GreyGull

"Sigh"

Our IT people set up some of the most complex technology on the market. They are present in the patient care area to troubleshoot and make sure everything is functioning as well as to TEACH RNs and MDs how to use it. That may definitely be during a ...

You guys tickle me sometimes and I'm the one who is 2 - 3x your age and grew up with the stone tablets. Get over your arrogance. You need computer specialists and the more they know about your job, the easier they can make it.

Define "record a code". In my hospital it has many meanings since we do teaching and have electronic gadgets everywhere. Someone writing events on a piece of paper is just one way and may be done while other methods are also be used to "record a code...

Then allow me to introduce you to the Philips elearning website. Philips bought Respironics who makes many pieces of RT equipment including the Vision. There is a good Vision inservice and NPPV courses along with ETCO2 and other noninvasive monitorin...

I see someone who is asking questions about the things he is seeing or reading and would like an explanation from those directly involved in patient care. Maybe he does not want to bother those where he works with these questions especially since man...

That would depend on the disease process (underlying and acute), the plateau pressures, the waveforms of the ventilator and at what stage of the acute or recovery/rehabilitative process the patient is in. ARDS protocols will run from 6- 8 ml/kg (emp...

But then over simplification is why some don't understand ABGs the way they should especially if they are in a position to assess and maybe treat. Over simplification is also why some still use "no more than 2 L for COPD" or toss out something like ...

I would check with the sleep lab about ANY medications, OTC or prescription, to see what they do allow. Many machines are now auto titrating (APAP) and many insurances do allow these. Some patients may have this study done in the hospital near the en...

I apologize for my lengthy posts. To summarize, sometimes patients are "assumed" to be a COPDer or in exacerbation with sole focus on the respiratory component. The clinical presentation and the ABG iare useful for the inital rescue but as the bedsi...

You must monitor the intrinsic or auto PEEP and plateau pressures. High Peak pressures are also just one small part of the story. By knowing the plateau pressure you can make an informed decision about whether it is a problem with secretions, broncho...

The over simplified teaching of ABGs do an injustice to the bedside clinical health professional. Many focus on the disease process of "COPD" without considering the many other pulmonary and non-pulmonary disease processes which are interconnected. ...

This is also a very public open forum. The OP expressed a concern for a nurse over something he/she thought he/she withnessed. The OP is also a member of the hospital team even if he does not have RN behind his/her name. The OP's question also seemed...

Since this was a teaching hospital there might be several ways to "record a code". We record the actual code in action to be played back. There are also electronic markers on a computer screen that has all the monitored data sent to it and it takes i...

Is the PA catheter used by Habit Based Medicine or Evidence Based? Because we've always done it like this no longer holds up in Evidence Based Practice. http://anestit.unipa.it/mirror/asa2/practice/pulm/pulm_artery.html Any invasive procedure will...

That is an interesting topic that might deserve a heading all to itself. We will also put DNR patients on NIV if we feel it is a short term situation. Sometimes it is a gamble and the patient doesn't turn around as expected. NIV falls into a gray ar...

Our bodies also adapt quite well to some objects as evidenced by stents, pacemakers, Blom-Singer valves, IUDs, spinal rods, artificial this and that. However, when it comes to body piercings I wish I could effectively use that argument on some young...

Patients may have trachs because of their disease process which creates secretions. Due to a weakened state or the advancement of their disease they are no longer able to cough, spit or swallow as others would. They are probably colonized with every ...

The industry has realized the issues concerning BiPAP™ and has responded with a new generation of technology. BiPAP™ was not intended to be a "ventilator" but some often believe it to be and set the rate as they would for an AC mode. I also agree tha...

The ethics of medicine can become quite involved with many factors to consider. Do we always know that a COPD patient will not wean from a ventilator if they are intubated for an exacerbation with an underlying that might be easily treated or if the ...

wikipedia? i must agree with gilarrt about a non-rebreathing mask being a low flow device. in the hospital we utilize many other devices that are considered flow by the true defiinition by delivery of inspiratory flow demand. there is also confusion...

When a patient is ready to be extubated the air hunger hopefully will not be there causing them to struggle. Whatever even such as a TBI hopefully will have improved which was causing them to have altered mental status and combative. How many times h...

Hurricane spray can be extremely effective if used properly. Lido 4% with an atomizer can be effective and so could a 30 minute nebulizer if you have time. We could also use Jackson forceps and a cotton ball to give a direct hit to the nerves dependi...

I have continued to lived in SF for many years by choice even though I could easily move somewhere else. I know the economic stressors. However, I do not believe being cautious when commuting, walking my former neighborhood (the Mission) or being awa...

48? I don't live in fear but I don't invite danger into my life unnecessarily. It seems you have not learned the difference yet. However, Tibourn and Walnut Creek are nice areas to consider. If I were to move either would be a nice option. A few fac...