offlabel

offlabel

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All Content by offlabel

  1. Preceptor issues

    offlabel replied to atlnurse7's topic in Critical Care

    You're 80% sure you were with her when you pulled the fentanyl. How sure is she that she was there? It is an unusual thing to not remember what you were doing and with whom, especially if the event...

  2. Taking blood samples

    offlabel replied to J.Robinson011's topic in PICU, Pediatric

    Best, most humane way for multiple blood draws is an arterial line...one stick and all the blood you

  3. The Unsung Hero of The Emergency Department: The 24G IV Catheter

    offlabel replied to Damon McGill's topic in Emergency

    It isn't the size of the catheter, per se, it's the quality of vessel that people choose to cannulate with such a small IV catheter. They're friable, thin walled and very fragile. IOW's they blow very...

  4. Amiodarone vs. Lidocaine

    offlabel replied to Tsicurn2020's topic in Critical Care

    Very commonly used to convert atrial fibrillation and very

  5. Getting Back On Track To CRNA

    offlabel replied to gennn19's topic in Student Registered Nurse Anesthetist

    Whatever you do, don't bail on the NP Program...that won't play well with the admissions

  6. Resources for Ordering Imaging/Tests

    offlabel replied to OncRN2015's topic in Nurse Practitioners, NP

    Was this not in NP training? This kind of plays into the arguments of physicians that accuse NP's of not having the expertise of discerning what, if any, diagnostic tests to order. Is there a...

  7. Best ICU for CRNA school?

    offlabel replied to Seli97's topic in Student Registered Nurse Anesthetist

    Not enough information here. All ICU's are not the same. A cardiac ICU that only sees bread and butter, healthy cabg's and valves might be far less valuable than a neuro ICU at Emory. Compare patient...

  8. Change in fellows and residents...safety

    offlabel replied to m0ckingbird's topic in Critical Care

    Post was way too long for me to read the whole thing but if there is an issue, call the resident's or fellow's attending...this isn't your

  9. Peripheral Vasopressor Administration - Considering Catheter Gauge

    offlabel replied to 0.9%NormalSarah's topic in Critical Care

    When did we change the conversation to include

  10. CRNA School Acceptance

    offlabel replied to studentnurse1004's topic in Student Registered Nurse Anesthetist

    You know what you need to do. Just do it and ignore folks that have some kind of burr under their saddle. Seems like you're aware of the consequences of entering anesthesia training unprepared and...

  11. Does anyone still teach percussion in assessment?

    offlabel replied to SHGR's topic in Nursing Educators, Faculty

    Percussion is a nostalgic curiosity that was used when there was little else available for diagnosis/assessment of anatomic cavitary pathology. Now with ultrasound and CT and MRI it's obsolete. If it...

  12. Do you work with PA lines often? Are they really a thing of the past?

    offlabel replied to BeatsPerMinute's topic in Critical Care

    I'd be interested in the source for that number. Seems crazy high. Are you sure that is balloon inflations or actual catheter placement? It would make more sense if the risk of arterial rupture is...

  13. Do you work with PA lines often? Are they really a thing of the past?

    offlabel replied to BeatsPerMinute's topic in Critical Care

    The old Edwards CCO monitor didn't have all the (useless) bells and whistles for SVV/PPV and CCO from the arterial line like the Hemosphere does. That seems to be what the company wants to sell and...

  14. CRNA School Acceptance

    offlabel replied to studentnurse1004's topic in Student Registered Nurse Anesthetist

    Don't need a 4.0 to get into school. But you're 5-6 years out before you should apply so you have plenty of time to gain meaningful experience and training in critical care to make yourself...

  15. Peripheral Vasopressor Administration - Considering Catheter Gauge

    offlabel replied to 0.9%NormalSarah's topic in Critical Care

    It is true that many people are ignorant about the role of CVP (right atrial pressure, really) and it's affect on venous return, downstream LV filling, cardiac output and ultimately, blood pressure....

  16. Peripheral Vasopressor Administration - Considering Catheter Gauge

    offlabel replied to 0.9%NormalSarah's topic in Critical Care

    Never heard of nor seen a VAE via a PICC. Can't say the same about an actual central line. Never measured a CVP via a PICC either. To say that the length of a catheter isn't pertinent makes no sense...

  17. Working as a nurse with a severe allergy to Cephalosporins

    offlabel replied to ashlyn0689's topic in General Students

    Would not have thought it was a thing...but talk to your allergy physician...

  18. hanging blood with the wrong fluids

    offlabel replied to newnurse012's topic in Medical-Surgical

    Old age?

  19. Peripheral Vasopressor Administration - Considering Catheter Gauge

    offlabel replied to 0.9%NormalSarah's topic in Critical Care

    "Central Line" and "PICC" are different terms to be understood differently. They are cared for differently, the safety considerations are different and they have vastly different use capabilities....

  20. Interpret This Order For Me Please

    offlabel replied to guest1143647's topic in General Nursing

    Is 440 ml of D51/2 NS going to be the difference between life and death? Yeah, it's an unclear order, but waking someone up in the middle of the night for that is what makes doctors complain about...

  21. Peripheral Vasopressor Administration - Considering Catheter Gauge

    offlabel replied to 0.9%NormalSarah's topic in Critical Care

    As some have alluded to, it isn't the catheter size...it's the vein size and condition. We run epi and dopamine thru 24 or even 27 ga cathers in neonates. Norepi thru a 24 ga catheter in a frail,...

  22. CRNA Job Alternatives?

    offlabel replied to Ketofol's topic in Certified Registered Nurse Anesthetist, CRNA

    Pain management is a frequent 'default' fall back alternative for both medical and nursing anesthesia trainees that are questioning their choice of sub-specialty. It is horrible advice. Pain is a very...

  23. PICC line

    offlabel replied to Trkavenger's topic in General Nursing

    You mean CVP...and if someone were on some type of blood thinner and had elevated right heart pressure and no one was paying

  24. Can Rittenhouse Become a Nurse?

    offlabel replied to lifelearningrn's topic in U.S. Politics's Talk Politics

    Western society has the collective memory and cultural literacy of a banana slug. Two years from now no one will remember a thing about this

  25. CRNA Job Alternatives?

    offlabel replied to Ketofol's topic in Certified Registered Nurse Anesthetist, CRNA

    If what you are concerned about is actually reflected by the reality (we're our own worst judges) you do have an ethical duty to either achieve more than competency before entering practice or get...