MICU, SICU

    Some of tythis stuff might have already been covered, but here's my 2 bits: 1. Get the bed ready, away from the wall, raisednup to about belly button level. 2. Suction ready 3. Pt on 100% O2 4. BP...

  19. Frustrated over a code

    dmc_rrt replied to pinky22786's topic in General Nursing

    I would write up an incident report in regards to the lack of training by the MRI/ ultrasound staff. Any person in the hospital should know that sats of 40% is not acceptable. They should have called...

  20. Transporting Pt. on O2

    dmc_rrt replied to bonestAx's topic in Patient Safety Issues

    Your plastic tank sounds like a refillable liquid O2 tank. The plastic housing can get banged up, but it is there to protect the metal tank

  21. Do your ICUs/hospitals offer all therapies?

    dmc_rrt replied to CNL2B's topic in MICU, SICU

    We have a 14 bed ICU. We don't offer PRISMA, HFOV, ECMO, we have NO but have not used it in 3 yrs. Any heart pts get transferred out to other hospitals for surgery. Our long term vents get transferred...

  22. Neuro Yawn

    dmc_rrt replied to MagpieCCRN's topic in General Nursing

    I noticed when I suction my vegatative trach pts that it also seems to trigger a

  23. Question about plateau pressures

    dmc_rrt replied to dorimar's topic in MICU, SICU

    Ok, I'm trying to follow this thread, but its a little confusing. PEEP is the constant, base level, minimum pressure applied to the lungs by the vent, helping to splint the airways open. Inspiratory...

  24. weaning

    dmc_rrt replied to bjaeram's topic in MICU, SICU

    Sorry about your Sister in Law, She sounds very sick. I don't know all the parts to this story, but here is my two bits:My guess is that the acidosis is probably caused by increased urea(ARF) and/or...

  25. ET size HELP!

    dmc_rrt replied to dulexsidlex's topic in MICU, SICU

    under the connector hub of the ETT are the numbers, they are hard to see. A trick is to press your bare finger underneath the flange. The numbers will be pressed into your skin and you can then read...