Road Trip Essentials

What is in your emergency med box? We don't have those where I work.

What I bring usually just depends on my patient and what's most likely to happen based on their condition. If they're too unstable to travel, but for whatever reason the team insists, I like to bring a doctor with me :)

Spectra Link phone is the most important. My scope of practice does not allow me to administer any of the meds in the med box without a physician order.

AMBU bag. (With mask!!)

Spectra Link phone is the most important. My scope of practice does not allow me to administer any of the meds in the med box without a physician order.

What really? We have an emergency drug box that contains a syringe of Epi, atropine, and lidocaine. We are allowed to use them in an ACLS code, because were ACLS certified. If you are certified ACLS you can run a code (well we can't intubate but you can manage an airway with out an ETT anyway). Just seems absurd to me that you couldn't give emergency meds if you had to. Like if they went asystole on the CT scanner you couldn't give epi? Or if they went into v-fib would you be allowed to shock them?

Anyway I always bring extra sedation, make sure my vasoactive drips are all full, emergency drug box, flushes, syringes.

We don't carry any meds either. Our imaging suite does have a crashcart with code meds, however.

We have a transport med box with epi and atropine, and we take a small tackle box with supplies (angiocaths, flushes, syringes, needles, etc), a monitor, ambu/anesthesia bag are on every transport. Obviously if the patient is ventilated, an RT comes too with either a transport vent or they just manually ventilate depending on where we are headed (and they bring the O2). If going to mri with a non-sedated patient, I'll bring whatever prn meds they have available in addition to all of the above just in case they can't stay still or have pain.

It can be a lot to carry sometimes :)

Usually it's just the RN and a tech, and An RT if needed, but I've had additional nurses, RT, residents, and intensivists go with if we think there may be a problem with the patient because they are very unstable but must go somewhere (this would typically be OR).

What really? We have an emergency drug box that contains a syringe of Epi, atropine, and lidocaine. We are allowed to use them in an ACLS code, because were ACLS certified. If you are certified ACLS you can run a code (well we can't intubate but you can manage an airway with out an ETT anyway). Just seems absurd to me that you couldn't give emergency meds if you had to. Like if they went asystole on the CT scanner you couldn't give epi? Or if they went into v-fib would you be allowed to shock them?

Anyway I always bring extra sedation, make sure my vasoactive drips are all full, emergency drug box, flushes, syringes.

It's not as crazy as you think. Many hospitals do not allow their ACLS certified nurses to run codes. In many cases the reason that nurses are certified at all is so that they know the process and can anticipate what will be needed to allow the code to run smoothly. In the hospitals I've worked only ACLS certified nurses were allowed to push drugs during the code. We can defibrillate without a physician as long as the LP20 is in the AED mode. I can see in rural critical access hospitals where there often isn't a physician in house that the nurses would be the ones to at least start the codes and many can intubate as well but in cities with large hospital systems and a doctor around every corner the need for nurses to run the codes simply isn't there. Personally, if I have a patient that is so unstable that I feel I need to bring code meds you can be sure I am not going alone and will have a physician along for the fun. I don't need that kind of responsibility. Been there, done that. It's not as fun as it might sound.

I've had to push atropine and epi w/o a physician order in radiology because the radiology doc had no idea what was going on ( he was very focused on emboli zing the massive bleed)

In my facility : you page the doc if things go south in a procedure area and then do what it takes to keep the patient alive until the prescribing provider gets there

It's not as crazy as you think. Many hospitals do not allow their ACLS certified nurses to run codes. In many cases the reason that nurses are certified at all is so that they know the process and can anticipate what will be needed to allow the code to run smoothly. In the hospitals I've worked only ACLS certified nurses were allowed to push drugs during the code. We can defibrillate without a physician as long as the LP20 is in the AED mode. I can see in rural critical access hospitals where there often isn't a physician in house that the nurses would be the ones to at least start the codes and many can intubate as well but in cities with large hospital systems and a doctor around every corner the need for nurses to run the codes simply isn't there. Personally, if I have a patient that is so unstable that I feel I need to bring code meds you can be sure I am not going alone and will have a physician along for the fun. I don't need that kind of responsibility. Been there, done that. It's not as fun as it might sound.

That really sounds like it defeats the whole purpose of having Registered Nurses caring for patients, not to mention the whole point of ACLS.

Maybe, but when you work in an enormous teaching hospital with about a million residents and fellows that's pretty much what you get.