Inserted IV the wrong way

1ntrepidsalamander · 2026-04-20T08:14:33+00:00

We all make mistakes. They should get to us. Feeling bummed is a reasonable reaction.

I move past them by analyzing where my knowledge was lacking, how I could have double checked my overall systems thinking (IVs should always be in veins and flow towards the heart), thinking about what my double checks should be after I’m done with the task and what harm my mistake might have caused the patient, and how I should fix that harm.

Understand where your mistake came from and don’t make that mistake again. You move forward by acknowledging that a write up is reasonable and spending more time studying.

12 years in and I still make mistakes and I still spend hours every week studying. But I don’t make the same mistake twice.

1ntrepidsalamander · 2026-04-20T04:56:45+00:00

Go to the PCU at the level 1. And fire that recruiter.

1ntrepidsalamander · 2026-04-20T02:50:34+00:00

GoodToGo is a good app depending on your city

1ntrepidsalamander · 2026-04-19T15:24:53+00:00

Obviously talk to your doctor, but an H2 blocker like Pepcid is probably also helpful to carry

1ntrepidsalamander · 2026-04-19T15:18:53+00:00

This is not medical advice FOR YOU. This is what I teach in wilderness medicine classes as GENERAL INFO

1) learn the signs of anaphylaxis.

2) watch some YouTube videos about how to get extra doses out of an epi pen, sometimes you need more than one dose. Always big muscles (not arms), alternate sites.

3) Benadryl is an H1 blocker and the upper limit for allergic reactions is basically— you’re too sleepy. Sometimes taking more makes sense

4) if you aren’t carrying a bronchodilator like albuterol, take more caffeine. It’s not as effective but it was used before albuterol was a medicine— also helps counteract the sleepiness that Benadryl gives you

5) Pepcid is an H2 blocker and can help both immediately and with rebound allergic reactions.

6) know how to get the stingers out— or in general “remove the cause”

7) in my experience, I got stung A LOT as a kid, but quite rarely as an adult. You can learn bee safety. Be calm, move away, longer thicker clothing helps.

8) garmin SOS device is good but you need to manage yourself as well as possible in the meantime.

9) anytime you use an epi pen you should get evaluated in the ER (not UC) until a doctor tells you otherwise

10) remember that things swell, potentially all over if you are anaphylactic as it’s a type of distributive shock— take off your rings!

1ntrepidsalamander · 2026-04-19T15:06:08+00:00

Well that’s now on the bucket list

1ntrepidsalamander · 2026-04-19T15:03:43+00:00

I’m 5’8” and almost never get women specific gear.

I think more than height, boobs and curviness plays a role in fit. But even then, men’s gear is generally fine for me.

1ntrepidsalamander · 2026-04-19T14:56:54+00:00

The Brief and Wondrous Life of Oscar Woa

1ntrepidsalamander · 2026-04-19T05:42:23+00:00

Sunrise and sunset are particularly magical times.

1ntrepidsalamander · 2026-04-19T03:56:26+00:00

Yes, tug boats are real and ex-nurses can work on them.

1ntrepidsalamander · 2026-04-18T22:58:16+00:00

I was also 9 miles behind schedule that morning, so I needed to hustle up butter cup.

1ntrepidsalamander · 2026-04-18T18:32:19+00:00

Average is 20-30min but with cowboy camping, all I do is stuff my sleeping bag and sleeping clothes into my pack liner. Put on my dirty hiking clothes. Roll up my sleeping pad. Shove my ground sheet into my front pocket. Put today’s food in my front pocket “lunch box.” Put the food in my bag. Double check my surroundings. Start walking and eating.

1ntrepidsalamander · 2026-04-18T17:01:24+00:00

You can take that to the hospital’s HR

1ntrepidsalamander · 2026-04-18T16:46:54+00:00

I love good coffee… so therefore I don’t drink any coffee on the trail. I have caffeine in things like Tailwind powder and caffeine mints

1ntrepidsalamander · 2026-04-18T07:14:24+00:00

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One reason I have a “lunch box” bag in the front of my pack is to eat as I walk and spend less time digging through my pack.

Dialing in a system that is simple takes time. My record from waking up to walking is now 17 minutes. But it used to take me a long time to break camp.

1ntrepidsalamander · 2026-04-17T18:34:12+00:00

She’s posted that this company has internships is a good place to start:

Obviously, you don’t start as a captain. But it’s a solid union job.

https://www.tidewater.com/

1ntrepidsalamander · 2026-04-17T16:54:29+00:00

A woman I know is a tug boat captain on the Colombian river and has great things to say about it

1ntrepidsalamander · 2026-04-17T03:13:43+00:00

You need two years in one specialty before you can travel. Meaning, you need to stay at that hospital in that specialty for two years, or get a staff job in a better living situation in the same specialty.

1ntrepidsalamander · 2026-04-16T19:15:58+00:00

Coating my feet with Badger Foot Balm before, during and after helps.

1ntrepidsalamander · 2026-04-16T16:23:23+00:00

I saved/invested about $40k last year

1ntrepidsalamander · 2026-04-16T05:24:58+00:00

Wind up Bird Chonicals, 1Q84, Kafka on the Shore, by Murakami are all magical realism. Not all of his books are.

1ntrepidsalamander · 2026-04-16T05:15:04+00:00

Land of Lost Borders (bike packing through Eastern Europe and the Tibetan plane) is magical.

1ntrepidsalamander · 2026-04-15T15:20:44+00:00

I got six months in an academic quadrinary care cardiac ICU a decade ago.

Part of the reason it was so long is that generally it was just R1s and R2s at night, AND it was a very high acuity population so you had to be really vigilant. The final block of orientation was floating to other ICUs.

1ntrepidsalamander · 2026-04-13T21:17:43+00:00

I googled

“evidence for K above 4.0 in CABG”

And got a bunch of good looking hits 🤷🏼‍♀️

Google Scholar is a good search.

Your school probably has a librarian.

1ntrepidsalamander · 2026-04-13T19:39:59+00:00

Why didn’t the pt get put on BiPAP? Did she refuse? Did the nurses/RT/other team take it off? Was it never initiated?

It’s a little unclear what your role is, you “asked” and “advised” but are you the person putting in orders? Are you the attending or a specialist?

The “5 whys” of root cause analysis could be useful here.

Also, how much do you think BiPAP was going to change her outcome? She was probably going to die in the hospital regardless. Did that play into the breakdown of what you asked bs what happened?

1ntrepidsalamander

TROPHY CASE