ICUPrincessNurse

ICUPrincessNurse

Surgery, Trauma, Medicine, Neuro ICU

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All Content by ICUPrincessNurse

  1. fentanyl dosing on a vent

    ICUPrincessNurse replied to robinicu's topic in MICU, SICU

    Usually our ED brings them up on propofol and we transition as ordered. We run at mcg/hr. I've used as high as 300/hr before (the dude was still awake and writing notes...no lie). We'll use the...

  2. Continuous Renal Replacement Therapy Guidelines

    ICUPrincessNurse replied to HLS2010's topic in Critical Care

    We pretty much only run CVVHDF. We have an order set with guidelines for potassium, magnesium and calcium replacement and we run all our electrolytes by our nephrologist for other tweaking as needed....

  3. How does your facility treat ARDS?

    ICUPrincessNurse replied to ICUNurseStat's topic in MICU, SICU

    We try to prone early, HFOV as rescue only (we participated in the oscillate study that got shut down) and we use low tidal volumes on a/c volume control. Our docs are also big fans of super adequate...

  4. Whats it like in your Trauma ICU?

    ICUPrincessNurse replied to strawberryheartRN's topic in Critical Care

    Trauma will see everything. You never know what a patients past medical history is when they come rolling in as a trauma. If they had any kind of steering wheel impact- expect cardiac implications....

  5. Are we tyrants?

    ICUPrincessNurse replied to Bortaz's topic in NICU, Neonatal

    I'm an adult ICU nurse but I'm just as territorial. Don't touch my

  6. Tx for seizures with anoxic brain injury

    ICUPrincessNurse replied to nsti's topic in Neuro Intensive Care, ICU

    We'll do continuous monitoring for status as well. We would have also used benzos to start with to help stop activity then started with the dilantin but we'll also do keppra or depakote, or both,...

  7. How critical is your ICU?

    ICUPrincessNurse replied to calivianya's topic in MICU, SICU

    1:1 for intubation sounds boooooring!!!!!! That said- I'm used to two sick ones and running all

  8. What do you love about the ICU?

    ICUPrincessNurse replied to EGVnurse's topic in MICU, SICU

    I love fixing things. I love getting a patient, learning what things are going wrong and spending my day working to fix it. Acidotic? I'll fix it. Labs jacked up? I'll fix it. Multiple pressors?...

  9. How critical is your ICU?

    ICUPrincessNurse replied to calivianya's topic in MICU, SICU

    We're pretty ridiculous. Level I trauma center. 36 beds. Mixed medical/surgical/trauma/neuro/CV unit. We do pretty much everything but transplant recipients. Our acuity is VERY high. It's nothing...

  10. Failure to maintain sats on ventilator

    ICUPrincessNurse replied to nurseJinicu's topic in MICU, SICU

    When they're like that we start looking at HFOV and rotoprone. Usually doesn't end well. BUt I'm a believer in the proning. IF anything is going to work- it

  11. Lunch breaks in ICU.

    ICUPrincessNurse replied to IvesRN's topic in MICU, SICU

    We're 36 bed and we report off to our neighbor for a 30 minute break or when we go off the unit for procedures. We also have a charge nurse with no patients and usually (when we're fully staffed) two...

  12. Food police?

    ICUPrincessNurse replied to mschelee's topic in CCU, Coronary, Cardiac

    Same same same as all above! Usually once I tell the families WHY the special diet will help their person, they become more compliant. I have rarely had a problem with our heart patients- they get...

  13. ICU Overflow, What Happens Then?

    ICUPrincessNurse replied to BrandonB779's topic in MICU, SICU

    If we're full, which is more often than you would think for a 36 bed unit, our "less sick" ICU patients go to PACU. Then we triage triage

  14. Max on Levophed?

    ICUPrincessNurse replied to Nurse_Sophia's topic in CCU, Coronary, Cardiac

    Learned yesterday that max on Neo, per our pumps, is 300 mcg/min. That patient was fine until we decided to put the chest tube in the empyema... By fine of course, I mean on 120 levo, 120 neo, 100%...

  15. Leaving Phenylephrine on with an Epi Drip?

    ICUPrincessNurse replied to Dodongo's topic in CCU, Coronary, Cardiac

    At my facility we only use those two when the poo has gone down so chances are if we're on both, we're staying on both because we're waiting on family or miracles. Usually

  16. Max on Levophed?

    ICUPrincessNurse replied to Nurse_Sophia's topic in CCU, Coronary, Cardiac

    Our pumps warn us at 100. Hard limit is 150. I've been told I can go as high as 200 but the pump wound't let me. So...150 it is. These are the people who are profoundly septic/bleeding...

  17. Open Heart Training

    ICUPrincessNurse replied to KRWICURN's topic in CCU, Coronary, Cardiac

    i got a notebook and a patient. Granted, I've been a nurse for 4+ years at that point and the notebook had pretty much all I needed to know as far as protocols and what values were okay and weren't....

  18. Are swans going "out of style?"

    ICUPrincessNurse replied to TemperStripe's topic in MICU, SICU

    Everyone of our hearts gets a swan and they all come out POD 1 unless we're having problems. We'll swan our MICU to look at fluid needs, LV function and PA pressures. Our SI patients RARELY get them...

  19. Sepsis Questions

    ICUPrincessNurse replied to kblalock6's topic in MICU, SICU

    My bad. Meant to say Epi. I got all stupid about this today as well. Epi!!!!!! Epi is second line.

  20. Definition of Hemodynamically unstable...

    ICUPrincessNurse replied to FenRN's topic in MICU, SICU

    Our only "hard" 1:1 are CRRT, IABP and fresh heart for the first 6 hours. That one time we did the guy on ecmo and nitric (niiiiiiiiightmare!!!) he was a 1:1. Our soft 1:1 are brand new organ donors...

  21. Crazy days when I take a CABG

    ICUPrincessNurse replied to cabgnurse's topic in CCU, Coronary, Cardiac

    1:1 for six hours at my facility! Our first case usually starts at 7 and depending on which surgeon dose the case, if it's a cabg or valve and how things go downstairs they pretty reliably come out...

  22. PAWP

    ICUPrincessNurse replied to LNRN11's topic in CCU, Coronary, Cardiac

    Our CT surgery patients NEVER get wedged. Our CT docs use the PA pressures and CVP to look at volume status and CO and CI as well, though not as much. Our medicine docs love the wedge. Mostly...

  23. Sepsis Questions

    ICUPrincessNurse replied to kblalock6's topic in MICU, SICU

    We have a standard sepsis protocol that works really well. I personally try to alllllllways avoid the use of a cooling blanket unless the patient is paralyzed and sedated. Shivering makes things...

  24. ETT Securement and Position Change

    ICUPrincessNurse replied to SticU <3's topic in MICU, SICU

    We use ties or an ETAD which sounds like a hollister. We changes ties and position once a shift, we change our ETADs as needed and position on them q2-4. ETADs are only used if our patients have all...

  25. New job in Trauma ICU, in need of advice

    ICUPrincessNurse replied to xjessx's topic in MICU, SICU

    TNCC. Originally meant for ED nurses, but our entire ICU staff is required to have it and it is a GREAT tool for a full Trauma assessment. Most ED's only get through ABC on the trauma assessment...