t3_1h3tihp

i work in an endoscopy unit where i do circulating, teching, and pre and post op
i worked in an ED for 2 years prior and i left that field because i was upset with the way my department handled patients and the staff

I have been exposed to critical situations during procedures in my current department where the CRNAs were the ones handling it and it had me missing what i loved in the first place … i miss critical care but i’m scared of the change of going to the icu from a outpatient setting…. 
any advice/ what programs i should apply for for icu?

<div class="md"><p>i work in an endoscopy unit where i do circulating, teching, and pre and post op
i worked in an ED for 2 years prior and i left that field because i was upset with the way my department handled patients and the staff</p>

<p>I have been exposed to critical situations during procedures in my current department where the CRNAs were the ones handling it and it had me missing what i loved in the first place … i miss critical care but i’m scared of the change of going to the icu from a outpatient setting…. 
any advice/ what programs i should apply for for icu?</p>
</div>

icu from clinic nursing

t3_1h3s21e

CVICU nurse of two years here. When I was on orientation, I very vividly remember being told that no IV meds should go through the PA port on the swan, and that port should exclusively be used for draw mixed venous gasses. I have since committed that to law. 

Fast forward to now, I’m wondering why that is? Theoretically, even when you pushing IV meds through the CVP port of the swan, the meds mix with the blood in the RA, but is just going to get pumped through the PA/pulmonary vasculature and back to the left side of the heart anyways. So is it wrong/dangerous to put meds through the PA port? 

Does anyone have any insight about this? Very curious. 

<div class="md"><p>CVICU nurse of two years here. When I was on orientation, I very vividly remember being told that no IV meds should go through the PA port on the swan, and that port should exclusively be used for draw mixed venous gasses. I have since committed that to law. </p>

<p>Fast forward to now, I’m wondering why that is? Theoretically, even when you pushing IV meds through the CVP port of the swan, the meds mix with the blood in the RA, but is just going to get pumped through the PA/pulmonary vasculature and back to the left side of the heart anyways. So is it wrong/dangerous to put meds through the PA port? </p>

<p>Does anyone have any insight about this? Very curious. </p>
</div>

Why can’t you use the distal PA port on a SGC for meds? 

t3_1h2mtwf

When a code is happening, we often want to find the femoral artery using one of those small hand held dopplers. The tips can have different specific ideal depths to locate pulses. For example, a 3 MHz probe is good for a pulse (heartbeat) detection of a fetus, where as an 8 MHz tip is good for superficial radial and dorsalis pedis pulses. What do you use for femoral?

<div class="md"><p>When a code is happening, we often want to find the femoral artery using one of those small hand held dopplers. The tips can have different specific ideal depths to locate pulses. For example, a 3 MHz probe is good for a pulse (heartbeat) detection of a fetus, where as an 8 MHz tip is good for superficial radial and dorsalis pedis pulses. What do you use for femoral?</p>
</div>

Which doppler tip to use for finding femoral artery?

t3_1h1y31b

Hi everyone, I’m a student nurse, and I’m feeling really anxious about handling intubated patients. My biggest fear is that the breathing tube (ET tube) might come out of place or accidentally get pulled up while I’m doing my tasks.

For example, when I’m in charge of draining the tubing, tapping it makes the tube move slightly, and it stresses me out. I’ve also noticed that some tubes are positioned downwards, and the weight of the tubing looks like it could cause the tube to shift or even come out. Is it really that easy for an ET tube to get dislodged?

I want to do my job confidently, but this fear is holding me back. Any advice, tips, or reassurance from those with more experience would be greatly appreciated!

<div class="md"><p>Hi everyone, I’m a student nurse, and I’m feeling really anxious about handling intubated patients. My biggest fear is that the breathing tube (ET tube) might come out of place or accidentally get pulled up while I’m doing my tasks.</p>

<p>For example, when I’m in charge of draining the tubing, tapping it makes the tube move slightly, and it stresses me out. I’ve also noticed that some tubes are positioned downwards, and the weight of the tubing looks like it could cause the tube to shift or even come out. Is it really that easy for an ET tube to get dislodged?</p>

<p>I want to do my job confidently, but this fear is holding me back. Any advice, tips, or reassurance from those with more experience would be greatly appreciated!</p>
</div>

Scared of Handling Intubated Patients as a Student Nurse – Advice Needed!

t3_1h1papi

Hi all! I'm an RN in a mixed CT surgery /cardiovascular medicine ICU. I realized recently that I struggle a lot when my patients need to go on field trips (obviously I go with them) or return from them. 


Ok so the other day: patient was going for a CT scan. Was supposed to be around 1pm, transport was delayed for 2 hours. I was on edge that whole time and didn't feel like I could take a lunch. 


Right afterwards the cath lab called for my other patient. Ok time to transfer them. Exhausting getting them on the travel monitor and disconnected and everything. 


At 630 they come back. It felt so debilitating to land and reconnect them.


I don't know why this is so hard for me. Any advice? 

<div class="md"><p>Hi all! I&#39;m an RN in a mixed CT surgery /cardiovascular medicine ICU. I realized recently that I struggle a lot when my patients need to go on field trips (obviously I go with them) or return from them. </p>

<p>Ok so the other day: patient was going for a CT scan. Was supposed to be around 1pm, transport was delayed for 2 hours. I was on edge that whole time and didn&#39;t feel like I could take a lunch. </p>

<p>Right afterwards the cath lab called for my other patient. Ok time to transfer them. Exhausting getting them on the travel monitor and disconnected and everything. </p>

<p>At 630 they come back. It felt so debilitating to land and reconnect them.</p>

<p>I don&#39;t know why this is so hard for me. Any advice? </p>
</div>

Travelling to CT scans or landing patients after procedures destroys my day. How to improve?

t3_1h193gi

Hello everyone i have a question that might be a bit... nitpicky but it has been bothering me for a while.

