NavySRNA

"26 year old female, written for 0.5mg of epinephrine sq due to a allergic reaction to a medication" The pt was young and healthy, which likely explains why she handled that dose of epi without any major adverse events. "PT had hives/facial swelling. The patient was given 0.5mg of epinephrine 1:10,000 IV push." As explained in previous posts, 1:10000 is the concentration of epi. You can look at the concentration another way... epi 1:10000 = 1g/10000ml or 1000mg/10000ml=0.1mg/ml. Epi 1:1000 = 1g/1000 = 1000mg/1000ml = 1mg/ml. The ordered concentration should be a clue to the route of administration. You probably wouldn't want to give epi 1:10000 SQ or IM since a 0.5mg dose would be a volume of 5ml. The route and dose ordered by the doctor was not unreasonable. He/she probably wanted the slow rate of absorption from SQ administration, since this doesn't sound like a life-threatening anaphylactic reaction. If you have a question about the order, it is not only our right to question it, but our RESPONSIBILITY. "The patient for a few moments had sinus tachycardia, shortness of breath, chest pain, decreased vision & the feeling as if they were going to pass out. After a minute or so vitals were back to baseline & the patient only had complaints of a headache." Epi hits alpha 1s and 2s and also beta 1s and 2 receptors, so the symptoms you described are exactly what you would expect. Epi is a sympathomimetic, meaning it mimics the sympathetic nervous system. Alpha 1s are going to give you an increase BP from vasoconstriction, Beta 1s are going to cause tachycardia, and Beta 2s will give you bronchodilation. In the OR we sometimes give epi when other pressors are not working (ephedrine, phenylephrine, vasopressin). When treating hypotension with epi, I'm usually giving IV doses of 10-20mcg (.01-.02mg), and see almost instant increases in BP and HR. I can only imagine how high this patients BP was after receiving 500mcg (0.5mg) of epi. The DOA of epi is around 5 mins, which explains why her symptoms quickly subsided. "My question is do epinephrine errors happen often?" Medication errors, unfortunately, are not uncommon. I would suspect that error rates go up with drugs not commonly administered (like epinephrine), but I do not have data to back that up. Some of the medications we give can have serious consequences, which is why we have things like 5 rights of medication administration. If you're giving a medication you haven't used in a while, take the time to look it up, ask a coworker, google it, or call the prescribing provider to clarify. Oh, and remember, we all make mistakes. Fortunately the human body is resilient, and its tough to kill an adult with a medication error.

Hello all, I really need some help. I have to interview a nursing informatics specialist for a class I'm taking, and I don't know that I've ever even met a person in this field. Is there anyone on here that may have a few mins tomorrow to answer a few questions for me? I have a list of interview questions just to give you an idea of what I am looking for. Any help would be GREATLY appreciated. 1. What advice do you have for new nurses in informatics? 2. How do you engage nurses in taking a more active voice in the informatics decision making at their hospital? 3. In what professional development activities have you been involved with in the past? 4. What is your favorite area to work on? Roll out? Innovation? Needs assessments? 5. What changes do you see truly impacting the healthcare delivery? 6. How does your practice interrelate to your research interests and practice? 7. What is your most challenging/satisfying informatics experience? If you're available to help, my number is 919-440-9710

Clearly I'm not against people driving cars. It was an example of how ridiculous the gun control argument is. Oh, and I don't have to "catch straws in the wind." My right to own guns is still constitutionally protected.

We have irresponsible people driving cars. People drink and drive, they drive while sleep deprived, they text, eat, read ect while driving, they get angry and drive their cars into crowds of people. People have accidently ran over children from improper operation of cars. We don't have enough car control. I say we ban cars and require everyone to take public transportation. After all, the bus and train drivers are highly trained and are required to go to driving school. Let's leave the driving to the professionals, since the average citizen is too irresponsible to be behind the controls of a 3500 lb dangerous weapon like a car. Besides, the constitution doesn't say a damn thing about people having a right to drive their own car. Think about all the lives we will save. Sounds ridiculous doesn't it?

im not misquoting anything. I suggest you go back and read my post, along with the quote above it. I was filling in the part that person I quoted left out.

