i think, at the very least, a further inquiry into child's risk of developing malignant hyperthermia is justified before proceeding with the tube placement. as healthcare PROFESSIONALS we often need to educate patients about risks and benefits of tre...
i try to be pleasant to everyone. but also to convey to them that i am in charge of triage - not them. when people ask about the wait time - i let them know that all of our rooms are full and that as they become available the sickest people go back f...
my er actually has portable call lights. they hook on the iv pole on the cart. pt pushes button on cord - yellow flashing light appears. i hate hallway pts. however, we frequently have to pull a patient out of a room to accomodate life threatening il...
I'm a Gen-X-er and i LOVE the computer-based learning modules. Even if they aren't quality it is usually more efficient for me to complete versus driving to work, parking, walking a mile and a half, sitting through "let's go around the room and intro...
In my ER we use dopamine a lot for hypotension (not low dose to improve renal fnx) and so usually pt is getting a hefty NS bolus. I generally like to piggyback my dopamine to NS (even if it's just KVO) because my dopamine drip is usually a low ml/hr.
I try to be very general with my med explanations. When the chest pain pt asks why he is getting metoprolol, I answer with "it helps your heart be more efficient." Generally I get a nod and an "okay," and we're on to other questions (what do all thos...
Anybody out there using a hypothermia after cardiac arrest protocol? We've just recently added this to our practice where I work and there is a lot of confusion about what to do, in what order, etc... Any advice out there on how to accomplish this an...
First - welcome to the ER! I started in ER as a new grad. I had 10 weeks of somewhat orientation (sometimes I was counted as staff, sometimes I was an orientee). To be honest, I felt pretty uncomfortable with anything/any pt that had a time sensitive...
From my experience, someone can be DNR and still wish to be treated with pressors. I would never ever ever ever ever initiate a dopamine gtt w/o cardiac monitor. i check bp's q 5 mins. i titrate up to acceptable bp q 5-1o mins. generally speaking...t...
I've been nursing for 2.5 years...and it is getting less as time goes on. I've had intermittent insomnia prior to my nursing career. I find that keeping a routine is key to me sleeping before my 12 hour shifts...even on my off days. I use benadryl re...
Part of nursing is being a patient advocate. Any patient may choose to leave against medical advice. If the situation allows, I try to provide basic discharge instructions, including we are here 24/7 and should you change your mind, we will be happy ...
Check out the ENA's Journal of Emergency Nursing -- (April 2006, Volume 32, Number 32) -- article "Ketamine: The Sedative of Choice in a Busy Pediatric Emergency Department" by Haley-Andrews, S. --- good info on dosing IV vs IM, etc... Good luck.
sometimes they call when i'm at work....yes, i'm already there. makes me wonder who is in charge! :) get caller id. if it's work...don't answer unless you want to go in for the night. also - there is nothing wrong with saying "i can come in tonight, ...
daily max dose for tylenol is 4 grams. where i work generally we give 1 gram at a time. so the 650 mg tylenol you gave plus one darvocet (which is a large pink pill) would not have toppled her over the daily max dose.
CONFIDENCE is what you need.....and lots of practice. Find someone with big, bulging veins and practice on those. when you get the hang of hitting the big ones you'll have better luck with the old, dehydrated, contracted patient in the hospital. And ...