GrannyRRT

GrannyRRT

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  1. We in hospice have a lot of educating to do

    GrannyRRT replied to duskyjewel's topic in Hospice, Palliative

    That depends on the ventilator patient. If they are already a long term ventilator/trach patient, Hospice is probably a good alternative or at least another option for consideration. But, it will also...

  2. bi pap?

    GrannyRRT replied to ViolinTreble's topic in Critical Care

    BIPAP machines are not meant to be ventilators. Since you used the term "backup rate" what I am about to say probably applies to your machine. Most of this is directly from the Phillips/Respironics...

  3. We in hospice have a lot of educating to do

    GrannyRRT replied to duskyjewel's topic in Hospice, Palliative

    Since a quote was taken from a post I made and used out of context to this subject, I am going to respond. Not all hospices are the same. The protocols and preferences are often those of the Medical...

  4. bi pap?

    GrannyRRT replied to ViolinTreble's topic in Critical Care

    ABGS are deceiving. Many ABGS will appear to have normal numbers but the patient may be working hard. By the time the ABGS show impending failure you may have lost the window of opportunity for BIPAP....

  5. Biox vs. Pulse ox vs. whatever else?!

    GrannyRRT replied to AJcardiacRN's topic in General Nursing

    Bottomline is to know the difference between a piece of technology and the diagnostic value or which of the many diagnostic values of it obtains. Another example is the use of the term "I-STAT". Some...

  6. Biox vs. Pulse ox vs. whatever else?!

    GrannyRRT replied to AJcardiacRN's topic in General Nursing

    For those who need a memory refresher: one Biox model had the green pulse pleth screen which was nifty in the 80s. I think another model had an orange or yellowish screen. The technology improved...

  7. Biox vs. Pulse ox vs. whatever else?!

    GrannyRRT replied to AJcardiacRN's topic in General Nursing

    Biox was one line of pulse oximetry measuring devices with several different models from a well known manufacturer several years ago. To use the term "Biox" would be like saying "I am going to get a...

  8. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    .Some hospitals just suck when it comes to policies and equipment. As I stated before, the nursing management may have played a role in neglecting this issue. I stated some of the issues we went up...

  9. PARAMEDICS IN THE ED...Do you have them????

    GrannyRRT replied to EDtraumaCNS's topic in Emergency

    If the nurse is going to be intubating, their training will exceed what is required by the Paramedic program. No EMS program around my city or county has a set minimum per year for intubations. The...

  10. PARAMEDICS IN THE ED...Do you have them????

    GrannyRRT replied to EDtraumaCNS's topic in Emergency

    I disagree. All (neonatal, pediatric, adult) of our transport nurses can intubate and do crics. To maintain their skills they are expected to intubate in the ER and anywhere else in the hospital. We...

  11. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    Thank you for that post. Every department has its problems. Our problem, which nurses have told us, with be very proactive and trying to be the leader for progressive therapy would be education time...

  12. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    I am now going to give you my opinion of the situation. In my other posts I was trying to not offend and to explain how policies vary, equipment differs and expected safety issues. Some here just want...

  13. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    All medical equipment requires proof of the original order. If you are in charge of a patient you should know this. Do you allow patients to bring in their own meds to take without confirming they...

  14. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    It will depend on the policy. If the alarms are set tight as they are in ICU, no one gets any rest. If the RT loosens the alarms out of the policy parameters, big, big problems if something happens...

  15. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    I think I have shown enough resources to support the differences between a hospital machine used for rescue using a NON VENTED Mask and a home machine using a VENTED mask. The RT does not bill for...

  16. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    No worries Don. We use ResMed/Respironics products for Sleep machines and mostly FP_ if we use heated wire for ICU. The home masks also have those little holes peppered on the bridge for additional...

  17. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    The OP (nurse) knew what was needed which was the mask. The hospital masks will not work. The OP also stated if the hospital machine is used the patient must be in the ICU. That means the hospital...

  18. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    True but still if the policy is not to touch the home care equipment, it is not about reimbursement. You can get a doctor to order me to touch the home care equipment and I will be calling my...

  19. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    I hear you. LTC is on a very tight budget with limited resources and poor reimbursement. CMS will not reimburse for the services of an RT. But, if the RT department in the hospital wants to change the...

  20. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    The OP asked for a face mask and assumed that since patients with CHF got CPAP, all maks were tne same. The RT said the masks would not work. It should be clear that you don't rig up homecare...

  21. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    It is frustrating but when a hospital decides to allow home equipment to come in without providing alternatives or resources you have tied the hands of the caregivers. For what it's worth RTs...

  22. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    Explain yourself. Have you seen the circuits and masks of ICU machines vs those of home CPAP? Let me see if I can go more into detail about this so it will be clearer. The ICU BIPAP machines usually...

  23. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    What exactly is that going to do? If the hospital managers (nursing, RTs and medical directors) have not had the foresight to establish a policy and allow funding for the little sleep machine, there...

  24. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    Big issue now and some DME and sleep centers do not take the time to explain the patient's insurance and warranty benefits (or patient did not understand). Many will provide for filters and at least...

  25. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    What's the one question CMS or their representative agency ask for anything? Where's your policy? No department can bill for anything unless it is approved at multiple levels and a policy is in place....