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Elenaster's Latest Activity

  1. Elenaster

    Question about TBI w/ cranioectomy?

    If a bone flap was removed to allow more room for the brain to swell, it's very possible there is an area with no protection to the brain tissue itself. This procedure is often resevered as a "last ditch" measure for hydrocephalus refractory to other...
  2. Elenaster

    Barbiturates in Critical Care

    I wasn't implying anything and my post certainly wasn't directed towards you. Just trying to add my perspective as an experienced neurosurgery nurse and educate those that are new or unfamiliar with that particular scenario. Additionally, the prop...
  3. Elenaster

    Barbiturates in Critical Care

    I agree that propofol is a far superior drug for providing sedation in ICU patients under most circumstances, however it should be noted that some patients experience a sustained drop in blood pressure that limits its use, particularly if they have i...
  4. Elenaster

    Barbiturates in Critical Care

    In my experience, barbituate comas are still used, but only as a last ditch effort for cerebral hypertension (not hydrocephalus) refractory to other treatments, such as mannitol in addition to what Gwenith stated. Barbituate comas have some very n...
  5. Elenaster

    Craniotomys in the PACU

    As a former Neuro ICU nurse and a current PACU nurse, I hope I can offer some well-rounded advice: 1. Tell your staff that neuro patients and EVDs are not that scary and with a little training, they can care for this population with confidence. ...
  6. Elenaster

    how hard is it for a RN to work weekends ONLY in ICU?

    I've been working weekends only in ICU for close to 2 years now. The plan at my hospital pays us for 80 hours in 2 weeks when we only work 60 (3 days one week, 2 the next). The majority of people that do it are parents with young children and student...
  7. Elenaster

    Trouble on Night shift

    Erin, I had the exact same problems working nights that you described and after a year, I told my manager that I either had to get on days or I was going to have to leave. I just couldn't physically do it and I think that there are some of us whos...
  8. Elenaster

    ICU gets differential and not ER??

    Having worked both ER and ICU, I have to say that paying diff to ICU and not ED is certainly unfair. I also have to agree with the part of the argument that most all hospital nurses work very hard and each area has differing aspects of the job that a...
  9. Elenaster

    Input Please

    Honestly Cubby, I don't know because laminectomies rarely come through the ICU. Has your NS referred you for PT or consulatation with Anesthesia/pain management? I'm sorry you're going through this and I hope you find some relief quickly.
  10. Elenaster

    Nimodipine shortage

    We haven't experienced a shortage recently, but our peak aneurysm season is over and we've had far more crani for tumor and head injuries lately, so I haven't been giving as much Nimodipine. As for Nicardipine, I attended a presentation last summe...
  11. Rach, Because this woman was still conscious, I would assume that she was put on a morphine gtt or some other comfort measures were taken to ensure that she would have as peaceful death as possible. I'm sorry you were so freaked out, but consid...
  12. Elenaster

    A few Neuro Q's....

    Good thinking NurseyBaby - that's why we make sure the EVD is leveled properly every hour and with any movement of the patient. Also you wouldn't want to LP a patient with a suspected or confirmed spinal cord injury because it's very important to mai...
  13. Bluesky, Sorry about the old bat projecting her misery onto you. Just ignore her as best you can and see if you can get one of your co-workers to swap assignments with you. Try to do it when you're going to be working several nights in a row so yo...
  14. Elenaster

    ICU nursing in USA ?

    Greetings Paul! Here in the USA, you can come right out of nursing school and work in the ICU, with a training period that varies from 3 to 6 months. ICU here is highly specialized and units are generally broken down by specialty like neurosurgery...
  15. Elenaster

    Maximum time on BiPap

    I've seen DNI patients stay on Bipap as long as a week, but IMO it seems like torture. Just watching a tachypnic patient trying to blow off CO2 on one of those things is exhausting. Longer-term use of bipap also results in some freaky ABGs.
  16. Elenaster

    Nipride drip and no MRI/MRA?

    Great answer CritterLover! I might add that Nipride is extremely potent and any sort of "accidental" bolus, even a really small one, could bottom out the patient's pressure, and trust me, you do not want to ever have to code someone in the scanner...