MLB55

MLB55

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All Content by MLB55

  1. PEA arrest

    MLB55 posted a topic in CCU, Coronary, Cardiac

    Pt is a 63yo male with a hx of a subarachnoid hemorrhage 30 yrs ago s/p clipping. Pt present early in June with a new Sah, from the same aneurysm. Pt was re clipped on the 16th, stayed intubated for a...

  2. PEA arrest

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

    The guy was well over a

  3. New to neuro/TBI/hypothermia

    MLB55 replied to maui2413's topic in Neuro Intensive Care, ICU

    We only do hypothermia protocol for pts post cardiac arrest. That is, we cool them down to 91.7 - if that's what hypothermia your talking about. Craniectomy within the first 24-48 hours is what our...

  4. PEA arrest

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

    The needle decompression. That's a great question. I'm guessing, since he was pusleless and kept losing his pulse? I just heard the attending say, he needs to be decompressed. And he had a central...

  5. ICP monitoring and ventricular drain.

    MLB55 replied to sugarmagnolia3's topic in Neuro Intensive Care, ICU

    In our 23 bed neuro icu, we clamp the drain to transduce pressures, position changes, and when we transport the

  6. Increasing creatinine

    MLB55 replied to MLB55's topic in MICU, SICU

    No I meant 4.5 liters. Not uncommon and not the most I've seen. I've had a patient that required 90+units of products... But that's another story. Her urine out put increased after the lasix and then...

  7. Increasing creatinine

    MLB55 posted a topic in MICU, SICU

    Pt is 74 yo with a hx of a parotid tumor that mets to the spine, "kidney insufficiency" (as reported by the patient),baseline cr seemed to be 1.09 and htn. Had a two stage back surgery something like...

  8. Increasing creatinine

    MLB55 replied to MLB55's topic in MICU, SICU

    Pts cr peaked the next day at 1.44, she's auto diuresing and cr is back to

  9. Increasing creatinine

    MLB55 replied to MLB55's topic in MICU, SICU

    Lasix immediately help here urine output. 400 in about 2 hours. Great input... She was definitely +a few liters since the or and had pulmonary edema on chest

  10. Increasing creatinine

    MLB55 replied to MLB55's topic in MICU, SICU

    We sent one. I don't remember, serum na was normal

  11. MAP vs SBP

    MLB55 posted a topic in Neuro Intensive Care, ICU

    Do your guys neuro Icus use sbp or map for goals when say triple Hing. Since cpp is map - icp... Why do we use sbp for goals. I've seen them order keep sbp > 200. So what do you use in Neuro? Sbp...

  12. Trust?

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

    I think everybody feels like this at first. Nobody is truly comfortable until at least there first year. Take this opportunity to provide good care and to be known for the care you can provide. Sick...

  13. cvp on introducer

    MLB55 posted a topic in MICU, SICU

    Have you guys seen when anesthesia hooks up the cvp to the port where you put a triple lumen or swan line through? I think this is a waste of a port and I sort of think not an accurate way to measure...

  14. cvp on introducer

    MLB55 replied to MLB55's topic in MICU, SICU

    They are hooking it up directly to that white/blue port where the slic or swan would go. We typically put in a tlic and transduce off the distal port. But out of the or, anesthesia transduces off the...

  15. cvp on introducer

    MLB55 replied to MLB55's topic in MICU, SICU

    Not the big line of a cordis. The part where you put a triple lumen or a swan. The same place and a

  16. MAP vs SBP

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

    I was only asking about triple H therapy for vasospasm patients. I think we would have better cardiac outcome with the same neuro outcome if we used maps. A lot of times these patients require 5...

  17. MAP vs SBP

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

    Great post. Are you a neuro critical care team? Again, it just doesn't make sense when your cpp is calculated via map. The reason I ask is that we have put people on phenylephrine, norepinephrine,...

  18. invasive lines

    MLB55 posted a topic in MICU, SICU

    I work at very large teaching, level one trauma center and there are a few practices that I have questioned in regards to lines. First one is, two Mac or cordis (introducter) lines inserted into the...

  19. invasive lines

    MLB55 replied to MLB55's topic in MICU, SICU

    In the same

  20. invasive lines

    MLB55 replied to MLB55's topic in MICU, SICU

    They are directly superior/inferior of each other. They are indeed in the same

  21. Insulin gtt rates

    MLB55 replied to *LadyNurse*'s topic in MICU, SICU

    It was between 60-70ml/hr or unit/hour. Guy it

  22. invasive lines

    MLB55 replied to MLB55's topic in MICU, SICU

    The two cordis' are for the OR. We would pull one of them once they got to the unit. I've heard of livers getting 91 liters of blood/fluid during a case. So the benefit of two major lines could be...

  23. Stay in NeuroICU or tx to sICU?

    MLB55 posted a topic in Student Registered Nurse Anesthetist

    I have two years Neuro icu experience in a large teaching trauma center in Chicago. I recently started being charge rn as needed, which involves responding to stroke codes. Should I opt to stay in...

  24. Desating and Suctioning

    MLB55 replied to SterlingArcher's topic in MICU, SICU

    Give them more sedation/analgesia before

  25. Levophed or Neosynephrine pushes?

    MLB55 replied to IheartICUnursing's topic in Critical Care

    Anesthesia gives "sticks" of phenylepherine, usually for sedation