GreyGull

GreyGull

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All Content by GreyGull

  1. o2 @ 2L

    GreyGull replied to Cat_RN's topic in General Nursing

    This has its limitations when it comes to the PaCO2 - PetCO2 gradient or V/Q mismatching where there are many variables involved. In the hospital we do ETCO2 but we also know those variables through...

  2. o2 @ 2L

    GreyGull replied to Cat_RN's topic in General Nursing

    I can not type everything again but here is the link to the other threads and the ATS position on COPD patients. The Long Term Oxygen section might be of interest....

  3. Rehab Nursing advice please...not a real nurse?

    GreyGull replied to leolomb's topic in Rehabilitation

    You'll actually have to be sharper than some of the other specialties. You may be getting some patients straight from an ICU or Stepdown on a ventilator who may be a "push" and not fully ready for...

  4. COPD- 98% O2 sat?

    GreyGull replied to payang0722's topic in General Nursing

    Extensive research went into those guidelines which are updated frequently just like the AHA does for cardiac issues. Many don't realize that the treatment for COPD and Asthma is an international...

  5. COPD- 98% O2 sat?

    GreyGull replied to payang0722's topic in General Nursing

    This means the physician may not have an understanding of LABAs and corticosteroids. LTC patients also need uninterrupted

  6. COPD- 98% O2 sat?

    GreyGull replied to payang0722's topic in General Nursing

    What are you nebulizing to dilate the pulmonaries arteries? While there are meds available for home use, this would then present a whole new set of problems to this situation. Or, the nebulizer was...

  7. Unbelievable !!

    GreyGull replied to NurseLoveJoy88's topic in General Nursing

    We just had a nursing student pull out an ETT instead of the esophageal temp probe. The list of things a student can do to a patient is endless if given the opportunity when their assigned preceptor...

  8. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    Forgot this one of Debi. This is how tracheostoma patients prefer to clear their secretions. That's it for my anti-smoking soapbox. Apologies for sidetracking the thread. But, for those who do smoke,...

  9. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    Tracheostoma patients are always a little challenging although you have this big hole looking at you (just like the TV anti-smoking commercial). For emergencies, you have to be mindful of a...

  10. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    All of the long term care facilities that I am familar with converted to inline suctioning about 15 years ago. At first the surveryors made a big issue out of it and wanted them to change the...

  11. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    Does this mean you would cite a hospital or LTC facility for using an inline suction device? These multiple use devices have been used in both LTC and nursing homes for over 25 years. It is also known...

  12. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    That is the inline suctioning device that I have been discussing. You might want to surf up the CDC sites for the multiple research done on this device over the past 25 years. Change q shift or q week...

  13. Is it really illegal to require BSN(NJ)?

    GreyGull replied to mamaxmaria's topic in General Nursing

    New Jersey is just preparing for the future. http://www.njsna.org/displaycommon.cfm?an=1&subarticlenbr=380 By requiring education to be higher than the minimum is common for health care...

  14. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    Absolutely and that is what we use on the ventilator trach patients in the ICU and stepdown. It is similiar to the one for an ETT but the catheter is shorter but still adapts as a t-piece for off vent...

  15. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    They are expensive when you consider the number used and a LTC facility reimbursement might be fixed. It is not just the LTC facilities that experience the cost. Most hospitals use one type of trach...

  16. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    It doesn't have to be on a ventilator. It used to make me a little queasy in ICU to go from vent to t-piece and back to vent with the same inline suction catheter also especially since the t-piece was...

  17. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    Since the OP was not clear about the type of catheter used, which may have been sleeved or inline, it is difficult to criticize the method. It has been found, including in our own VAP studies, that...

  18. Tracheostomy Suctioning Sterile?

    GreyGull replied to aimessue's topic in Geriatric, LTC

    When teaching long term trach care, clean technique is sometimes the best expectation. Sterile would be ideal but not practical. This is going to be facility specific and will depend on the suction...

  19. Inaccurate story on CNN?

    GreyGull replied to amyphee's topic in Burn

    For serious burns, especially for peds, it has been my experience that the burn team will take the patient back to their unit as quickly as possible. The team, including the doctor(s), would not...

  20. how is Vent weaning supposed to be done?

    GreyGull replied to wantsthebest's topic in Pulmonary

    If the patient is already on a ventilator or has any artificial airway, there should be a suction set up at bedside. It is doubtful that a patient on a ventilator has made it to the weaning phase...

  21. Inaccurate story on CNN?

    GreyGull replied to amyphee's topic in Burn

    You can not judge every hospital by your one experience nor can you judge all doctors by a few bad ones. New physicians will sometimes strive to get into certain residencies programs for the overall...

  22. Just accepted into adn program! Should i accept or decline?

    GreyGull replied to marcopolo's topic in General Nursing

    I'm going to be a little different here since so many have put up arguments against the BSN in other discussions. With prerequisites and then the ADN, you are spending probably 3 years in college. If...

  23. Inaccurate story on CNN?

    GreyGull replied to amyphee's topic in Burn

    This article may not be that inaccurate. Jackson Memorial is a large teaching hospital and this is a pediatric patient. I do know in other teaching facilities the residents may be required to have...

  24. BCLS (BART)

    GreyGull replied to Marie1205's topic in General Nursing

    It is not that they are teaching "their own thing" or reinventing ACLS or CPR. These classes are a benefit to ensure their employees know the hospitals protocols and equipment. It also gives them an...

  25. Drug seeking patients

    GreyGull replied to Art_Vandelay's topic in General Nursing

    You did not know this when the patient presented to you. Remember a Paramedic can not tell for sure either since they do not do labs and one EKG may not show everything especially if you do not have...