There are certainly people that are too incompetent to carry a firearm. I can pick them out the second they open their mouths.

George Zimmerman was found not guilty.

No, that sentence is absolutely bizarre. I haven't read all the posts, so I may have missed something. Who was talking about respecting animals? I don't know about respect for animals, but I pray for them every day....right before I eat them.

Yeah, I've heard your liberal talking points before. I like how you conviently leave out the part in the 2nd Amendment that says "the right of the PEOPLE to keep and bear arms shall not be infringed." Im not sure how they could have spelled that out any simpler for you. Suggesting that they would have restricted the ownership of certain types of weapons is not consistent with the language used in the Constitution. Would you agree that a cannon that could launch a 42 lb steel ball up to 2 miles is considered "high powered weaponry?" Where does it say, "the right of the people to keep and bear muskets, but not a howitzer, shall not be infringed?" Oh, and the Constitution that was written way back then is the same document I, and your President, swore to defend. Not just the parts we like, but ALL of it. We do have a violent culture in America, and banning guns from law abiding citizen will do nothing to change that. I thank God that I have the right to protect my family instead of having to "learn to be safe" until the police arrive to save me. The police are not there to save us, they are there to clean up the mess. Just ask the family of the 14 people slaughtered in California.

Killings in America are the result of our violent society, and a segment of our population who have no value for human life. Passing more gun laws will do absolutely nothing to keep guns out of these people's hands. All about money? I would like to think its all about our constitution.

Comments like this show how misinformed the anti-gun people really are. An AR-15 shoots a 223 round (the military version is a 5.56). This is actually a very small round for a rifle. A .308, 7mm, 30-06, all of which are popular hunting rounds, are much larger, much more powerful. There is this fantasy that the misinformed have about the ability of military and law enforcement, and them (us) being the only ones capable of possessing and responsibly using a firearm. I have witnessed people from both organizations who I questioned their competence in handling a firearm. There is no difference as long as the person puts in the practice. Believe me, those of us that carry put in PLENTY of practice. I agree with the comments that a headshot would be difficult in an active shooter situation, but that's not an absolute necessity to stop or slow down the bad guy. Body armor doesn't make you feel all that protected when you have large chunks of led whizzing by you at 1000 fpm. Body armor or not, I guarantee that if the bad guy encounters someone that starts shooting back they will take cover. This will, at the very least, slow them down. It could save lives. If the good guy has a gun then at least he has a chance to defend himself. If he has no gun he has no chance. To just lay down and play dead, as someone in this thread suggested... no thanks. I especially got a chuckle from the one comment in here from someone saying if they were in a shooting situation like the one in California, and knew someone beside them had a CCW, that they would get as far away as they could. Trust me, if someone starts shooting, you would want me by your side.

You may feel like your nursing program made you a "confident, competent" nurse, but your post reeks of arrogance. While I'm sure you attended a great program, and without a doubt learned alot, I assure you that you've only scratched the surface. I suspect the learning curve is just beginning to level out for your preceptor who graduated only a year ago. I began my nursing career in a civilian ICU at a busy level 1 trauma center, and it took at least a year or two just to start feeling comfortable in that environment. I couldn't imagine having to precept an extremely knowledgable nurse such as yourself after only a year of experience. If they don't fire you I recommend you request a new preceptor, since I'm sure the one you have now has had it with you. Then I recommend you have a large slice of humble pie before your next shift. As a new nurse I can remember being bailed out many times by my senior coworkers, whether it was being overwhelmed by my patient load or some idiotic mistake I made. I guarantee that you will find yourself in a similar situation no matter how good you think you are, and those nurses you were so eager to criticise will be more than happy to sit back and watch you drown.

You could join the military and get paid to go to school full-time. You'll have plenty of money, just no time to spend it.