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Pediatric Emergency
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chul_soo has 5 years experience and specializes in Pediatric Emergency.

chul_soo's Latest Activity

  1. chul_soo

    Before you buy a $300 Vein Finder

    I have an LED Flashlight and doesn't get hot enough to burn babies. If you were to use an otoscope, that would be a big no no. Also older flashlights aren't quite bright enough unless you use a tactical flashlights and those get skin burning hot. At the end of the day, if I had a neonatal translumenator in front of me, I'd use that. My flashlight is normally used in a pinch. I could understand 10 years ago, the IV light was state of the art but it's 2017. i just feel that the IV light should've depreciated in value...
  2. chul_soo

    Behavioral health holds in ER

    In my department, it's done in triage but if they come in kicking and screaming, it might have to wait. =P
  3. My ED orientation was about 3 months and my residency was 1 year. That being said, the residency program was hospital wide and cover basic pediatric stuff for all the new grads on the critical care side. My ED gave great didactic lectures on common illness seen in my ED. To be honest, most of my learning was on the floor and not in the classroom. But then again, I learn best when there's hands on involved. I finished my residency 4 years ago now. I'm actually speaking to the group of new grads that's finishing up their residency soon in my department. No worries on all the question, that's why we all come to this forum. As far as tips... coffee? Lol~ There wasn't much I did outside of my residency. I thought about memorizing different dilutions for meds but it wasn't really needed. I felt like I had a leg up on all the other residents because of my previous experience as a Army Medic and working part time as a medical assistant while going to nursing school. Plus, I feel that the hiring process weeded out 99% of people that wouldn't cut it in the ED. Since I've been in this department, I've only seen 1 new grad that didn't make it through residency. Ah, 1 good tip. Find a good mentor on your floor. It doesn't have to be your preceptor but someone that you look up to and has vast amounts of knowledge in the floor and in the nursing career. I hope this helps!
  4. Is a woods lamp needed to check for a corneal abrasion? Don't forget the fluorescein strip. Oh btw, the exam is done on a toddler that pretty much hates everyone in the building. How can you free up a hand while staining the eye? Fluorescein eye drops! I got this idea from Dr. Ian Brown from ALiEM Educational Videos and slightly modified it. i hope this helps someone in their next woods lamp eye exam.
  5. Adults or Peds? Mixed? Be ready to learn! Meaning... recognizing sick vs. not sick and prepare to give MAXIMUM EFFORT! Sorry, Deadpool quote... When I started my residency, I didn't know the in's and out's of... anything. So I had to compensate by putting in extra effort to keep up. It also helps that my department has an excellent new grad program with amazing educators that are on the floor and working with the staff nurses. Best of luck to you!
  6. chul_soo

    Nurse Life Hack, Hair Tie

    If you have disposable gloves with cuffs, you have hair ties. I hope it's useful for some of you guys/gals. Check out the short how to video below. [video=youtube_share;DHhruVGgl6I]
  7. chul_soo

    Push Pull vs Pressure Bag

    I work at a level 1 peds trauma ED and the Attending/Fellows are in love with push pull bolus infusions on hemodynamically unstable patients. From my experience, doing a push pull bolus are effective up to about 20-30kg and after that, user fatigue starts to set in. I've looked them dead in the eye and told them that, it's not happening when I had a hypovolemic 85kg patient. I ended up using a pressure bag before I got extra help to run the level 1. From my experience push pull - pros > better accuracy in amount of fluids injected > fast delivery method for administering fluids for patients under 30-35kg (not 100% where the cut off is) - cons > administering fluids turns in to 1:1 > user fatigue > skill level dependent on fast administion Pressure Bag - pros > non-stop fluid administration until bag is complete > easy to set up > not 1:1 dependent to admin rapid fluids - cons > must be pumped up occasionally > possibility of getting air in line So back to my original question, any other pediatric ED's advocating push pull on hemodynamically unstable patients?
  8. chul_soo

    tips and tricks for difficult IV starts?

    In the pediatric world, IV lights (Vein finders) are the go to option. US is slowly starting to creep in. I only got better by watching other people better than me and by doing them myself. When at all possible set everything up because toddlers can be a hand even with a good holder... I also use a LED flashlight as my vein finder. From neonates to small toddlers, I'm able to see veins in their hands. I did a little demo and posted it on YouTube. PSA: Never use an otoscope! They get real hot and cause burns.
  9. When the ED gets old, I plan on becoming a sedation nurse at the radiology department. Sedating 1 pediatric patient at a time isn't a bad gig. Plus diffs are usually decent since PALS are involved. I'll probably still work PRN in the ED. I DIDN'T CHOOSE THE ED LIFE, THE ED LIFE CHOSE ME.
  10. I started out as a new grad in my ED. I suggest that in your last year of nursing school, get to know the management of ED you want to work for. I'm sure your next question is... how do I do that? There are several ways to approach this. - Get a senior practicum spot in that ED - Get a part time job as an aid if they are hiring - Voluteer All I'm saying is get your foot in the door. Show the staff that you can become a valuble asset to the department. If that that plan fails, apply to any RN jobs out there and suck it up for a year or 2 then apply to the desired ED. Most large ED's have high turn over rates so getting a job shouldn't be too difficult.
  11. chul_soo

    Favorite Apps in ED

    One of the Attendings I worked with got this app up and running for my Peds ED. Great for checking max doses for peds also a great reference for NG tubes, foley's, etc... It's commonly used in my ED. http://Pediatric Quick Reference by Children's National Medical Center https://appsto.re/us/RAPLI.i My 2nd go to app is http://Pedi STAT by QxMD Medical Software https://appsto.re/us/_lfJt.i I primary use this app to calculate MIVF for burn patients. One of the limitation of Pedi STAT is the cut off of weight based calculation after 50kg.
  12. chul_soo

    Before you buy a $300 Vein Finder

    Hey guys, I did a review on $20 Flashlight vs. $300 vein finder. I've noticed that my LED Flashlight works as well as an expensive transilluminator. The flashlight is lacking in ecgonomics but that's no reason to pay that much extra. Anyone else feel like medical equipment is expensive for no good reason? Here's what it looks like side by side.
  13. chul_soo

    Starting Pay for New Grads RN's in Southern CA

    So if new grads are making around $30-40/hr. What are the projection of salary in 5 years? 10 years? 20 years? Given that you do what a good nurse would do, ie. get superior ratings, ACLS, PALS, certify in their specialty (CCRN, CEN, etc...)
  14. chul_soo

    Any Hospital Hiring in MD?

    How is it starting off as a floater? Other experienced RN's I've talked to think that using new grads as floaters is the craziest thing they've ever heard.
  15. chul_soo

    getting hired with the VA as a new grad

    On the same boat as you. Just wanted to ask an additional question. When would be a good time to start applying? Would they even consider me with out my RN? From what I've been reading, it looks like the application process takes a while so I want to get started as soon as I can. Btw, graduating in dec too if you didn't get that.
  16. chul_soo

    Any RNs with CMBs, CIB or CABs ?

    I have my CMB. I received it during OEF 03-04. I was a paratrooper with the 1/501 ABN. I was also deployed to Iraq in 05-06 w/ 4/23 stryker brigade. Now I'm 3 months away from getting my BSN. Im currently doing my practicum and my preceptor asks me if i knew how to give an injections or draw blood. I just smile and say, show me how you want me to do it. I earned my CMB. Kinda hard not to earn one if you were in Khost, Mosul or Bagdad. But if your in the ANC, it's hard to get a CMB/CAB because your jobs to stay on the fob and work at the CSH/FST.