MLB55

MLB55

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All Content by MLB55

  1. AV fistulas and lines.

    MLB55 posted a topic in Dialysis, Renal, Urology

    Recently, I had a pt admitted to the ICU with a LUE av fistula and a LUE Picc line. He was hypotensive, so he got an art line... In his left radial. I was always under the impression that NO lines...

  2. Things to know on first day?

    MLB55 replied to deflowerkidRN's topic in Neuro Intensive Care, ICU

    The ventricular system, csf, arteries. I agree, a good Neuro

  3. Things to know on first day?

    MLB55 replied to deflowerkidRN's topic in Neuro Intensive Care, ICU

    Ask questions about anything and everything. If you have a nurse willing to teach, you can learn a lot...

  4. Troponin leak and pressor of choice.

    MLB55 posted a topic in CCU, Coronary, Cardiac

    Long story, semi short. 60 some yr old guy with a hx of cabg x 2 and chole admitted for syncopal episodes at an OSH. Patient was over there for a month runs into aki requiring dialysis and cvvh....

  5. Troponin leak and pressor of choice.

    MLB55 posted a topic in CCU, Coronary, Cardiac

    Long story, semi short. 60 some yr old guy with a hx of cabg x 2 and chole admitted for syncopal episodes at an OSH. Patient was over there for a month runs into aki requiring dialysis and cvvh....

  6. Troponin leak and pressor of choice.

    MLB55 replied to MLB55's topic in CCU, Coronary, Cardiac

    He was tx to us after a month of being vented and on ativan. Ativan was shut off before tx. Followed commands by nodding and wiggling, failed a sbt as his tv were 100 x 40, for us. Was with us less...

  7. Troponin leak and pressor of choice.

    MLB55 replied to MLB55's topic in CCU, Coronary, Cardiac

    Mag was normal, phos was a tad high, liver fx was high, blood gasses were metabolic acidodic, wbc was 20 something, hbg close to

  8. Troponin leak and pressor of choice.

    MLB55 replied to MLB55's topic in CCU, Coronary, Cardiac

    Guy was making ~30m an hour of urine. K =4.3 credit. Cr = 1.6 appeared to be his new baseline. He responded to the fluids, urine picked

  9. Troponin leak and pressor of choice.

    MLB55 replied to MLB55's topic in CCU, Coronary, Cardiac

    No iabp, echo was pending at our hospital as he was

  10. MSICU vs trauma ICU?

    MLB55 replied to meghan91's topic in MICU, SICU

    I work In a large teaching, level 1 trauma hospital. I'm specifically in neuroICU, we also have mICU, sICU, ctICU, and ccu. In mICU, you will see your sepsis, ARDS and everything in between medical....

  11. AV fistulas and lines.

    MLB55 replied to MLB55's topic in Dialysis, Renal, Urology

    No neuro issues. Just a micu overflow! My first time cvvhing, I think it went well as he looked as he was not going to make it

  12. proper orientation for CTICU

    MLB55 replied to rn6889's topic in CCU, Coronary, Cardiac

    I work at a very large teaching institutio, in neuroICU. When I started almost 2 yrs ago with 1 yr of neuro floor experience I received 8 weeks with Ecco class during that time. Now a days, nurses get...

  13. "I DEMAND an antibiotic. I am the customer and I am paying your salary"

    MLB55 replied to Nascar nurse's topic in General Nursing

    Daughter over the phone yelling at me to give her father pain medicine. I asked the pt again, after asking him every hour x 6 hours. He said no right over the phone to his daughter. Daughter goes on...

  14. The next pressor...

    MLB55 posted a topic in MICU, SICU

    I work in a neuroICU at a large teaching hospital, but are the primary mICU overflow and we get alot of them. In neuro, we use neo first and Levo 2nd, vaso is third if need be. mICU seems to do Levo...

  15. Patients overstaying their welcome in hospitals

    MLB55 replied to fallinnstyle's topic in Patient, Colleague Relations

    We had another GB syndrome, flaccid up to his eyeballs. No movement. Family fought tooth and nail to get them to stay in the ICU. Didn't work. Just shows, you either need a ton of money or be homeless...

  16. Patients overstaying their welcome in hospitals

    MLB55 replied to fallinnstyle's topic in Patient, Colleague Relations

    We've had multiple pts over stay there welcome. One was a prisoner with a SAH who happened to be here illegally. The prison signed off on him (grade 5 SAH) He was trached and pegged, no ltach would...

  17. Can someone PLEEEEASE explain INSULIN DRIPS?

    MLB55 replied to H_2_O's topic in MICU, SICU

    That's why I like working in a big teaching hospital. Endocrine problems? Consult them. Endocrine does a conversion on how much insulin gtt the pt requires to lantus and humalog. The pt probably does...

  18. Can someone PLEEEEASE explain INSULIN DRIPS?

    MLB55 replied to H_2_O's topic in MICU, SICU

    I don't see alot of dka, again I work in neuro and we use GTTs for tight glucose control in any sort of head injury. We use GTTs when pts are being fed enterally, continuously. It can be hard/unsafe...

  19. Can someone PLEEEEASE explain INSULIN DRIPS?

    MLB55 replied to H_2_O's topic in MICU, SICU

    I've been in neuroICU for 2 yrs, and anytime they order a diet they switch them over to lantus daily and humalog qMeal + appropriate sliding scale for extra coverage. Someone that's eating does not...

  20. Why two anticonvulsant are using at same time

    MLB55 replied to munch666nath's topic in Neuro Intensive Care, ICU

    Im not familiar with "citicholine", although a quick google search found its more for memory problems? I could be wrong. But, we use multiple seizure drugs all the time. There are different types of...

  21. EVD/ICP monitoring??

    MLB55 replied to PICNICRN's topic in PICU, Pediatric

    What filter are you talking about? In the transducer? I was never taught to leave the drain that way, although I did have to teach some micu RNs that they were not transducing. They were surprised...

  22. How detailed is your change of shift report?

    MLB55 replied to rcon's topic in MICU, SICU

    Relevant history, plan for the day, detailed neuro exam (in neuroICU), pertinent lab values, access and GTTs. Keep it simple. Don't go off on tangents about non clinical information. I don't write...

  23. Sedation Woes...

    MLB55 replied to MegNeoNurse's topic in PICU, Pediatric

    Pentobarbital for sedation? Interesting. I work with adults, but we use pentobarb to induce coma (literal, no cough, gag, movement, corneals, etc...) for refractory

  24. Easy job??

    MLB55 replied to TiddlDwink's topic in General Nursing

    I was thinking about doing home health one time. After talking to nurses that have done it, the paper work talked me out of it. I just want to go to work and finish it there, not take it home and...

  25. The next pressor...

    MLB55 replied to MLB55's topic in MICU, SICU

    It's always interesting to hear other teams strategies, sometimes other units even.We (neuro) titrate Levo 0-30mcgs/min as listed per rph, micu titrates only to 20mcgs/min. We use vaso @0.04 and neo...