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Tips 'n Tricks: Pearls the Newbies Need to Know

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Specializes in being a Credible Source. Has 11 years experience.

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency. Has 21 years experience.

If you have a trauma coming in, go pee. You may be busy for the next 3-6 hours, or more.

Yeah, same for cpr in progress, code stroke, etc. when you get told medics inbound to you, hit the restroom.

Remember your ABCs!

do you repeat pain assessments and vitals

watch out for abnormal labs a try to let the dr know about it

it's better to go a little slower at first, than to cut corners...

As much as possible, before you go to the doc about a patient, be prepared with a request for what you think is appropriate.

Be ever mindful of their teeth, nails, fists, and feet.

Loose restraints are worse than no restraints... if they need to be restrained, they need to be restrained well.

If you have to pin them down, pin across the articulating joints.

Know where are your spit masks... and double them up if they're real spitters... the experienced ones know that they can spit on a single layer and then blow it through onto you (I learned that the hard way.)

If you know a code or seriously sick pt is coming in, have a snack and a pee.

Then, prep the room.

check o2, suction, supplies, etc.

And, if possible, remove extraneous furniture, and make sure you have easy access to a laundry basket, large garbage bin, and biohazard bag.

I am not especially neat, but all the crap that ends up on the floor is a hazard.

bvalerio23

Has 2 years experience.

Coming from a tech--

Not all techs are good, some are meant for the floor, some are natually built for critical care. If you have a feeling your tech is not going to be satisfactory, address is professionally and within the correct channels. Telling other RNs that so-and-so tech isn't qualified or isn't good just turns ALL techs against you. We can make your shift a breeze, or we can **** off a patient before you even get in an assessment, loose blood, etc.

Another point to make is that most techs are not offended if you ask us to do something/ask us to stop doing something. Some RNs don't want techs starting IVs, and that is okay - its a preference thing. Some RNs rely on techs to an absurd amount to the point that it comes off as laziness. Just as RNs have their favorite Nurse Managers or Charges, techs have their favorite RNs and some they resent to work.

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

I had to take a pt to a tertiary care center last night and the medic put all of the IV bags on a carabiner and hooked it on the pole. I thought it was genius because there was no fumbling with multiple iv bags.

LadyFree28, BSN, RN

Specializes in Pediatrics, Rehab, Trauma. Has 10 years experience.

Keep em' coming-from a "newbie" coming into the ER! :up:

Any specific tips for a Pedi ER? :shy:

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

Let mom hold the little one in her lap and give the albuterol neb as a blow by with a blue circuit.

Kids need about twice as much versed as adults to be sedated. That's a little scary when you do it the first time.

Try once then place the IO.

My peds experience is very limited.

Lev, BSN, RN

Specializes in Emergency - CEN. Has 7 years experience.

From Adult ED

Always stay in the room when giving SL nitro for the first time - it can really drop that pressure!

When giving a new EKG to the doc, print out an old one for comparison

Any complaints of dizziness, suspicious abdominal pain, tachycardia, any history of arrhythmias, history of MI or cardiac issues, suspicion for stroke, syncope, HTN, electrolyte issues etc goes on the monitor. It's there, so you may as well use it.

When in doubt, transport your patient yourself

Make sure your IV aspirates before giving rapid flush after adenosine. Also helpful to use a stop-cock and attach syringe with 20-30 cc NS to one end. Another body doesn't hurt to man the flush.

Also good to set up your monitors to cycle BP q30 minutes for ESI 2s and up. And check alarm limits!

Edited by Lev <3

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

Ask do you take cialus levitra or viagra before giving nitro.

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

Know how to work the biphasic. Know the placement of the pads for defib vs pacing and cardioversion(front and back)

Also know how to set up a chest drainage system

look at the veins that appear with the bp cuff inflated. Use kelly clamps and gauze to clamp the nibp tubing and pop in an iv.

icuRNmaggie, BSN, RN

Specializes in MICU, SICU, CICU. Has 24 years experience.

Put the lady on an upside down bedpan to see the meatus and ask her to cough.

males need lido jelly for foley insertion. Hold it in there for three minutes to numb the

urethra. Use a 14 if the man has a narrow meatus.

Sedative before paralytic in rapid sequence intubation.

LJ85, ADN, BSN, CNA, LPN

Specializes in Hospice/Infusion. Has 13 years experience.

FYI if you wear danskos or other patent leather finish shoes those wipes will wipe the finish right off