Dodongo

Dodongo APRN, NP

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All Content by Dodongo

  1. Leaving Phenylephrine on with an Epi Drip?

    Dodongo posted a topic in CCU, Coronary, Cardiac

    I just want to get a feel for what you guys do in your ICUs. A lot - a lot - of the nurses in the main ICU I work at (MICU/CCU) leave the neo drips on with an epi drip. The ICU I float to (trauma)...

  2. Max on Levophed?

    Dodongo replied to Nurse_Sophia's topic in CCU, Coronary, Cardiac

    Our hospital policy has us max levo at 1mcg/kg/min - which is obviously silly. Epi is supposed to max at .15 mcg/kg/min but we can go as far above that as we need to go. It doesn't make any sense to...

  3. Leaving Phenylephrine on with an Epi Drip?

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

    Crnahopeful, you're going off on tangents. I'm sure everyone reading this knows what receptors they both act upon and how they influence CO, SVR, etc. The point I'm making is that having neo with epi...

  4. medication mismanagement?

    Dodongo replied to Eyerly's topic in Patient Medications

    In my ICU we frequently modify orders in the computer to suit our needs. If it were me I would have changed the order, taken out the 10/650, given it and then let pharmacy (we have our own satellite...

  5. Help! I don't "get" vents!!!

    Dodongo replied to Penelope_Pitstop's topic in MICU, SICU

    Do you work in a teaching ICU with residents? At the beginning of every month the pulmonologist/intensivist will go over every aspect of the vent during rounds with the new interns. The experienced...

  6. What type of device goes in the ankle during cardiac arrest??

    Dodongo replied to stdntograd06's topic in CCU, Coronary, Cardiac

    IO for sure. Weird place though. Our ED and EMS providers loooove IOs. We keep them for the 1st 24 hours just in case. Even after they're lined. If it was the intensivist working down near the foot I...

  7. What would you do?

    Dodongo replied to tnelso150's topic in CCU, Coronary, Cardiac

    I've had a lady code in a chair. Luckily she was little so we grabbed the sheet underneath of her, threw her back on the bed and started compressions. It was way more stressful than a normal code...

  8. Nurse's Role in Therapeutic Hypothermia

    Dodongo replied to trider73's topic in Nursing Student Assistance

    I don't know about any research publications, but we use either the arctic sun hypothermia machine or the blanketrol. Both are pretty similar. We put the temp probe in their esophagus or rectum, wrap...

  9. Beta Blocker OD

    Dodongo replied to nursenancy27's topic in Critical Care

    Insulin has positive inotropic effects - as does glucagon, which is great for countering the negative effects of a BB

  10. Proper disposal in the SICU

    Dodongo replied to rort's topic in MICU, SICU

    The ultrafiltrate line from our CRRT goes into the sink or toilet. Just like urine or feces (if you have a flexiseal/rectal trumpet). Diprivan isn't a controlled substance in the same way benzos or...

  11. Looking for some insight from seasoned CCU nurses :]

    Dodongo replied to alyssaryan797's topic in CCU, Coronary, Cardiac

    Wait - so you're not an ICU nurse? But you were hired as a float RN for an ICU? How? Do you have an orientation? I hope you do. How else would you know how to manage the MI, arrests, drips, invasive...

  12. Sepsis Questions

    Dodongo replied to kblalock6's topic in MICU, SICU

    "Never use vasopressin for sepsis" You're kidding right? You're scaring me if this is not a joke. MunoRN is absolutely correct. Someone needs to do a little book

  13. Consolidation vs Infiltrate vs Opacity on CXR

    Dodongo replied to mcmurrayjr's topic in MICU, SICU

    Infiltrate is when your alveolar spaces are filled with some sort of fluid, i.e. transudate, exudate. Consolidation is more of a measure of the texture and hardening of the lungs. But on a CXR you...

  14. ARDS: Should We Be Prone to Prone?

    Dodongo replied to Corey Narry's topic in MICU, SICU

    My MICU uses rotaprone beds pretty frequently with ARDS patients. Our intensivists do not use ECMO and I think the literature at this point favors proning. Good

  15. PAWP

    Dodongo replied to LNRN11's topic in CCU, Coronary, Cardiac

    It depends on the physician who puts the orders in. I've had some MDs that order the wedge once a shift and some that want it only sometimes and they'll ask for it. But, yes, we do wedge in my ICU....

  16. Sepsis Questions

    Dodongo replied to nursenancy27's topic in Critical Care

    Low white count can occur early on in an infection because the leukocytes will extravasate at first making it seem as though absolute counts are low when in fact the circulating levels of WBCs are...

  17. Sepsis Questions

    Dodongo replied to kblalock6's topic in MICU, SICU

    What else did you try for the fever? Take the blankets off, make the room cool, etc. Tylenol would be my next choice. And no patient that is awake and alert is going to take the cooling blanket....

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

    Dodongo replied to Scrubs911's topic in MICU, SICU

    "Slamming a liter of epi" means nothing. If you don't know the concentration then you have no idea what the patient is actually getting. Was it 16mg/1000ml? 32mg/1000ml? 64mg/1000ml? If you don't have...

  19. No rapid response for a DNR?

    Dodongo replied to AlphaPig's topic in General Nursing

    When the family fills out a code sheet the provider should also discuss other treatment options such as intubation, blood products, pressors, Abx, etc. We have plenty of patients in the ICU who are...

  20. amiodarone/a-fib

    Dodongo replied to kgirl22's topic in CCU, Coronary, Cardiac

    Amio or dilt - 6 to one and half a dozen to the other. Depends on the provider prescribing. I know our intensivists prefer to use amio in patients who are hemodynamicly unstable because dilt can cause...

  21. amiodarone/a-fib

    Dodongo replied to kgirl22's topic in CCU, Coronary, Cardiac

    I agree with the people above. There's a lot to consider. Is it new a-fib or is the pt normally in a-fib? If they're normally a-fib are they normally well controlled? Is the HR up and BP down due to...

  22. Patients per nurse??

    Dodongo replied to AmandaBusch's topic in CCU, Coronary, Cardiac

    https://allnurses.com/micu-sicu-nursing/icu-nurses-3-a-452294.html There is a huge discussion about this right

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

    Dodongo replied to Scrubs911's topic in MICU, SICU

    CRRT makes sense. We are 1:1 for that. But why IABPs? We manage our own and it doesn't add much more work to the RNs workload. Just keep track of the timing (frequently) and adjust as necessary. And,...

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

    Dodongo replied to Scrubs911's topic in MICU, SICU

    That sounds just like my hospital system. They can take it if they want but they're bottom of the list. And like I've mentioned before, 1:3 in a community hospital is often not much of a stretch. Our...

  25. Fevers In CCU

    Dodongo replied to Nursingbride12's topic in CCU, Coronary, Cardiac

    You know what, this may be the case where I work, but I'm in the ICU (as are most posters in this thread I would imagine). So I use it often