offlabel

offlabel

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All Content by offlabel

  1. How to develop ICU critical thinking skills and move away from being "task" focused

    offlabel replied to midnitej's topic in MICU, SICU

    Get a medical (not nursing) pocket critical care handbook or phone app and use it at work. Get a good medical critical care textbook and read about your patient's problems and therapy for that day....

  2. Why no NICU?

    offlabel replied to goldens1's topic in Certified Registered Nurse Anesthetist, CRNA

    It's just a matter of "well rounded-ness". Patients in the NICU compared with adult critical care have nearly an insignificant number of working diagnoses. There are some general principles that cross...

  3. Vent management and sedation/pain management

    offlabel replied to MaxAttack's topic in Critical Care

    Depending on your Diprivan dose, that can be "pain control". What kind of patients are we talking about here and what kind of pain do they

  4. Peritoneal Dialysis in the ED?

    offlabel replied to robrn1123's topic in Emergency

    Must not be a very busy ER. Holy cow. But the procedure itself is not rocket science. Lay people with no formal training or knowledge in sterile technique\ microbiology do this in their living room...

  5. Precedex vs. fentanyl/versed vs. propofol

    offlabel replied to RNSAC's topic in Critical Care

    Great response...I'd only add that since the understanding of propofol infusion syndrome, although fairly rare, folks around here have been looking for ways not to use it, use it briefly or minimizing...

  6. Delivering fetal demises

    offlabel replied to sharonx's topic in Ob/Gyn

    What is

  7. Delivering fetal demises

    offlabel replied to sharonx's topic in Ob/Gyn

    Are these all unexpected demises or are some of them elective inductions for fetal anomalies and there is an ethical objection? If they're refusing these in the case of true still borns, it's odd...

  8. What is "The Nursing Model?"

    offlabel replied to RNDude2012's topic in Nurse Practitioners, NP

    That is as good a definition that I've heard, but it implies that nurses pay a lot of attention to issues that are not really relevant to the problem at hand and also that there is a much longer...

  9. NP's answering to Nursing Management?

    offlabel replied to ohiosam2's topic in Nurse Practitioners, NP

    Pretty hard position to defend being "medical staff" when much (not all) of the advanced practice establishment clings to the "nursing model". The problem is that while the vast majority of APRN's...

  10. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    Not a matter of policy, it is what the objectives are for the particular patient. If a PA pressure is all that is needed to asses cardiac function, the CCO catheter is way overkill, so we use the...

  11. Ultrasound Guided IV insertions

    offlabel replied to pluckyduck's topic in Emergency

    A slow injection with a 27 ga needle for a lidocaine wheal is pretty painless compared to an IV catheter, especially big ones. When you use buffered lidocaine, there is hardly any sensation at all....

  12. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    We have

  13. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    Our Edwards device gives CO's every 2 minutes which, for cardiac output, is for all practical purposes real time. But that is way overkill in any other setting besides the CVOR and immediate post op...

  14. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    Not dismissing them out of hand in the least. When cardiac function needs to be followed and they're all you have, they're as good as the CCO systems for getting a number. All things being equal,...

  15. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    I don't know what that

  16. CRNA Abusive, disruptive HELP!

    offlabel replied to Dani T's topic in Ambulatory Care, Clinic

    With all due respect, what are readers here supposed to do? What you describe seems to be bad. So do something about it. If you've been doing this for 30 years and no one will listen to you at your...

  17. Is the back of the gown sterile?

    offlabel replied to Lorodz's topic in Operating Room

    Hah! Orthopedic surgeons think there is a 3 foot sterile field in all

  18. OR to ER -Is this possible??

    offlabel replied to ILUVFLRN's topic in Operating Room

    Regardless of your experience, if your aptitude matches your desire and enthusiasm for working in the ER, you'll do fine. There is a lot of stuff you learn without even being aware of it in 3 years of...

  19. Ethical dilemma HIV positive mother and baby

    offlabel replied to KatelynRodriguez's topic in HIPAA Challenges

    The mother can decide anything she likes. As others have stated, if the father's rights as a parent have not been terminated or restricted by the court, once that baby is born, he has the same rights...

  20. Albumin and DKA

    offlabel replied to JVerne07's topic in MICU, SICU

    Very simply, because of the inability to transfer glucose into the cell, one of the energy production defaults is protein catabolism which consumes albumin. Hypoalbuminemia, though, is pretty low on...

  21. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    Must be cheaper...sure not

  22. To run infusion with CVP or not... That tis the question..

    offlabel replied to kmarieCCRN's topic in Critical Care

    Do places still do manual CO injections? Haven't seen one of those in years. All CCO now where I

  23. Foley Cath Insertion

    offlabel replied to sammiesmom's topic in Critical Care

    Not anywhere near an inclusive list...but to the patient at hand, he was admitted to the hospital for sepsis and the physician wanted a foley while he was awake. If that were the case, he certainly...

  24. How do CRNAs get treated by MDAs ?

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

    I've worked with 15 or 20 CRNA's with BSN as their highest degree. Their advanced training of course was anesthesia, but it was a certification course, not a degree. I've also worked with a handful of...

  25. drug calculations help please

    offlabel replied to petrit's topic in Nursing Student Assistance

    No one is going to correct the OP's spelling? That's the bigger problem here, 'cause you can give 160 mg of Lasix way faster than 40