candyndel

candyndel

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All Content by candyndel

  1. Milranone and B/P

    candyndel replied to MacNurse's topic in CCU, Coronary, Cardiac

    I am confused now because Primacor is a vasodilator (albeit antiquated in the world of cardiology). That's why they used to use it for pts with ADHF.... what were you using it

  2. Surgical Site Verification in the ER

    candyndel replied to RNin92's topic in Emergency

    We also recently adopted JCAHO's Universal Protocol which requires several procedures to assure right patient, right side, right site, right procedure. We are supposed to be marking the level of the...

  3. Collecting co-pays at the ED registration desk.

    candyndel replied to TlhRNED's topic in Emergency

    Everyone is moving to collecting co-pays at discharge. (We generated $40K last year by doing so.) We also sign patients up for chartity care at that time and verify their demographics. Its...

  4. Im curious about ER tech qualifications

    candyndel replied to qwitcher13itchin's topic in Emergency

    We will hire someone as a new ERT if they have completed 1 year of nursing school or passed a nurses aide certification and have related experience (sometimes we hire EMTs, too). We then...

  5. ? Charcoal Aspiration?

    candyndel replied to tridil2000's topic in Emergency

    Poison control centers are recommending it less and less because its risk-benefit ratio is so narrow in many clinical situations. I am hoping your pt took bottles of tylenol (or something just as...

  6. Clinical Educator

    candyndel replied to vikvik1978's topic in Emergency

    send me your email and i'll send u a

  7. NP specialty question.

    candyndel replied to joey442000's topic in Nurse Practitioners, NP

    I agree, you should consider PA school. Several PAs here work/worked with orthopods and in surgery. A lot work in CT sx, too. They do the harvestings and closings, etc. If you are a technical (hands...

  8. ENP programs

    candyndel replied to zacarias's topic in Nurse Practitioners, NP

    What boards will you take though, as an ENP? Remember, they dont even have CCNP or ACNP as a designation anymore. the ANCC is now the certifying agency (the AACN gave it up) and your designation will...

  9. Computers in the ER

    candyndel replied to Dixielee's topic in Nursing Informatics

    We use Ibex in our ED for the past 3 years and have had only a little trouble with it. They update templates as needed and add templates as needed (ie, Universal Protocol). It doesnt talk to the new...

  10. Clinical Educator

    candyndel replied to vikvik1978's topic in Emergency

    We now have specific 'Medication Admistration' guidelines in our ED P&P. the practice of giving meds is much different than that practiced in house (ie, no MAR, pharmacy doesnt double check your...

  11. Need help choosing topic for research class

    candyndel replied to Berta B's topic in CCU, Coronary, Cardiac

    You might consider weaning pts while using sedation during weaning. (Unless you already have a standard weaning protocol that is working well...) Our weaning parameters are not uniform and some MDs...

  12. Educated discussion of practical knowledge of marijuana dipped joints

    candyndel replied to LIVANDLUVER's topic in Emergency

    They call it "Dip Jamming" around here and the pts are wild! It is similar caring for a pt on Dust (PCP) and we have to snow them quick and hard. I have seen several different sedatives used, most...

  13. A few Neuro Q's....

    candyndel replied to raindrop's topic in Neuro Intensive Care, ICU

    The Coma scale is a crude measurement and is only one small part of the neuro assessment. It is very important to assess pupillary response to light (are u really checking accomodation on all your...

  14. Cardiac Nurse Practitioner

    candyndel replied to can25rn's topic in Nurse Practitioners, NP

    You might also try an online MSN program where you set up your own clinicals to what you want to do with your degree. For example, get in an ANP program, and work with cardiologists for your 2-3...

  15. CVP and SV02 monitoring in the ED

    candyndel replied to Kireri's topic in Emergency

    We are not monitoring CVPs in the ED. This would not be a huge deal, but if you want an SVO2 measurement, you also have to put a Swan in as opposed to just a sheath (TLC) for CVP monitoring. I would...

  16. Learning thread (ER medicine)

    candyndel replied to TraumaInTheSlot's topic in Emergency

    Endocarditis usually affects the aortic and mitral valves, so your murmur will depend on which valve is affected. It becomes important when a new murmur is detected in the pt. (Although a Carey-Coombs...

  17. Question about internal defibs

    candyndel replied to Antikigirl's topic in Cardiac

    I am impressed that your hospital has empty beds and can take direct admits!! Who knew that happened in the real

  18. Question about internal defibs

    candyndel replied to Antikigirl's topic in Cardiac

    what i want to know is, why did u put a magnet on the pm that got him so mad? i am sure it wasnt just for the hell of it! and i also dont agree with him that the machines are the smartest things in...

  19. Notched QRS question & BBB

    candyndel replied to Toby's mum's topic in CCU, Coronary, Cardiac

    A significant notch in the S wave is called an Osborne wave and is usually associated with hypothermia. A small notch may be a normal variant. I am not sure why you are measuring the QRS of the PVC....

  20. Question about internal defibs

    candyndel replied to Antikigirl's topic in Cardiac

    I cant say I would be trying to get an appointment with an EP MD if my pt was shocked, nor as a homecare RN would I be calling the company rep (usually an RN) to see if they could come out and run the...

  21. Why reverse sedation?

    candyndel replied to Jolie's topic in Emergency

    No way should you have been given Narcan as part of a protocol. Actually, giving narcan after Moderate Sedation is considered an untoward event and needs to be reported to risk management, pharmacy...

  22. Father still having fainting spells 2 wks after cath...

    candyndel replied to LButlerRN2007's topic in Cardiac

    Did your cardiologist recommend/suggest a tilt table

  23. Haldol IV??

    candyndel replied to dabestrn's topic in Emergency

    Haldol works good IV, but can also prolong the QT (same as droperidol, its cousin and an old PACU favorite) which can potentiate VT. The IV form is an option on our Ventilator Sedation Protocol, too...

  24. Question about Mitral Valve Stenosis

    candyndel replied to jnette's topic in Cardiac

    right... and stenosis affects the blood moving through the valve (when the valve is open). the mitral valve opens in diastole, so MS is heard at the beginning of diastole (S2). MR would be heard in...

  25. EMR in the ED

    candyndel replied to ERnursie172's topic in Emergency

    we use ibex. we were the first ed in nj to go paperless, but not without heartache. the quality of our documetation is suffering, not to mention the ease of finger swipe errors. people just arent...