jwk

jwk

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All Content by jwk

  1. Tips for IJ placement

    jwk replied to bwt02's topic in Certified Registered Nurse Anesthetist, CRNA

    Thanks, I understand the anatomy very well. The OP didn't specify exactly what his problem was with IJ placement. When I've been observing students, it seems there is more of a problem hitting the...

  2. Tips for IJ placement

    jwk replied to bwt02's topic in Certified Registered Nurse Anesthetist, CRNA

    More lateral perhaps? Do you have access to ultrasound? A lot of folks are swearing by it, plus there are some with the opinion that it should be the standard of care (not me). If you're in the...

  3. When to start the job hunt?

    jwk replied to makeusleepy's topic in Certified Registered Nurse Anesthetist, CRNA

    Some would think that starting to look as soon as you APPLY or are accepted into school is not too early. All depends on if you have a pre-conceived idea/limitation on where you want to settle or the...

  4. propofol

    jwk replied to popbob's topic in Emergency

    1) We're not talking about ventilated patients in the ICU. 2) Neuro patients in my OR get pentothal. 3) Trauma patients, particularly unstable ones, NEVER get propofol. They get etomidate,...

  5. propofol

    jwk replied to popbob's topic in Emergency

    Hmmm, we don't generally have the neurosurgeons setting standards for the anesthesia

  6. Double Lumen LMA for Lap procedures?

    jwk replied to TraumaNurse's topic in Certified Registered Nurse Anesthetist, CRNA

    You're right, the sales reps push it, and the usual thing they say is "they do it in the UK".There are two separate issues here - LMA's with vents, and LMA's with laparoscopies. LMA's with vents on...

  7. propofol

    jwk replied to popbob's topic in Emergency

    I never said you were incompetent, but your statements pretty much prove the "cocky" part. You should read this entire thread, and read the several other threads on this board regarding adminstration...

  8. propofol

    jwk replied to popbob's topic in Emergency

    You should read that package insert again - you're missing the part about it being used ONLY be those trained in administering general anesthesia which you are NOT. And again, it doesn't really...

  9. propofol

    jwk replied to popbob's topic in Emergency

    It's rarely used for "conscious" sedation in the ED. And inducing general anesthesia in-flight ain't my idea of a great thing to do either.I'm tellin' ya boys and girls - read that package insert,...

  10. Md's Against Crna's?

    jwk replied to LLL123's topic in Certified Registered Nurse Anesthetist, CRNA

    Dream on - it will NEVER happen. But hey, at least you found the right

  11. CRNA accused of sexual misconduct

    jwk replied to subee's topic in Certified Registered Nurse Anesthetist, CRNA

    Sounds a lot like losing your inhibitions with alcohol. I've seen a couple of very similar situations in GI as well although the patients have not remembered them. I've also heard of the sexual...

  12. propofol

    jwk replied to popbob's topic in Emergency

    Wrong on several levels. Propofol should be reserved for anesthesia providers. Head bleeds and trauma? Gimme a break. Yet another example of propofol being used by the wrong

  13. CRNA being black-balled by former employer

    jwk replied to crnadg's topic in Certified Registered Nurse Anesthetist, CRNA

    Once you hit the "quote" button, just start typing. Sounds like you're really getting screwed here. I agree, I think you need an attorney if you're going to pursue this - if you're not getting help...

  14. CRNA being black-balled by former employer

    jwk replied to crnadg's topic in Certified Registered Nurse Anesthetist, CRNA

    Just playing devil's advocate here - did you give adequate notice or did you leave suddenly with little or no notice? Were you under any kind of contractual obligation to stay for a certain period of...

  15. Is Indiana RN allowed to give Ketamine for procedural sedation ??

    jwk replied to samaritan's topic in Emergency

    Fentanyl/Versed works well. Conscious sedation using propofol is an

  16. Is Indiana RN allowed to give Ketamine for procedural sedation ??

    jwk replied to samaritan's topic in Emergency

    Well said. :yelclap: Any chance you could provide a link to a news report of this recent

  17. Is Indiana RN allowed to give Ketamine for procedural sedation ??

    jwk replied to samaritan's topic in Emergency

    At least they did it with appropriate

  18. Is Indiana RN allowed to give Ketamine for procedural sedation ??

    jwk replied to samaritan's topic in Emergency

    Total crap and totally outside the mainstream, although I've seen this perspective from a couple of well-known anesthesiologists as

  19. Md's Against Crna's?

    jwk replied to LLL123's topic in Certified Registered Nurse Anesthetist, CRNA

    So why did your CRNA school decide to have a clinical rotation here in the first place if there are so many downsides? Surely they knew this would be the case ahead of

  20. propofol

    jwk replied to popbob's topic in Emergency

    You have described a general anesthetic, not sedation. The fact that you have added MS or fentanyl makes it even more dangerous. Once again you prove the point of all of us who are saying it should...

  21. Physostigmine + Neostigmine

    jwk replied to devine1's topic in Certified Registered Nurse Anesthetist, CRNA

    OK - all this being said - does anyone use physostigmine routinely for reversal of neuromuscular blockade, and if so,

  22. Propofol

    jwk replied to czipp's topic in Gastroenterology

    And of course this is all TOTALLY unbiased....... Just remember: The package insert has NOT been changed - poor outcome will equal a big check with lots of zeroes on an indefensible lawsuit; and...

  23. propofol

    jwk replied to popbob's topic in Emergency

    Now that's an incredible oxymoron - "slightly deeper conscious sedation". Propofol in the hands of non-anesthesia providers, with the exception of ventilated patients in the ICU, is dangerous -...

  24. Propofol

    jwk replied to czipp's topic in Gastroenterology

    You don't become "immune" to the standard drugs just by having used them a few times. Sure, propofol is a great drug, in the PROPER hands -

  25. Physostigmine + Neostigmine

    jwk replied to devine1's topic in Certified Registered Nurse Anesthetist, CRNA

    OK, an ACH inhibitor it is, but in 25 years, I've never seen it used for reversing NMB's. I've got a few old-fashioned tricks up my sleeve as well, but this isn't one of them. However, I'll stand...