LisaRn21

We always use them in my er. As far as liability goes, if your facility has them available to you then use them. If not then it is a liability issue. If your policy states you don't use them then don't use them. If ever taken to court Policy and stanard of care at the facility play a major role in liability. But maybe you can talk to your educator about the concept of why and why not use them.. Do some reasearch have valuable research behind what your requesting.

Its a plastic shiley.. it doesn't matter if its soaked or not.. once you get the brush in (with some resistance) it is really really hard to get out lol

Hey guys quick question! I have a patient that has an extra long trach, and when doing trach care the brush gets stuck inside the trach..almost as if the brush is too big for the inner cannula.... Anyone ever have this experience? Am I supposed to be using a different kit? Also what is everyone's policy on trach care? I am doing a PI on it and wanted to get some info.. Do you do it q 8 hours ... once a day or whatever if the patient has an old trach with minimal secretions that gets suctioned once a day if that... Thanks guys

Going for magnet status...must do PI/evidence based practice study..any suggestions? We have already done handwashing, pain, IV checks/infiltrates, need for 4am VS, cont nebs vs. q2 hr. Running out of ideas... thanks for all your help!

Thanks guys! I get it now that would make total sense......and yes it is unacceptable so is a ton of stuff that has happened in the past 2 weeks....ie the room not being cleaned before she was placed there....insulin being given without checking the bs (the cna charted it so its done says the nurse...yet I didn't leave the bed side and she didn't do it while I was there), telling my mom she stunk cause she hadn't bathed in a week (well duh! she was sedated and intubated in the ICU ... geez) oh and the list goes on ... never ever would have thought this from a top ten hospital, needless to say the nurse manager and I had a little chat ... but thanks for the info guys!!

My mother had a huge PE .. they are sending her home on both lovenox and coumadin...I don't understand why both.. when my mother asked they said that her daughter (me ) could explain it better but I work with kids and ever hardly ever I can only think of one patient I gave anticoagulants to so I am not sure... anyone have experience with this?

Thanks for all your help guys... now they are gonna place the trach tomorrow... the doctor didn't seem hopeful in being able to do it .. Seeing as my dad has a huge fat short neck...he's 348lbs and has lost most of his muscle tone in the past three years so its all like loose skin... he kept saying his neck could occlude the site if he moves his head certain ways and stuff. Then they wanted to do it under general anethesia the ent doc wanted to and then anethesiologist wanted to do a local since he was high risk... I"m concerned about the general only because he's having the lung issues and he just had the collapsed lung yesterday.. and everyone keeps saying he'll be fine but then the docs look nervous and worried.. heh I don't know.. I jsut want to slap them so hopefully tomorrow goes ok and if soo I will be returning to work on monday thanks guys for all your help this stuff is just so new to me.. I never dealt with it vents and trachs and all that I'm learning a lot though haha might end up switching to icu or special care!!

Ahhh! I didn't know there was a temperature gauge.. my dad was fraeking out cause it was numbing his nose.. they could have warmed it up for him!! I didn' tknow he said the pressure is awful but the cold is what got him well when we had one lol

ok! So I have some new questions!! I am just not understanding and you guys have helped out so much! So last night my dad coded his left lung collapsed from a pneumo they inserted a chest tube and it reinflated. They also told us they want to place a trach cause he was a hard intubation and its more comfortable. The nurse told us it is normal for people to require chest tubes when they are on a vent because of the positive pressure and she also said most patients get trachs if they are vented for more than 2 weeks which is gonna happen in my dad's case.. they aren't even gonna try and ween him for a couple more days to a week... I was just wondering if anyone has heard of this.. I"m not really understanding what the difference is if the he has a endo tube or a trach... why take the endo out if its placed and working properly... I understand a trach is more comfortable and stable (if it pops out you pop it back in) but why not just keep him sedated and resting as llong as the endo is working? any thoughts??

IV pumps that don't beep in the room ..just at the nurses station so that when it does go off patients and their families don't yell at you for not getting there for 3 minutes! They will never know when its beeping and you can finish what your doing and keep your prioritizing straight!

Thanks guys for all your help. They are doing mouth care.. and they are backing down on the sedation acctually the nurse backed him down and before she could tell us what she did I had asked a question and she started to answer that and he started thrusting his head violently to get the tube out and I though I was gonna throw up lol and then she explained it. He calmed down when we told him to and he squeezed the nurses hand with his right hand and when she said with his left he didn't and when she asked if he could he shook his head no and then started real violent again and she turned the sedation up. I forget the name its milky white and they change the tubing really frequently. The vent is giving him 800cc and breathing 10 times a minute I don't know if thats really important but thats what they told us. the doctors said they think he is giving up but I don't know.. its not his nature to give up. Everything else is better its just he keeps retaining co2 his last blood gas prior to intubation and on cpap was a co2 level of 85.. I don't know... I guess its just a waiting game.. but I now know how families feel when they see their members laying so helpless like this.. I used to think itshelping them why are you so upset (I kinda understood but nothing like I do now) I don't know

no they are well they were doing it when he had the cpap on..but they placed the tube last night and shortley after we left... so I am not sure if they are or aren't I would imagine they are.. I'm in pa

how do you do mouth care? I was doing it when he was on the cpap cause his mouth was exposed but now the tube and the ties and all that are in the way... do you just go around it?

Hey guys I need your help. My dad was placed on a vent yesterday and his last words prior to being intubated was help... I want to help him so bad but I just don't know how. i've never worked with vented patients before so I"m not sure how much they know is going on. The doctors promised me they would keep him sedated but they also put his in soft wrist restraints so how sedated can he be? I can't do mouth care obviously....and he's 300 lbs so I can't reposition him tooo much myself.. any suggestions on hwat I can do to make him more comfortable would be greatly appreciated.

Can I rant too? If I hear one more time already this season, "You don't have kids why can't you work xmas" I am gonna shoot myself! Really! Like Idon't have a family and then for the nurse to say "Well in 15 years come talk to me" I don't care how long you have worked there your holiday is your holiday geez. ok I'm done :)