Things you'd like the ER to Know

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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.

Specializes in STICU, CVICU, Flight.
I actually had a patient rolled in on top of a body bag...lmao

They say it "skews" their numbers if the pt dies in the ED...well, I guess if they leave the body in the ED...lol

Niiiice. I hope you kept their tech until the postmortem care was complete!

Specializes in Emergency.

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

Specializes in Not too many areas I haven't dipped into.
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

Third edition??? Oh man, i didn't realize it was out! Snatch that one up my dear! :) Great book...

Specializes in MICU.

I bought the second edition of Marino's book for five bucks several times from used book stores. If you are just starting out, I think the second edition is more than adequate.

Specializes in MICU.

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! :D

Specializes in Critical Care, Emergency, Education, Informatics.

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

Specializes in ED, Geriatrics/Alzheimers, Peds.

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.

Specializes in MICU.

I admit that IV thing was a rant, but it does speak to a bigger issue of considering the next step and thinking about a continuum of care. Maybe just instill the idea to think, "What would I want on this pt if I had to stay with and manage him for the next 12 hours?"

Specializes in ED, ICU, PACU.
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

Specializes in CVICU.

I used to work in the ER, and they put IVs in people's ACs all the time, not just on critical patients. This is a huge pain in the orifice when the patient gets upstairs and their IV pump beeps every 5 minutes when they bend their arms. There are other veins :)

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