usalsfyre

usalsfyre

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All Content by usalsfyre

  1. can young,healthy,athletic men have heart attacks?

    usalsfyre replied to Lurker011's topic in General Nursing

    Quick word here. Multi-phasic ventricular tachycardia is a shockable rhythm but an unsynchronized countershock (defibrillation) must be delivered rather than a synchronized one (cardioversion). If you...

  2. Calling a Death

    usalsfyre replied to KareBear0609's topic in General Nursing

    Part of being a resucitation team leader is taking input from team members. The doc was just making sure he had

  3. How do you perform CPR to a patient with hunchback?

    usalsfyre replied to Kalleigh2011's topic in General Nursing

    As above, as best you can. Don't expect a good

  4. So frustrated with IV starts!!

    usalsfyre replied to NeoPediRN's topic in Emergency

    Because of supplier changeovers, we've got both on the trucks right now, so it's a crapshoot what I'm going to pull out of the cabinet any particular time. We're going to the Protectiv, I can't wait...

  5. So frustrated with IV starts!!

    usalsfyre replied to NeoPediRN's topic in Emergency

    So my guess is the new IV catheters look like this: Where as what you used to looks like this: I had to do this same transition...and it's not an easy one. A couple of tips. 1)DON'T SAFE THE NEEDLE...

  6. ER nurses, let me pick your brains...

    usalsfyre replied to carolmaccas66's topic in Emergency

    Good lung goes down, almost always. Reason? Gravity assist in

  7. 20 Things Nurses Wish They Never Had to Say

    usalsfyre replied to VivaLasViejas's topic in General Nursing

    I refer to this as "fishing for the

  8. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    I know, but if we're going with the "gold standard" argument one goes with the other, do they not? Agree 100%. I was simply trying to be a voice of caution aginst the "I would never allow no...

  9. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    The one I was specifically looking for. Preventing active regurg in the non-NPO patient. Yes, but I've tube plenty of non-paralyzed patients who never experienced laryngospasm, and it can be...

  10. What would you do? ...stop TPN or not

    usalsfyre replied to IheartICUnursing's topic in MICU, SICU

    Would have stopped the TPN, and have been paging a physician to get a central line ASAP. I get VERY suspicious of line sepsis in the patient with undifferentiated sepsis and TPN through a

  11. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    The "very good reasons" are fairly common in the population of patients that gets tubed. Morbid obesity, limited neck mobility, obstructive sleep apnea, small thyromental space, limited mouth...

  12. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    If your docs are topicalizing with just Hurricane spray they're not doing enough. I'm talking nebulizer lidocaine, lidocaine applied directly to the cords via atomization, and pain control waiting...

  13. Cardio questions...

    usalsfyre replied to kat7464's topic in General Nursing

    ACE inhibitors work by preventing the conversion of Angiotensin I to Angiotensin II (Angiotensin Converting Enzyme inhibitor). Remember the AT II is a powerful vasoconstrictor, especially on the...

  14. discipline of nurses vs. other health care professionals

    usalsfyre replied to jrt71's topic in General Nursing

    I hate to break it to y'all, but nursing is actually fairly lenient in its disciplinary proceedings. My, as well as my wife's, field of allied health would face immediate delicensensure in many cases...

  15. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    Agree with this. There's probably also a lot of situations where we should be waiting, topicalizing the patient and tubing them

  16. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    Sedation and paralytics are an awesome way to kill someone who's a poor candidate, just so you can be

  17. Intubation without RSI meds??

    usalsfyre replied to BeachyRNn08's topic in Emergency

    Although this sounds like just poor airway management, there are acceptable ways to intubate someone without changing their LOC. Just assuming it's appropriate to RSI everyone is a good way to get...

  18. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Remember, CAB only applies is cases of cardiac arrest (and really more medically oriented arrest) and massive uncontrolled hemorrhage. Everyone else still gets their airway taken care of

  19. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Exactly! But then you probably think like me because you sat in the same classes as I did ... We need to move beyond cookbook terms like "always" and "never" and into "at times" and

  20. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Never's a dangerous word in medicine. You don't need radiography. You need a good understanding of trauma kinematics and what injury paterns typically produce basilar skull fractures. Like I said,...

  21. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Been meaning to answer a couple of things here.... As you note, it's highly dependent on the medic sometimes. Most of my respiratory failure patients get at least a trial of CPAP before moving onto...

  22. What do you do with motorcycle helmets after a motorcycle accident?

    usalsfyre replied to LegzRN's topic in Emergency

    Remember also, to technically be a "biohazard"'it has to be saturated to the point of being able to wring blood out of

  23. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Chances of passing a NPA into the cranial cavity are probably way overstated. I would be more cautious in the case of maxilofacial injury, but the general category of "head injury"' isn't really a...

  24. What do you do with motorcycle helmets after a motorcycle accident?

    usalsfyre replied to LegzRN's topic in Emergency

    I got my clothes back after being a trauma alert patient. I also try to make sure anyone who I cut the clothes off of gets them back. The car door gets put with the vehicle, which usually becomes...

  25. Anybody ever have an MD actively campaign to have you fired?

    usalsfyre replied to imintrouble's topic in General Nursing

    Agree with you on this point, I consider it more just having respect for your coworkers and treating everone as if they're human. I will say a lot of people need to learn this