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I'm working on an education program on Critical Care Education for ER Nurses. My question is;
What things the you as ICU nurses know that you'd like the ER nurses to know?
for starters I"m working hemodymic monitoring and how to use MAP.
As an emerg nurse I desperately wanted more education on:
- How exactly patients are supposed to be weaned (I had no idea what the RT was doing when they said they were weaning)
- Hemodynamic monitoring (MAP, CVP, Central Line stuff)
- ET tube cuff pressure assessments. (10cc vs less, fistula development, and cuff leaks)
- The expanded neuro assessment
RNFelicity,Sure! The best book (by far) that i have picked up is:
The ICU Book (second edition) by Paul Marino
My preceptor when i first started working in the unit read it and she was one of the smartest nurses i've ever met. They have all kinds of info in this book. Like i say, it's one that the residents usually have to know...so loads of info. It's quite pricey (last i checked around $90.00 or so)...i'd check amazon.com and see if you can find one used. It's very much worth the money though! :wink2:
I just saw the third edition on e-bay for 40 bucks with free shipping and handling
I didn't read every post here, but one thing that makes me grind my teeth about the ER is when they start and IV and attach the primary tubing line directly to the catheter hub and then plaster it down with five pounds of tape because it is in the AC. Dozens of times they have done this with blood tubing which MUST be changed out then the bad is dry, or they hang saline wide open without a pump and then let the bag run dry which leaves us unable to prime a the line when we hang a new bag. It just seems kind of ignorant and lazy to not take the extra one second to attach a J-loop before covering with a tegaderm.
GRRRRRRR
I didn't read every post here, but one thing that makes me grind my teeth about the ER is when they start and IV and attach the primary tubing line directly to the catheter hub and then plaster it down with five pounds of tape because it is in the AC. Dozens of times they have done this with blood tubing which MUST be changed out then the bad is dry, or they hang saline wide open without a pump and then let the bag run dry which leaves us unable to prime a the line when we hang a new bag. It just seems kind of ignorant and lazy to not take the extra one second to attach a J-loop before covering with a tegaderm.GRRRRRRR
What does this have to do with a critical care education program? I know....you're just ranting. It drives me crazy too!
I've been around long enough to be able sort out the need under the ranting. :)
The things I've added so far
how to titrate
Using MAP instead of systolic pressure
Ventilator use (when to call resp) and how to perform oral care on patient
Assessing like an ICU nurse and not an ER nurse
Scheduling medications
Lactulose and Kayexelate. (and how to give a lactulose retention enema)
Why the head of the bed should be at 30% even though the patient still has a c-collar on
Proper packaging of patient and how to set things up to make your life easier
Thanks all
I think it would be beneficial for us to have more insite on ventilators in general. And isolation/percautions. It's crazy how many people come into the ED and it turns out they have possible TB, and have been breathing, coughing, sneezing, etc. in the waiting room, walking into the ED, and the nurse handling them doesn't make them wear masks, or while in their room-doesn't gown up. Ridiculous and Scarey.
I didn't read every post here, but one thing that makes me grind my teeth about the ER is when they start and IV and attach the primary tubing line directly to the catheter hub and then plaster it down with five pounds of tape because it is in the AC. Dozens of times they have done this with blood tubing which MUST be changed out then the bad is dry, or they hang saline wide open without a pump and then let the bag run dry which leaves us unable to prime a the line when we hang a new bag. It just seems kind of ignorant and lazy to not take the extra one second to attach a J-loop before covering with a tegaderm.GRRRRRRR
I don't know about your ER; but, in all the ERs I have worked we put the saline lock/J loop on with every IV start. The ones that do not have them usually come in from EMS like that-especially the ones that seem as though it was a frustrated attempt to use duct tape. I have the same complaint as you regarding this; but, it is directed at the EMS personnel
cvicugirl, BSN, RN
54 Posts
Niiiice. I hope you kept their tech until the postmortem care was complete!