JohnW

JohnW specializes in SICU/CT-SICU.

Latest Activity

1. Which Pumps are OK for Blood Transfusions?

   JohnW replied to JohnW's topic in General Nursing

   Thanks for the replies. I've always used Alaris pumps (and I know they are approved for blood). The hospital where my wife (she is also an RN) works uses Baxter pumps, they have blood tubing, but their policy is that blood can only be run through a ...

2. Which Pumps are OK for Blood Transfusions?

   JohnW posted a topic in General Nursing

   Does anyone know of a resource that lists which major brands of IV pumps are OK to run blood products through? I searched on the Baxter site for a while and could not find anything. Thanks!

3. can someone please explain the heparin drip calculation to me?

   JohnW replied to NPs4health's topic in Medications

   It really depends, most institutions have a Sliding Scale heparin order sets that tell you how much to go up or down the gtt based on the ptt. As the nurse, there is no set calculation that you need memorize.

4. Rapid Response Team and Families

   JohnW replied to Grumpy's Girl's topic in MICU

   RRTs by familes? I think that's absurd. If you don't trust the floor nurses/MS on the floor where your loved one is staying TRANSFER to another hosptial. If the family thinks the floor nurse (and supporting team) are so weak that they can't recogni...

5. Anyone use ibutilide?

   JohnW posted a topic in Medications

   We used this drug in my SICU the other day (per cardiology) for a paitent who had ended up in Afib/Afluuter. The paient, who was in his 20s, was given concentrated IVP neo (by mistake) in the OR. He dropped his HR down to 30 and was given atropine....

6. aspiration

   JohnW replied to fatoma's topic in MICU

   Of course, sitting someone straight up will help prevent apiration, but it's certainly not a cure all. Many people with MS changes are not safe to eat (or eat everything) and deserve a S&S consult. Don't forget lots of people are silent aspirator...

7. Arterial line insertion by the RN

   JohnW replied to CactusFlower's topic in MICU

   Wow, that is a big difference. You guys do a lot, but it seems weird to me that you guys pull pleurals, but they don't let you draw ABGs? Our NPs or PA pulll epicardial wires as well.

8. Arterial line insertion by the RN

   JohnW replied to CactusFlower's topic in MICU

   We don't insert A-lines, although I wish we did, as sometimes it's painful to watch Interns struggles to get one. RNs and RTs can draw AGBs. We dc Swans, but do not advance them. We maintain CVVH, but do start it. We do not place central lines, IV...

9. aspiration

   JohnW replied to fatoma's topic in MICU

   Not sure what you mean here? Are we talking about non-vented people? It's comon sense and comon knowledge that for any patient with trouble swallowing that you sit them straight up when you feed them. Or are we talking about people getting TFs? O...

10. Smart Cardiac Nurses

    JohnW replied to kleona's topic in CCU

    In my view, this is a very sick patient. As others have posted, you would need to check her code status ASAP, she is a hair away from being tubed and on pressors. It's a big problem that she is not on a monitor and probably a liability. It's not OK ...

11. does anyone use swans anymore?

    JohnW replied to squirlkeeperCCRN's topic in MICU

    All of our hearts come out with Swans. We do not wedge, we use PADs. We seldom Swan our non-CT patients, surgical patients. When we do it's most often a septic paitient whose heart is failing. We are just starting to see the "Presept" triple...

12. Nitro drip help please...

    JohnW replied to MissERN's topic in Medications

    Don't you guys do a re-back on verbals? That would have been time to clarify. In this case, you can be pretty sure the Doc meant 10ml/hr. Depending on the concentraion you guys are using, 10ml/hr often works about to about 30mcg/min, a nice place to...

13. Lopressor drip

    JohnW replied to traumagirll99's topic in CCU

    We use PO cardene as part of our vasospasm protocol for strokes/coils etc, but I have not used it IV. Personally, I don't like using Calcium channel blockers as first line drugs to control hypertension, but that just might be my comfort level.

14. Pressors and Sepsis

    JohnW replied to CraigB-RN's topic in MICU

    We were inserviced the other day on the "presep" triple lumen CLs that allow for cont. SVo2 monitoring. One hope is that if these lines are placed in the ED, the Docs will be more willing to really pour in the fluid, even with an "ok" BP, in light of...

15. Explain ARDS?

    JohnW replied to JohnW's topic in MICU

    Perfect, thanks! I'm assuming the wedge is used as a differential versus CHF?