BelgianRN

BelgianRN

GICU, PICU, CSICU, SICU

Member

  • Content

    190

  • Visitors

    8,574

  • Followers

    0

  • Likes

    2

All Content by BelgianRN

  1. Lovenox order for patient with active GI bleed

    BelgianRN replied to callbelldiva's topic in Critical Care

    Hey I wanted to add my five cents. In general I check in with the physician on call when they prescribe LMWHs when patients are admitted with a bleeding disorder. Not sure how things are organized in...

  2. Worst doctors orders ever received

    BelgianRN replied to jenfromjersey's topic in Emergency

    Had a doc (GE resident) come in on our ICU telling a us he is going to shock patient X. So we ask him why he wants to punish poor Mr. X. He goes well obviously he is in atrial fibrillation. So my...

  3. Nurse: Patient Ratios

    BelgianRN replied to aei09a's topic in MICU, SICU

    It hapens regularly in my ICU. We hardly ever have staffing to give 1:1. So when acuity needs 1:1 it means the other nurses have to chip in and work harder. Generally during the day we have 1:1.5 -...

  4. Apologizing for my prima donna ICU coworkers.

    BelgianRN replied to NickiLaughs's topic in Emergency

    Ah the ER and the ICU it is like little brother and big brother or vice versa. Sometimes perhaps more like sisters when they start pulling hairs. I love "fighting" with the ER nurses in our hospital...

  5. Turn Teams?

    BelgianRN replied to canurse24's topic in CCU, Coronary, Cardiac

    Must be wonderful to have the staff to pull it off. We barely manage turning Q 8 hours. But to make up for it we use alternating air mattresses on all our patients so pressure sores are usually a...

  6. Question about a code we had last night

    BelgianRN replied to Kittypower123's topic in Geriatric, LTC

    From my experience if a patient codes long enough or often enough they always end up with bleeds somewhere. We take up the majority of all OHCA's in our area and we see our share of traumatic...

  7. Insight in how ICU's are run in the USA/Canada

    BelgianRN posted a topic in Critical Care

    Hey there, I'm wondering. As I don't practice in the USA/Canada I have little experience with the way things are run on the other side of the ocean. So I was hoping if people could explain the...

  8. Drawing blood from central lines

    BelgianRN replied to Altra's topic in CCU, Coronary, Cardiac

    Our base fluid is glucose not normal saline so we need a waste of about 10 - 20 ml if we want accurate glucose levels when drawing blood out of this lumen. Generally we'll use the art line or CVP-port...

  9. Post CV A-Fib Protocol?

    BelgianRN replied to PMFB-RN's topic in CCU, Coronary, Cardiac

    amen to that

  10. what are common times to run IV's in ?

    BelgianRN replied to Amy10BSN's topic in CCU, Coronary, Cardiac

    In our hospital: KCl/Kphos: 10 - 30 mEq/hour depending on K+ and heartrhythm. Always via a central line, if they have a peripheral they'll get substituted orally. MgSO4: push during codes, 2 g in 10...

  11. Hourly doses of vent sedation, is this common?

    BelgianRN replied to jkej's topic in MICU, SICU

    I can recall only one instance where I kept a patient under with diazepam and fentanyl pushes and that was when we where going in and out of codes when the BP was barely holding under massive amounts...

  12. Post CV A-Fib Protocol?

    BelgianRN replied to PMFB-RN's topic in CCU, Coronary, Cardiac

    Did the protocol specify anything concerning LVEF or any type of contractility disorder to take into acount when pushing

  13. Multiple drip administration

    BelgianRN replied to Sugarcoma's topic in CCU, Coronary, Cardiac

    @Janfrn: I remember those times when we were trying out the new generation pumps. Are you using the Braun ones? Switching a syringe went from 2 seconds to a minute and all our patients started...

  14. Multiple drip administration

    BelgianRN replied to Sugarcoma's topic in CCU, Coronary, Cardiac

    There are pro's and cons to any methoud I'd guess. We only have 2 volumetric pumps per bead and 6 syringe pumps so we kind of have to do it this way

  15. Multiple drip administration

    BelgianRN replied to Sugarcoma's topic in CCU, Coronary, Cardiac

    All our vasoactive meds are delivered in 50 cc syringes (except levosimendan) and we don't routinely close the lines before changing the syringes. This means that when we switch the line is open and...

  16. Multiple drip administration

    BelgianRN replied to Sugarcoma's topic in CCU, Coronary, Cardiac

    I try to use a three line principle as much as possible (vasoactive/sedation/bolus). I'd prob handle it like this: Distal lumen CVC: CVP measurements (intermittent) with your maintenance fluid + boli...

  17. metabolic acidosis and tachypnea

    BelgianRN replied to vic_rn's topic in MICU, SICU

    Addendum: In a spontaneously breathing patient you would accept tachypnea as it is the compensatory mechanism for metabolic acidosis. You accept this as long as the patient isn't getting exhausted and...

  18. ECG interpretation

    BelgianRN replied to jtwing's topic in CCU, Coronary, Cardiac

    I personally like ECGpedia.org It comes with the downside of any wiki of course but they are working hard to get all the little mistakes corrected. I like the tool they have where you can change the...

  19. SCU (special care unit)???

    BelgianRN replied to froggy8's topic in MICU, SICU

    I know of only one hospital over here that uses a SCU in their surgical ward. Basically it is the same as a medium care unit, high dependency unit, step-down unit but their unit is reserved for...

  20. metabolic acidosis and tachypnea

    BelgianRN replied to vic_rn's topic in MICU, SICU

    As said before the ABG's are incomplete to make a definitive statement. Furthermore the ventilatory settings are incomplete as well. For this patient I would factor in following settings/measurements...

  21. Ketamine during an emergent intubation

    BelgianRN posted a topic in MICU, SICU

    Hi all, I just want to ask your opinions on the following case that came across our ICU. A 35 year old woman gets admitted to our ICU following emergency C-section due to HELLP syndrome and possible...

  22. Ketamine during an emergent intubation

    BelgianRN replied to BelgianRN's topic in MICU, SICU

    Sorry, poorly formulated stating it doesn't stress out

  23. Ketamine during an emergent intubation

    BelgianRN replied to BelgianRN's topic in MICU, SICU

    Well I don't mind quarterbacking as long as it says polite and constructive. It's how we learn and how we improve. It's just hard at times because every institution has its way and materials...

  24. Ketamine during an emergent intubation

    BelgianRN replied to BelgianRN's topic in MICU, SICU

    First off I want to say I'm sorry for the "tone of words" in my previous post. Just ended a hectic night shift so I took it the wrong way. In Belgium placement of surgical airways is a rare...

  25. Ketamine during an emergent intubation

    BelgianRN replied to BelgianRN's topic in MICU, SICU

    Dosage of fentanyl was at around 0,6 µg/kg (50 µg in total) pushed directly following the ketamine. We chose for a low dose approach. We generally use ketamine at 1 mg/kg which is within the...