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Tag: holiday

GIFT GUIDES

Holiday Gift Guide 2018

December 13, 2018December 13, 2018by Kirsten BSN RNLeave a Comment on Holiday Gift Guide 2018
Holiday Gift Guide 2018

    I have been so busy with school and work over this past semester and I am so glad to finally have some time to buy gifts for my loved ones!  Although there is no substitute for quality time spent together, I have curated this list of some of my favorite products perfect for [...]

GIFT GUIDES

Holiday Gifts for Your Favorite Nurse

December 14, 2017December 13, 2018by Kirsten BSN RNLeave a Comment on Holiday Gifts for Your Favorite Nurse
Holiday Gifts for Your Favorite Nurse

I am sitting here wondering where November went and how it is already December with Christmas right around the corner.  Over the past couple of weeks I have curated a list of gifts perfect for the medical professional or student in your life, and I have to say I am struggling to not go out [...]

About Me

 

Welcome to The Emergency Nurse, a nursing and lifestyle blog!  My name is Kirsten and this blog is a personal insight as I explore working in a busy level 1 trauma center: coffee, codes, and 12h shifts.  Please feel free to contact me!  I love hearing from you!

Recent Posts

  • Case Study: SVT Management January 11, 2019
  • Holiday Gift Guide 2018 December 13, 2018
  • Tips to Surviving Night Shift November 15, 2018
  • 10 Ways “Bedside Manners” Can Make You A Better Nurse June 8, 2018
  • Free Nursing Resume That Will Make You Land The Job April 30, 2018

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This lovely get up right here is the PPE we wear when caring for a patient with suspected Ebola. Although the facility I work at is not the primary location in my city for Ebola patients, patients can show up at any emergency department, requiring all emergency department staff to be prepared. . How do we determine who is potentially at risk? Patients are first identified by our triage RN by asking if the patient has had any international travel to an Ebola epidemic country such as Congo, or Uganda in the last 21 days or contact with an individual who has been diagnosed with Ebola virus (such as nurses, aid workers), and is exhibiting bleeding, vomiting, diarrhea, or fever. Once the patient is designated as a “person under investigation” they are moved to isolation. . At this point the DHHS is contacted and the Ebola team is notified. The Ebola team is a group of individuals who have been specially trained on how to appropriately care and transport potential Ebola patients. A minimum of 3 staff members is needed at a time and rotate patient care every 4 hours; one to actually care for the patient, one to assist in putting on the PPE, and one to act as an observer who makes sure that there are no breaks in PPE. . Ebola is spread through direct contact with blood or body fluids that can enter through breaks skin or unprotected mucus membranes, therefore PPE must fully cover all skin, eyes, mouth, and nose to prevent exposure. Applying this type of PPE is a multistep process requiring multiple layers including impermeable surgical/isolation gown, N-95 or PAPR mask, disposable scrubs, close toed crocs (washable foot wear), disposable boot covers, 2 pairs of disposable examination gloves, surgical hood with full face shield, and disposable apron. The layers allow nurses to remove soiled layers without breaking PPE, however this also makes it extremely hot and more difficult to do things such as start IVs. . It's estimated that 18 RNs are needed to care for one Ebola patient for one week, and everyone involved in their care is followed by the health department for 21 days folowing their last potential exposure. Would you want to join the Ebola team?
Happy #MedicationMonday today we have Cardizem or Diltiazem. This medication is a calcium channel blocker, so it inhibits the influx of extracellular calcium ions across the myocardial and vascular smooth muscle cell membranes during depolarization causing relaxation and vasodilation of the heart. This gives Diltiazem its negative inotropic, negative chronotropic, and dromotropic properties. Diltiazem is commonly used to treat hypertension, angina, and certain heart rhythms such as atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia. In the ER, I would say we most commonly give Diltiazem to patients experiencing atrial fibrillation with rapid ventricular response (RVR) in order to achieve rapid rate control. We typically give a loading or bolus dose of .25 mg/kg IV then begin a continuous infusion that can be titrated up or down depending on the patients response. Patients must be on cardiac monitoring during the administration of this medication! This medication should not be used on patients with hypotension, or those with heart conditions such as sick sinus syndrome or a second or third degree heart block. Grapefruit juice should also be avoided when taking this medication. Common side effects included slowed heart rhythm, palpitations, feeling light headed, shortness of breath, headache, and dizziness. What conditions have you given Diltiazem for? Comment 👇🏼
Pedestrian vs vehicle accident. What are we looking at here? What type of fx is shown? What is your treatment plan?
“For those who are afraid to become a nurse because they have a weak stomach, It won’t be the vomit or needles or blood or urine or feces that turns your stomach. You’ll get used to that. You’ll come to accept it’s just part of the job and get to the point where you’re thinking of the 38 different things you have to do while absentmindedly cleaning up a bowel movement. What will turn your stomach will be 40 shallow breaths a minute in a patient in respiratory distress. A freshly born infant that is limp and blue and hasn’t cried yet. Tripled troponin levels on your sweating and anxious patient as you realize they’re having a heart attack. Feeling cord during a cervical check, then trying to hide from your patient the shaking in your voice as you call for help. The pale skin of a Jehovah’s Witness with a hemoglobin of 4 as she declines a blood transfusion and says goodbye to her family because they haven’t found the source of the bleed and she’s running out of time. A blood alcohol level of .18 on a 4 year old who is barely responsive and being intubated after getting drunk on mouthwash and then hitting his head. An elderly woman in the ICU signing her DNR while her sobbing daughter begs her to reconsider, knowing if treatment is stopped then her mother will die. A child in the pediatric ICU who hasn’t had a visitor in months. Not being able to find the heartbeat on a pregnant mom who hasn’t felt the baby move in a while. In the face of everything else that comes with being a nurse, I promise you’ll get used to the poop.” - Andrea Pellerin
Happy #MedicationMonday today we have Zosyn! Zosyn is an antibiotic made of semisynthetic antibacterial piperacillin sodium and β-lactamase inhibitor tazobactam sodium, giving it its generic name of piperacillin and tazobactam. Zosyn works by inhibiting septum formation and cell wall synthesis of bacteria. Zosyn works against gram positive and gram negative aerobic and anaerobic bacteria making it a broad or extended spectrum antibiotic. Zosyn is used to treat patients with severe infections such as cellulitis, pneumonia, and appendicitis. In the ER we often give it as a first line antibiotic to septic patients because of its broad spectrum while we wait for their blood cultures to result so a more specific antibiotic can be chosen. What conditions have you given Zosyn for? Comment 👇🏼
This is the med sled, it is used to evacuate non mobile patients from hospitals, but is being used my EMS, schools, police, etc.! Think about it, how would you get non mobile patients on the 6th floor out of the hospital in case of emergency? The elevators would be down and it’s not feasible to give everyone piggy back rides! That’s what med sleds are for! They utilize a system of pulleys to safely lower a patient down a stairwell and to safety. The system requires at least one person to work the pulley and can hold up to 1000 pounds! The sleds also come in bariatric, pediatric, and infant size! If the patient is on oxygen or vented a tank can be sent down with the patient and IV solutions should be stopped and sent down or discontinued. The entire process of getting a patient down one flight of stairs should take about 10 seconds, and requires immense cooperation from every floor and those waiting at the bottom of the stairwell. I hope we never have to utilize this tool but I definitely feel better being more prepared! Do you have any questions about med sleds and do you have these at your facility? Comment 👇🏼

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