thanatos

stuff is constantly "walking" off...stethoscopes, reflex hammers, thermometers, diapers, tube gauze holder, and a doppler U/S. I had this one guy who was acting reeeeaaal weird...he took some splinting supplies and put a splint on one of his hands. I even caught looking at Media on the triage computer! He left..I wrote down his license plate #...called the cops...he was arrested.

This topic has been addressed numerous times. If you do a search, you will find a plethora of useful information.

I taught the same thing to my college speech class. I arrived to class early and put the glow stuff on the tables. I gave my presentation about halfway through the class (plenty of time for them to get the glow stuff on themselves). At the beginning of my presentation, I had some volunteers go wash their hands. I then darkened the room and used the black light. It was quite impressive seeing all of the glow stuff on people's faces, mouths, eyes, hands...basically all over. The volunteers who washed their hands still had the stuff on them. I think if you approach it that way, you can do it without boring them. You can also put some of the stuff on the sink and paper towel dispenser to emphasis the need to turn off the water using a paper towel. Good luck.

interesting...almost all of the kidney stone patients I have taken care of were not obese. I can only think of one that was. I wonder if there is an increase of a particular type of kidney stone, e.g. uric acid, calcium oxylate, etc? I will have to research this.

yup...valium is no longer recommended to be given via ETT.

PDA = Personal Data Assistant, e.g. palm pilot.

flu. flu. flu. r/o appy. "fell on butt". flu. suicide attempt. positive M.I. . frequent flier..."sciatica". and dental pain. didn't have to speak spanish once!!

All animal (including human) bites should be treated urgently. Antibiotics is the key. I've seen some cat bites turn ugly very rapidly which required hospitalization and IV abx. Even with thourough irrigation, antibiotics are needed. This is something that I would not "wait till tomorrow and see your regular doctor" but come in to the ER now.

I found the following books very helpful: Critical Care Cerification: preparation, review, & practice exams. Thomas Ahrens & Donna Prentice. Pass CCRN! Robin Dennison. Core Curriculum for Critical Care Nursing. Alspach, Ed. Core Review for Critical Care Nursing. Alspcha, Ed. I started reviewing the top 3 books about 10-12 months before the exam. As time got closer, I studied more intensely. I found the last book, which is 3 example tests, very helpful. In addition, I attended a couple of CCRN review courses, one by Laura Gesparis (sp?) and another one by Robin Dennison. I also listened to Laura Gesparis' CCRN review on tape while in the car. Her voice can get pretty annoying after a while, but I still found it very useful. Since I work in a rural hospital and the clinical experience is generally lacking, I hit the books pretty hard. If you work in a major ICU and you study up on the areas you are not familiar with, you shouldn't have a problem.

ok, back to those mast trousers.... 2. what is the tx of choice for cat bites? tridil, Are you still using MAST pants for hypotension? Haven't seen them used in years. Also, regarding cat bites, I though Augmentin was the tx of choice; at least that is what our docs use. T.

If their GCS drops to a 5, they have, or will soon have, a serious problem with "A" & "B" of the ABCs, i.e. they will need assist with maintaining the airway & ventilating. C-collar (if c-spine injury cannot be ruled out). Intubate. That way you can also maintain the PaCO2 (measured indirectly via PetCO2) at desired level. Give Mannitol if indicated (intraparenchymal bleed/injury). Be judicious w/ crystalloids but ensure mean pressure sustains blood flow to brain . Maintain head in neutral position and keep HOB up to 20-30 degrees (if feasible). NG/Foley/Temp probe if time allows. Get them to OR ASAP. Basically you stablize the best you can until you can get them to the OR/ICU.

I agree w/ above poster re not using ice. But I don't understand about the Doc's comment about the cold water. Stopping the burning process is number one priority, i.e. douse w/ water. Was he referring to potential long term infections from not using sterile water & burn sheets?

uuuummmmmm...how about all of the above. The fall caused the head injury...that caused the epidural bleed...that then caused increased ICP...and now it sounds like he may be herniating. Okay, seriously, what is his main promblem? I would say the increased ICP caused by the bleed. Yes, the initial insult was the head injury, but the epidural bleed is his main problem now. Fix the bleed and you fix the problem (hopefully). BTW. How were his pupils? Babinski?

aaaahhhhhh! sustained VT, not supraventricular tachy. In order to be "sustained" it has to last 30 seconds or more. Here's a reference: http://www.merck.com/mmhe/sec03/ch027/ch027g.html Be careful w/ the SVT acronym. As far as I know, it is used exclusively for SupraVentricular Tachy, but I could be wrong.

I'm confused (more so than usual)...could you please clarify? V tach and SVT (SUPRAventricular tachy.) are mutually exclusive. It's either one or the other. The length of time does not matter. Maybe I'm missing something?

This sounds like hereditary angioedema (HAE) which results from a deficiency of C-1 esterase inhibitor. Here is a link on the disorder and the blood test: http://www.hereditaryangioedema.com/ http://www.labcorp.com/datasets/labcorp/html/chapter/mono/sc003000.htm Hope that helps

We still use them on occasion. Patients seem to like them. I have heard the argument against their use, but I haven't seen any scientific studies.

I do see your point. Again, I'm sorry you've had such a bad experience with med/surg nurses. Where I work, most of them are excellent. Also, I used to work med/surg, and I believe this speciality (and I do believe it is a speciality) is unjustly underappreciated and maligned. IMHO.

It is too bad you have had such a bad experience w/ med/surg. Since I know & work with some outstanding med/surg nurses, I don't want you stereotyping these nurses. I would rather have a staff nurse attempt an IV than call for help the second the first line blow; how else are they are going to learn? I am glad there are nurses who enjoy med/surg because I cannot stand taking care of the same patient for more than 4-6 hours; I truly tip my hat to them. Please give them the respect they deserve. We are all nurses...just different specialities.

ditto what needsmore$ said

In general terms, there are different causes of hypovolemia. Dehydration is one. So to answer the OP: protracted N/V/D will lead to hypovolemia, specifically dehydration. Contrast this to a trauma patient who has had significant blood loss: he/she would be hypovolemic secondary to blood loss.

not weird...it is "none-of-your-business". the anonymity of this b.b. allows some people to be more "revealing" about themselves than they would be in person. btw I always like your avatars, quite funny

yea...it wasn't that long ago. I tried a search but couldn't find it. I do remember that most of the responding posts were defensive and basically "why do you want to know?". Now everyone is "baring" it all! :)

the same thought crossed by mind. that poster was critisized and the thread didn't last long.

ditto...I had tears running down my face I was laughing so hard. It read like a Dave Barry article!