GrannyRRT

GrannyRRT

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All Content by GrannyRRT

  1. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    You clearly do not understand what is meant by not having the equipment available in the hospital to git home CPAP machines. If the hospital only uses Visions and V60s, those masks are clearly not...

  2. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    Yes, the use of respiratory equipment including CPAP and nebs are now on the CDC questionnaire for required reporting. We also have changed our policies on routine nebulizers and their care in the...

  3. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    I posted the major differences between the hospital machines normally used for CHF and sleep machines. You didn't mention any specific names for either masks or machines in your original post. Sleep...

  4. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    Have you worked with hospital machines used for CHF? Their circuits and masks are not compatible. Do you do any patient education in your sleep center about hospital admissions? I hope this "bs"...

  5. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    The risk and cost of an infection definitely will exceed that amount. As cited by ECRI, an infection resulted in death. I guess you haven't seen many of the home machines brought into the hospital...

  6. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    The machines used for rescue CPAP are usually the Vision and the V60. I will again say I hope the RTs are not running to ER or ICU with a little home style machine to rescue a patient in CHF. That...

  7. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    What type of whisper valve or exhalation port is on the mask or hose? How much deadspace does that machine model compensate for? Different mask brand can vary in deadspace. Does the machine have...

  8. CPAP on the unit

    GrannyRRT replied to canoehead's topic in General Nursing

    We no longer allow home CPAP/BIPAP machines in our hospital due to the many safety concerns. This is also the trend in other hospitals. Increased levels of CO2 is just one concern. It is a very real...

  9. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    It is the ICU which can get the patient's long term goals started. I think I mentioned this before that we will know in ICU through our rounds what the patient will need for care and learn from CM...

  10. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Cuts in CMS have hurt LTC. What you are saying is heard loud and clear. There is not always time to really work with a patient individually for some goals. You hope others can carry out the plan in...

  11. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Cuts in CMS have hurt LTC. What you are saying is heard loud and clear. There is not always time to really work with a patient individually for some goals. You hope others can carry out the plan in...

  12. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Of course you run around all shift doing patient care. We are all over worked in LTC but still get to know the patients to be part of the team helping to make the decisions to improve care. And, there...

  13. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Long Term Care is about the long term whether the condition is chronic or will improve with healing or rehab. You don't have to rush like in Acute care where all the care begins and ends sometimes on...

  14. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Did this patient have a bad autonomic dysreflexia episode from bladder distention? Basically there are 3 options for emptying the bladder especially if bladder retraining is not possible. But, this...

  15. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    I disagree about this being written off as freakitis. Trachs are like shoes. They must fit properly. Cuffed or unruffled play a huge role. Depending on the level and completeness of injury, sensation...

  16. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Dustin, no one is nitpicking you. With the very few details you gave, it is hard to offer specifics. You got defensive even when asked about the nebulizer med. I have written about reasons to use to...

  17. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    There really are so many things to address with the care of a trach. Suctioning before and after is not excessive and even once in between can sometimes be expected with nebs. Depending on the...

  18. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    My posts are to give whoever reads them more insight on troubleshooting problems with trach patients. There are also about 50 medications which can be nebulized or given by

  19. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Dustin, our attached subacute holds 64 trach patients with more than half on ventilators. The acute rehab is 50 beds and has 5 - 10 new quadriplegic patients at any given time. There may be only one...

  20. Interment cath and trach suction per pt request limit

    GrannyRRT replied to Rvanurse2012's topic in Patient, Colleague Relations

    Why are you giving the trach patient nebulizers? What medication? Frequency scheduled? The extra cold air flow from the nebulizer is an irritant and if done regularly the airways will remain...

  21. Paramedics in the hospital setting

    GrannyRRT replied to Ellekat2's topic in Rural

    Why did you say the post you quoted was incorrect when you said the same thing? For the ER I do not agree with you or BR. I have never seen a Paramedic do any of that in an ER and if they could it...

  22. self extubation

    GrannyRRT replied to lmarti10's topic in MICU, SICU

    But, don't just dismiss it as something which just happens or use the "ready to come of the vent anything" excuse either. Use each event as a learning tool. Self extubation is not always benign and...

  23. self extubation

    GrannyRRT replied to lmarti10's topic in MICU, SICU

    In the ICUs here both the RN and the RRT fill out a rather lenghty form which covers the physicians, medications, restraints, ET tube type, suction device placement, tube fastener, tube retaping and...

  24. Turfing patients to other hospitals

    GrannyRRT replied to NextGen's topic in Patient, Colleague Relations

    I can see the holiday weekend thing. It will depend on who is covering and some places might not have coverage. Patients might go to the ER before the weekend. ER to ER transfers are alot easier...

  25. Turfing patients to other hospitals

    GrannyRRT replied to NextGen's topic in Patient, Colleague Relations

    The patients with no insurance who are taken to a larger center will probably do better than the person with excellent insurance who is kept at a hospital for that reason and be at the mercy of a...