maloneys

maloneys

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All Content by maloneys

  1. Internal jugular IV

    maloneys posted a topic in Critical Care

    Hi everyone! I could really use some help here. Pt had a 16 gauge, jugular IV that was heplocked. In for 4 days, never flushed, nor verified if still venous return. Pt was febrile, and I wanted to...

  2. IJs

    maloneys posted a topic in MICU, SICU

    Hi everyone! I could really use some help here. I posted in this on another forum and haven't received any replies so I'll try here, if that's ok. Pt had a 16 gauge, jugular IV that was heplocked....

  3. Internal jugular IV

    maloneys replied to maloneys's topic in Critical Care

    Thank you for the very helpful feedback and information. We know the 16 gauge is not a central line, in this case, but there was no consistent documentation on when it was inserted, nor on its care....

  4. Internal jugular IV

    maloneys replied to maloneys's topic in Critical Care

    Hi Sallyrnrrt, thank you for your thoughtful feedback. Do you trendelenburg the pt when d/c'ing the IJ or EJ IV, you mean? How does this prevent air embolus? Thank you for helping me

  5. Internal jugular IV

    maloneys replied to maloneys's topic in Critical Care

    Thank you for comments, ArmaniX. Yes, you can have EJ or IJ cannulation. Basically, when protocols are not in place, we want to ensure best practice. Because the 16 gauge periph IV was used, and...

  6. IJs

    maloneys replied to maloneys's topic in MICU, SICU

    RNs can remove them, but there are no set guidelines in place. Thank you for your

  7. Succ vs Etomidate

    maloneys posted a topic in MICU, SICU

    What are you seeing most for bedside procedures, like intubation? We always used to use succ, along with versed, ketamine, etc. Now am seeing a trend towards etomidate. I'm wondering what others...

  8. Clots related to fast afib

    maloneys posted a topic in CCU, Coronary, Cardiac

    Hello! I wonder if someone might help here. I work in a med/surg ICU and we monitor telemetries in the hospital as there is no CCU. A post-op cholectomy, 84 years old, not on anticoagulants, with a...

  9. Clots related to fast afib

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

    After about 90 minutes, he went 130-180 and continued til the end of my shift, with me documenting like a madwoman. It was certainly stressful because of , as you stated, I was worried about him...

  10. Clots related to fast afib

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

    I agree about not anticoagulating someone who is fresh, post-op. We're talking 6+ hours. However, I mentioned that because of the fast afib. The patient is under cardiology which is why the...

  11. Bullying

    maloneys replied to maloneys's topic in MICU, SICU

    I hope so, Ruby, thank

  12. Bullying

    maloneys posted a topic in MICU, SICU

    This is an old story, I know, but only now am I experiencing it. I work in a small ICU and only at night when the staff is minimal. 4 nurses for 11 patients and telemetry monitoring. No orderly or...

  13. Bullying

    maloneys replied to maloneys's topic in MICU, SICU

    Thank you, detroitdano. I'll call them tomorrow. So

  14. D-Dimers

    maloneys posted a topic in MICU, SICU

    I wonder if someone might help shed some light here. Post-op day 4, abdo abcess drainage patient who went from room air to tachypneic 30-40 and 100% FiO2 over a couple of hours. I did a D-dimer as I...

  15. D-Dimers

    maloneys replied to maloneys's topic in MICU, SICU

    Hesitation to do a scan was lack of docs to read the scan at night, due to absence of docs. Thank you very much for taking the time to do this teaching! I'm very

  16. D-Dimers

    maloneys replied to maloneys's topic in MICU, SICU

    I agree, prep8611, and I wasn't using the d-dimer to try to diagnose PE, but without a doc available, it is typical for us to do labs following the physical assessment. That way, if we do need to...

  17. D-Dimers

    maloneys replied to maloneys's topic in MICU, SICU

    Thank you, Juan de la Cruz, for taking the time to answer my questions and for citing those sources. I'm afraid my continued learning is going down the tubes working in a small, peripheral hospital...

  18. D-Dimers

    maloneys replied to maloneys's topic in MICU, SICU

    Hmm, thanks for all the wonderful feedback. So in these cases, both patients should have been scanned then! How many days post-op would I expect to see an elevated D-dimer in the absence of liver...

  19. D-Dimers

    maloneys replied to maloneys's topic in MICU, SICU

    Really, prep8611? I didn't know d-dimers weren't' used anymore! Both patients had pneumatic boots

  20. ICU nurses, Is 3:1 patient to nurse ratio a common occurence or am I just tripping?

    maloneys replied to Scrubs911's topic in MICU, SICU

    Where I work, it's always 3:1,

  21. Blood cultures from old CVC

    maloneys posted a topic in MICU, SICU

    I had a patient last week who spiked a temp, had a 2 week old triple lumen in her SC. Horrible peripheral access so I took one set of blood cultures from her central line. A colleague said it was...

  22. Blood cultures from old CVC

    maloneys replied to maloneys's topic in MICU, SICU

    In my case, my only access was the CVC so that's why I used that. No docs at night in the ICU so fem stick would have been out of the question. I appreciate the feedback. Thank you so much! So if...

  23. Low census = Crappy staffing, true everywhere?

    maloneys replied to KymmD77's topic in MICU, SICU

    Where I work, we have 11 ICU beds, plus we monitor telemetry for the hospital. On the night shift, we are 4 nurses, no orderly, no managers, no secretaries, no body! Plus, if there's a code on one...

  24. Strange hgb results

    maloneys posted a topic in MICU, SICU

    Hi everyone, can I pick your brain? Last weekend had a post cardiac arrest patient, 59 y.o.man , hx of HTN, afib, back pain, ETOH abuse, cocaine abuse, who arrested at home. When ambulance arrrived...

  25. Strange hgb results

    maloneys replied to maloneys's topic in MICU, SICU

    Esme, you're a star! Thanks for the teaching/learning, yet again