usalsfyre

usalsfyre

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All Content by usalsfyre

  1. Drug seeking patients

    usalsfyre replied to Art_Vandelay's topic in General Nursing

    I deal with these patients daily, this is far from a textbook answer from me. At one point in my career I would get upset and angry over drug seeking behavior. As I matured, I realized, "why do I...

  2. What can the prehospital crews do in your area?

    usalsfyre replied to nfdfiremedic's topic in Emergency

    Most of this was disproven by EBM/easiser methods became available. For instance, adult IO has nearly completely eliminated the need for prehospital central lines, pericardiocentisis is really just a...

  3. 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'm a medic, not a nurse. Our service has standing orders for IV or IM lorazepam or IV/IM/IN midazolam for agitated patients. In addition we are able to treat pain as a "possible cause of agitation"...

  4. What can the prehospital crews do in your area?

    usalsfyre replied to nfdfiremedic's topic in Emergency

    Huge advocate for prehospital medicine, but... EMS scope of practice is far to big for what passes as a paramedic in a lot of areas of the

  5. Drug seeking patients

    usalsfyre replied to Art_Vandelay's topic in General Nursing

    Probably wouldn't give Narcan to anyone conscious enough to tell me they hadn't taken narcotics..... You can encourage all you want. The patient has a right to refuse pain control if they want to,...

  6. Reapply a Fentanyl Patch?

    usalsfyre replied to wifeandmomoftwo's topic in Patient Medications

    Gee, the manufacturer recommends using more of their product? Ya don't

  7. With-holding resuscitation on pt in the absense of a signed DNR order form? What?!

    usalsfyre replied to Cat_RN's topic in Patient Safety Issues

    Then yep, then all of the above are participating in complete and utter idiocy. Stuff like this is not about respecting the wishes of the patient, it's about beuracratic process and ensuring a...

  8. With-holding resuscitation on pt in the absense of a signed DNR order form? What?!

    usalsfyre replied to Cat_RN's topic in Patient Safety Issues

    Ideally, heck no, you don't start CPR. However, if there is question as to validity, ect as some people here are saying then you initiate resucitation until you can clear the situation up. As to the...

  9. Can nurses do x-ray procedures like in urgent care?

    usalsfyre replied to willowRN's topic in General Nursing

    You may want to check your state laws. I know in this state if your applying radiation there's some level of formal education/licensure that has be be met if your applying radiation for medical...

  10. With-holding resuscitation on pt in the absense of a signed DNR order form? What?!

    usalsfyre replied to Cat_RN's topic in Patient Safety Issues

    I work in EMS, we deal with this on a regular basis. One of the biggest myths is there must be a state form present for DNR patients. In the case of a signed order, initiate resuscitation and contact...

  11. in a difficult situation with "natural med" friend

    usalsfyre replied to anon456's topic in General Nursing

    I personally could not remain friends with this person. "Naturopathy" to the neglect of other, accepted medical treatment has another name. It's called quackery. Your friend is setting her child up to...

  12. Punctured lung via OG tube with intubated patient?

    usalsfyre replied to Alford's topic in General Nursing

    Yes, but it sounds like that was in an unintubated patient. There's no doubt you can put an NG in the lung, but getting past the inflated cuff an an ETT would be, uh, IMPRESSIVE.... To amend my...

  13. Can nurses do x-ray procedures like in urgent care?

    usalsfyre replied to willowRN's topic in General Nursing

    Depends on the state, in Texas there is a "limited license tech" that is allowed to shoot certain low risk films. That said, you may want to think about how you feel about UAP taking over nursing...

  14. Punctured lung via OG tube with intubated patient?

    usalsfyre replied to Alford's topic in General Nursing

    Very, very unlikely without someone using a hugely inappropriate amount of force. Most pneumothoraces in the intubated patient are iatrageniocally caused by mechanical

  15. outpatient mrsa protocol

    usalsfyre replied to linguine's topic in General Nursing

    Wrong thread... BUT, MRSA is wide spread. Anyone who has spent time in healthcare most likely is colonized with

  16. S. 4040 - Importance of this Legislation

    usalsfyre replied to sweetsugar's topic in Activism, Healthcare

    How about we loosen the restrictions on the best treatment of malaria, prevention. Currently the cheapest, most effective agent for killing malarial mosquitoes is DDT. Yet, due to mass overspraying of...

  17. nitro drips

    usalsfyre replied to gonzo1's topic in General Nursing

    Postural hypotension is common with NTG, hence the high fall risk. Just as a thought, was he voiding or having a

  18. Dropping pressures with nitro. Anyone experience this??

    usalsfyre replied to TinyRNgrl's topic in Emergency

    Who is obtaining a 15 lead or at least looking at V4R prior to NTG in inferior

  19. Using BSN when you have not earned it

    usalsfyre replied to sportsmom84's topic in General Nursing

    The real solution? If facilities would stop letting people list useless deritus after their job on

  20. Supplies You Can't Live Without

    usalsfyre replied to felineRN's topic in Emergency

    Coban. With the end of the roll clearly marked. It's the bee's knees fir securing IV's in the combative

  21. Dropping pressures with nitro. Anyone experience this??

    usalsfyre replied to TinyRNgrl's topic in Emergency

    NTG will cause hypotension and bradycardia. The effects of this are almost always transient, and will go away on their own. So while having a line and opening the fluids up might make US feel better,...

  22. Another thread on lateral harassment...

    usalsfyre replied to Poi Dog's topic in Patient, Colleague Relations

    My advice, you can take it or leave it. If your consitently finding your disliked, your probably underperforming. I learned this the hard way. A lot of people can't place their ego aside long enough...

  23. Question for the IV Gurus re: IV Needle and Cannula Lengths

    usalsfyre replied to thehipcrip's topic in General Nursing

    The largest IV cath I have ever seen is a 10ga, designed to be inserted over a wire (why you would go through that much trouble and not just put in a Cordis is unknown to me). The longest is 3.25"...

  24. Fibromyalgia

    usalsfyre replied to veetach's topic in Emergency

    The typical FM patient ED sees: Has an Axis II disorder Has allergies to all non-narcotic and many low-level narcotic pain management options Has multiple narcotic prescriptions from multiple...

  25. Another thread on lateral harassment...

    usalsfyre replied to Poi Dog's topic in Patient, Colleague Relations

    Is this one or two people? Or is it all of them? Sometimes the honest, hard truth is you have to realize the common factor in all of the relationships in the workplace being bad is