usalsfyre

usalsfyre

CCT

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All Content by usalsfyre

  1. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Not even a trauma bay. He needs a neurosurgeon and a trauma surgeon evaluation and possibly an OR. The tramua bay is just another delay, albeit a necessary one. There's back up options besides a...

  2. Does he need to be intubated??

    usalsfyre replied to InmyblooD's topic in Emergency

    Generally I'm going to RSI this guy. Two minutes from a tertiary ED however, I'm not. An RSI generally takes at least 5-7 minutes, which if he's not hypoxic and I can maintain his airway via...

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

    usalsfyre replied to imintrouble's topic in General Nursing

    So I guess a CNA is also a RN's equal? Because we're talking about similar a education

  4. Are the "chest thumpers" new?

    usalsfyre replied to cogath's topic in General Nursing

    None of these were randomized, one was retrospective, only Ornato's was of any particular size, pick any number of other issues about the data presented. The ASPIRE trial which was supposed to solve...

  5. Are the "chest thumpers" new?

    usalsfyre replied to cogath's topic in General Nursing

    This has never been proven. They're expensive, heavy and have shown absoloutely no survival benefit in trials so far. One company's device caused such grevious injuries when applied improperly a...

  6. Difficult access: Would you go for EJ or pedal?

    usalsfyre replied to Murse901's topic in Emergency

    Neck stick FTW. Pedal IVs are generally a poor choice in the patients that get them anyway, as there's a good chance one of the reasons the arms are shot is due to

  7. A few questions:

    usalsfyre replied to felineRN's topic in Emergency

    EMS is bound by whatever local policy is in place. It's not the individual medics fault, but... [rant] Transporting asystolic patients IS lame. No lesser an authority than the AHA has stated this. The...

  8. Advice: On An MD Order

    usalsfyre replied to Raquel8's topic in General Nursing

    It was originally developed as a pulmonary hypertension med. The subjects in the trial just reported a "happy" side-effect, leading to it's other, more popular

  9. Advice: On An MD Order

    usalsfyre replied to Raquel8's topic in General Nursing

    If they deny symptoms and their vitals, UO, skin signs and mental status otherwise indicate good perfusion it's fine. Try not to get hung up on numbers too much, try to judge overall perfusion

  10. An ER "First" for Me...

    usalsfyre replied to Music in My Heart's topic in Emergency

    I once was prescribed Vicodin 10/650 for pain after a fairly major auto accident (luckily didn't require admission). This strength, combined with a concussion made me act loopy enough to convince my...

  11. Have you ever done IO IV Placement?

    usalsfyre replied to UM Review RN's topic in General Nursing

    I've been using the EZ-IO for close to five years now, I've probably done close to 50 of them. Currently first-line access for cardiac arrest at our prehospital service. Far faster than a central...

  12. Can a RN...

    usalsfyre replied to SRT1115's topic in General Nursing

    Didn't offend me, I just don't see where this would ever be an issue. Scope of practice can be restricted as far down as your job description wants. Granted, you might be held to the knowledge...

  13. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    Very well said

  14. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    They may have been trained at some point, but two year old training is darn near worthless. They certainly weren't equipped. In the real world, you make risk/benefit analysis and risk you life ONLY...

  15. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    Would it change anyone's mind to know that the families of these men or women would have VERY likely been denied death benefits in the event of a fatality because they were making a rescue for which...

  16. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    In other news, unicorns were discovered

  17. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    Again, I REALLY think people fail to understand the difference between being in the water for a few minutes and dragging someone back in vs an extended rescue effort of a conscious person in water...

  18. WOW! The public really doesn't like us, huh?

    usalsfyre replied to Mrs. SnowStormRN's topic in General Nursing

    People have been given unrealistic expectations of healthcare, both by mass media and hospitals own marketing machines. The public now expects a hospital stay to be something like a vacation with some...

  19. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    Yep, absolutely. Again, if your not familiar with contact water rescue, you don't know how difficult this discipline is. Risk:Benefit. In this case the risk was great, and the chance of success was...

  20. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    I understand this, but again, not everyone can be saved. I don't believe suicidal ideation and mental illness are anything other than a medical condition. But some people are going to be successful....

  21. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    I understand, and agree to a certain extent. However, asking someone to attempt a rescue when the chance of failure is greater than the chance of success on someone, who voices or not, has placed...

  22. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    Which is a societal and familial issue which heaping more blame upon the responders in this case won't fix. Life's tough. Not everyone can be saved. This man, mentally ill or not, placed himself in...

  23. Can a RN...

    usalsfyre replied to SRT1115's topic in General Nursing

    Maybe I'm dense, maybe I haven't been exposed to the intricacies of RN licensing, but.... How would "being held to the standards of you license" ever end up being an issue? Your scope can be...

  24. As basic decency slips away....We watch them die and do nothing.........

    usalsfyre replied to greenfiremajick's topic in General Nursing

    Have you ever seen or done a contact water rescue? Have you ever submerged your body in 50F water? What your saying is not based in reality. We can probably find some media cliches about nurses as...

  25. Can paramedic or EMT administer an IM med like Haldol or Ativan to help unruly pt?

    usalsfyre replied to ~Transplant Nurse~'s topic in Emergency

    I know a lot of medics. A LOT of medics. I have NEVER heard of a sedative being used in the manner you described. Even from the dumbest, hates medicine, came from a six month mill, would rather be on...