kampswas

The question was beyond the obvious of patient requiring intubation. I should have made that clearer but after much research I found my answer. In short it is the combination of the depression of gag reflex and severe gerd resulting in scar tissue of the esophageous that impaires the ability of secretions to move naturally up the trachea therefore pooling. Response to the heart and flash ....Nope heart was fine, the patient had severe etoh and benzo dependence.

All through nursing school I wasnt sure if it was what I wanted, alot of people feel that way, Keep at it despite your feelings in the end You will be glad you did. If not you can always sell RX or medical supplies or teach. lol IT is a degree that is always respected no matter where you go.

I never went and didnt miss a thing nor do i feel like I did in retrospect My wife went and she felt silly. Go figure.

I never see any issues, with hiring. just my 2 cents

My coworker had an interesting patient last night which I had no answer for so here is the scenario any ideas? Came in mental status change with normal lytes ? ??dt's, urine was positive barb benz. Put on ativan drip 10 and versed drip was I think 40mg and hour Still breathing believe it or not not vented. I guess the previous nurse took her off the the ativan drip and was told wean off the versed. was given dekanoate 250 at 2000 the versed was off by 12 and was on bipap at 11 the patient throughout the night became more somnolent the nurse was suction him nasopharyngeal but the patient kept on producing enormous secretions like flash pulmonary edema. Actually I did hear her suctioning through the night so i know she was on top of it I figured for good measure i would do the same when I went in there noticed no gag with suctioning and within 15 minutes same thing filled up like pulmopnary edema Suction consistency white some clear almost like exudative stage ARDS not pink tinged I recommended CXR, and ABG, Sugar and Lasix for good measure she called Dr an gave report next shift. VS all seemed normal Sinus- HR 80's Afebrile BP 120's on 80's map 70's PP >50 02 sats on a venti 40% ->93% Breathing like he was acidotic to me. Urine output normal Stat CXR-normal Abg Slightly acidotic but a COPD patient Home O2 PO2 Normal base excess normal Sugar normal Lasix put out 500 I have no clue any ideas?

1to 2 sometimes 1 to 3 depending on acuity vents etc, never 4 unless pcu overflow

We use a special VAP et tubehttp://www.deborah.org/publications/clinicalupdate15/15story3.html It gets hooked up to 20 cm of it is also part of a bundle pack we use hob etc.

I know how you feel, Some things I use that helps me anticipate questions and flow of the patient is a couple palm programs I use almost everytime I work. One is ICU from pocket medicine called icu management it is pretty outlined to include first things first,diagnostic test, complications, etc also I use katherine white fast facts for critical care. Both are great resources hands on. It takes time and it get's better, be glad your in 5 years, some never make it that far.

1. I work in NY state is there a law that states that RT's are the only ones that do arterial sticks. I know of some hospitals that nurses do arterial sticks. I was wondering if this is just a Hospital policy or in fact any Nurse can do artial ABG's with proper training of course. I came from another state where the nurses obtianed the ABG's. 2: The RT's also put in arteial lines and some even suture these lines, this seems beyond their scope of practice. Any thoughts about the legality of this as well.