offlabel

offlabel

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All Content by offlabel

  1. Why are you listening to the heart?

    offlabel replied to grizun's topic in Emergency

    Incidental murmurs get picked up every day somewhere during routine physicals. That's what routine physicals are for...to pick up stuff you didn't know the patient has. If heart sounds are important...

  2. To Float a Swan

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

    We've cut our use in CT surgery by 90% because the risk outweighs the benefits so often. A "little" v tach in a patient with severe AS can be lethal, even on the OR

  3. Should ED put in lines before sending up arrest patients?

    offlabel replied to Paris01's topic in MICU, SICU

    The more "lines" in the patient in the ER the less urgency the receiving service has getting the patient admitted. They want lines they can do them when they admit them to the unit of their

  4. To Float a Swan

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

    For the sake of the conversation, what was wrong with the

  5. To Float a Swan

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

    The greater the indication for a PA catheter, the more difficult they are to place. Anymore they are reserved for severe LV systolic failure and RV failure secondary to severe PHTN generally speaking....

  6. Should the title "CRNA" be rebranded?

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

    Grump alert.... this is a dumb conversation. Bigger fish to fry than this and no one is going to change the term CRNA or nurse

  7. how bad is 11a-11p?

    offlabel replied to ivyleaf's topic in Emergency

    Just leaving the hospital was taking your life into your hands. One night we were leaving for a beer and there was a running gun fight between a beamer and Mercedes at 35 mph past the hospital. We...

  8. Trauma Room MEds

    offlabel replied to canoehead's topic in Emergency

    wow...that is a concierge trauma

  9. Recommendations of books helpful for new RN in SICU?

    offlabel replied to laurenbianca10's topic in MICU, SICU

    Principles of Critical Care,

  10. Trauma Room MEds

    offlabel replied to canoehead's topic in Emergency

    How does that follow not having a "dedicated trauma team?" That means people are unqualified and untrained? By what standard? There are ED's where the whole staff is the dedicated trauma team, medical...

  11. CRNAs in Critical Care Medicine

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

    An anesthesia component to ACNP training would go a long way

  12. albumin and hypotension

    offlabel replied to zzyzx's topic in Critical Care

    The altered distribution in critical illness is related to an increase in capillary leakage.26 It involves dysfunction of the endothelial barrier, resulting in capillary leakage and loss of protein,...

  13. sodium amount in sodium bicarb

    offlabel replied to zzyzx's topic in Critical Care

    The bicarb works because it disassociates immediately with an immediate corresponding bump in serum Na. In those rare cases (I've had a couple) where several amps are being given, following the Na to...

  14. I have to have heart surgery...now what???

    offlabel replied to itsalexk's topic in General Nursing

    Once symptoms appear, damage has been done and recovery is more difficult. The idea is to fix the patient before they get sick if at all

  15. sodium amount in sodium bicarb

    offlabel replied to zzyzx's topic in Critical Care

    That's a really good question and one that isn't asked very often. Short answer to your question is 'no'. So, in each ml of 8.4% NaHCO3, there is 1 meq of sodium which converts to 23 mg/ml. To save...

  16. CRNAs in Critical Care Medicine

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

    Don't know what shadowing experiences you've had, but there are many, many anesthesia jobs that are for all practical purposes, critical care. CC patients come to the OR every day and are managed...

  17. I have to have heart surgery...now what???

    offlabel replied to itsalexk's topic in General Nursing

    Then I'd say the OP is better off with a new mitral valve than working for a place that would wouldn't hold his/her spot for that. You'd agree,

  18. I have to have heart surgery...now what???

    offlabel replied to itsalexk's topic in General Nursing

    It's a bit of a psychological blow to say the least, as I am very physically active outdoors, biking, backpacking, gym etc So, you can do all that stuff with a sick mitral valve, and you won't be...

  19. Trauma Room MEds

    offlabel replied to canoehead's topic in Emergency

    Dangerous,

  20. Overly rapid correction of hyperglycemia

    offlabel replied to zzyzx's topic in Critical Care

    When serum glucose levels are lowered with insulin too quickly, an osmotic gradient from brain to plasma occurs and cerebral edema can result. As far as kids and HHS, since treatment involves fluid...

  21. Should the title "CRNA" be rebranded?

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

    Why do CRNA's not re-brand themselves as an anesthesia provider less the "Nurse" title? A rose by any other

  22. Nursing Boards control of Nurses

    offlabel replied to Cougar1113's topic in Nursing Professionalism

    Free speech is defined by the nation in which it is a question. Legally, free speech in Canada and the US are two different things. Free speech, as understood in the United States, does not exist in...

  23. Case Review: Patient with pulmonary hypertension with deteriorating hemodynamics

    offlabel replied to Catticus11's topic in CCU, Coronary, Cardiac

    It's pretty easy for us to Monday morning quarterback. We have a very black and white presentation in the comfort of our downtime here with all of the pertinent facts presented to us very clearly....

  24. DEA #

    offlabel replied to sc0811's topic in Advanced Practice

    It's practice/state specific. For example, CRNA's in some states can write an order for a narcotic under their anesthesia privileges granted by the hospital without a DEA number nor prescriptive...

  25. Gun Owning Nurses

    offlabel replied to hppygr8ful's topic in General Nursing

    For home protection, IMHO, a short barrel (legal) shot gun is superior to a pistol. I can hardly find the bathroom at 2 AM let alone double tap a crook in my house out of a sound sleep. Loud, major...