  
When using a 5 Lead Monitor ECG we get Lead I , II, III, aVR, aVL, aVF, and V. My question is how do you call 'Lead V'?  
Do you call it 'V' (just pronounce the letter) or do you call it five?  
In my facility (in germany) it's usually called Lead 'five' ('fünf' in german) which feels very wrong to me.  
In contrast to the other leads Lead V is the only chest lead and can be placed in position V1-V6, therefore it should be called Lead 'V' and not 'five' or am i in the wrong here!?

<div class="md"><p>Hello everyone i have a question that might be a bit... nitpicky but it has been bothering me for a while.</p>

<p>When using a 5 Lead Monitor ECG we get Lead I , II, III, aVR, aVL, aVF, and V. My question is how do you call &#39;Lead V&#39;?<br/>
Do you call it &#39;V&#39; (just pronounce the letter) or do you call it five?<br/>
In my facility (in germany) it&#39;s usually called Lead &#39;five&#39; (&#39;fünf&#39; in german) which feels very wrong to me.<br/>
In contrast to the other leads Lead V is the only chest lead and can be placed in position V1-V6, therefore it should be called Lead &#39;V&#39; and not &#39;five&#39; or am i in the wrong here!?</p>
</div>

Question about 5 Lead Monitor ECG Nomenclature

t3_1h0eods

I’m an ICU nurse with about 5 years experience in a medical ICU. Was admitting a patient recently who was intubated, on some light prop, levophed had been turned off about 35 minutes ago.

She started to tank on us, provider (PA) was at bedside to do a quick POCUS to look at her heart. I mentioned laying her flat to help her blood pressure while we were getting the levophed back up and running. PA said laying flat wouldn’t help because she has right sided heart failure.

I guess I’m just looking for an explanation of the patho here. I wanted to ask the PA but we were all very busy with the patient and it wasn’t really the time for a lesson. I’m just looking for some clarity to take into my own practice going forward. Thanks!

<div class="md"><p>I’m an ICU nurse with about 5 years experience in a medical ICU. Was admitting a patient recently who was intubated, on some light prop, levophed had been turned off about 35 minutes ago.</p>

<p>She started to tank on us, provider (PA) was at bedside to do a quick POCUS to look at her heart. I mentioned laying her flat to help her blood pressure while we were getting the levophed back up and running. PA said laying flat wouldn’t help because she has right sided heart failure.</p>

<p>I guess I’m just looking for an explanation of the patho here. I wanted to ask the PA but we were all very busy with the patient and it wasn’t really the time for a lesson. I’m just looking for some clarity to take into my own practice going forward. Thanks!</p>
</div>

Lying supine with right side HF

t3_1h0q55t

Hi everyone, I'm an ICU resident approaching his boards, and I wanted to ask if anyone here has some decent app to recommend as a tool for prepping for a written part? Wanted to buy the Go The Extra Mile app called "Critical Care MCQ's", but they have a limitation of 3 tries per test, so that's kinda not too good. 
Thanks in advance for any help, 
Eugene.

<div class="md"><p>Hi everyone, I&#39;m an ICU resident approaching his boards, and I wanted to ask if anyone here has some decent app to recommend as a tool for prepping for a written part? Wanted to buy the Go The Extra Mile app called &quot;Critical Care MCQ&#39;s&quot;, but they have a limitation of 3 tries per test, so that&#39;s kinda not too good. 
Thanks in advance for any help, 
Eugene.</p>
</div>

Any good EDIC part I preparation apps?

t3_1h0hbqc

What are you preferred ventilation modes and which respirators do you use?

Standard at my place is BIPAP and we use Evita V600s. Before that, we used PC or PS on Servo Is.

<div class="md"><p>What are you preferred ventilation modes and which respirators do you use?</p>

<p>Standard at my place is BIPAP and we use Evita V600s. Before that, we used PC or PS on Servo Is.</p>
</div>

Which ventilation modes and respirators do you use?

t3_1gyvhsv

Hi, I’m a new grad RN looking for outside opinions. So, in my hospital we mainly use fentanyl for sedation. I know it’s a common analgesic and has sedative properties, but is it common for that to be the only form of sedation for vent patients? I thought we would need prop/precedex or something else on top of it.

I only ask because I feel like we often have to use high doses of fentanyl and it never sedates them properly, they’re always super aware and uncomfortable and moving around and pulling things. The RNs and residents here are constantly fighting about what proper sedation should be and I want to hear some other opinions because I don’t have the experience to really know what to say or when to advocate. 

<div class="md"><p>Hi, I’m a new grad RN looking for outside opinions. So, in my hospital we mainly use fentanyl for sedation. I know it’s a common analgesic and has sedative properties, but is it common for that to be the only form of sedation for vent patients? I thought we would need prop/precedex or something else on top of it.</p>

<p>I only ask because I feel like we often have to use high doses of fentanyl and it never sedates them properly, they’re always super aware and uncomfortable and moving around and pulling things. The RNs and residents here are constantly fighting about what proper sedation should be and I want to hear some other opinions because I don’t have the experience to really know what to say or when to advocate. </p>
</div>