AwesomeManRN

Pressors are usually all compatible. Stack them all together on a CVL port. Next find compatibilities for your other 2 ports. Draw blood through the non- life sustaining gtt lines. If you got a CVP, use it for blood draws and IVPBs. If you have not vesicant meds, run them through peripherals if not compatible. Get as many peripherals as needed. If poor IV access, get another CVL and start from beginning

If he was following commands post arrest, he does not need hypothermia. Hypothermia is only indicated in pts who are unresponsive post arrest. The anoxic injury was not significant enough to have any benefit from hypothermia. Side note- recent study shows that hypothermia has no clinical improvement over preventing hyperthermia post arrest.

Usually the rule of thumb for afib and a clot my cardiologists use is 24 hrs. If a patient knows when they go into afib and it's been less than 24 hrs, they will just receive a cardioversion. If unknown time or greater than 24 hrs, you do a tee and then a dccv. The more worrying thing is cardiac demand ischemia and potential for prerenal failure second to decreased CO.

Was therapeutic hypothermia performed post code? While some facilities have moved away from it, it is still believed to be best practice post code for neurological injuries. Everything else sounds correct for his tx. It is an almost certainty that his seizures were brought on from the anoxic brain injury. An MRI, to me, would be a useless and needless risk. Seizures, burst suppression, and flat line EEG readings post code are very ominous signs. There is very little chance for any neurological recovery due to the amount of damage, even with performing hypothermia.

It really depends on the insertion device. The EZ-IO drill is approved for the distal tibia in adults. It is not a common insertion site. In our facility, I do the education for all ICU nurses. The EZIO is used in codes in places of dropping in a femoral CVL. I've done tons of knee insertions, but only one ankle. It worked just as good as the knee though.

It was most likely an IO. The first choice for selection for a drill-based IO is the tibial tuberosity below the knee cap. If the pt has had knee replacements or trauma to that area, the second selection is the medial malleolus at the ankle. Last spot is the shoulder which is very difficult to palate and positional. Some 'driver' type IOs can be started sternal as well.

I have a newborn so didn't get to study near as much as I wanted. It's more in-depth medical than CCRN. It was heavy on hemodynamics, shock, ACS, CHF, pacers; and all the meds/assessment/interventions for all. The biggest difference for me between the CCRN and CMC was the style of the questions. CCRN was straightforward ie if the answer was hypokalemia they would give hypo/hyper K and hypo/hyper Na as your answer choices, more knowledge based question. The CMC was more NCLEX-y-'What's your initial action','what's your priority?'. So while it was slightly more in-depth, the difficulty of the question was increased. There were MANY times where I fought between 2 answers. I honestly don't think if I studied harder/longer or even less if it would have changed my score. Resources I used: all my CCRN study materials, Pass CCRN (CD only), and the $10 CMC AACN review question.

Just took the CMC exam, and I felt it was much more difficult than the CCRN. While I did well on both ( CCRN 114/125 and CMC 63/75) the CMC just had a different feel to it. Much harder IMO. Maybe cause it didn't have any easy ethical questions to buffer the medical ones.

Check out CCRN review podcast on iTunes. Very good review seminar