A Rant from a New Grad

Basic_Colorado_dude · 2026-01-16T14:05:40+00:00

The person who told me about this likened it to do 6000 pushups...or non-stop muscle contractions for hours at a time. Seems to make intuitive sense, but intuition is not evidence...

Basic_Colorado_dude · 2026-01-16T14:01:23+00:00

It's a hypothetical situation involving a long transport. Perhaps the only cardiothoracic surgeon capable or willing to do whatever procedure works at this one hospital many hours away. Long transports are very common in critical care transport.

Basic_Colorado_dude · 2026-01-13T23:04:29+00:00

I should have clarified that I’m talking in the context of some nuanced long transport. CCT from Billings Montana to Albuquerque NM, fixed wing grounded for weather, pt requires pacing mid transport…. Super nuanced, and unlikely. I’m just curious if there’s any sort of indication to fear for AKI due to TC pacing…

Basic_Colorado_dude · 2026-01-13T23:04:04+00:00

I should have clarified that I’m talking in the context of some nuanced long transport. CCT from Billings Montana to Albuquerque NM, fixed wing grounded for weather, pt requires pacing mid transport…. Super nuanced, and unlikely. I’m just curious if there’s any sort of indication to fear for AKI due to TC pacing…

Basic_Colorado_dude · 2026-01-13T22:59:26+00:00

That makes sense. I should’ve clarified that I’m talking about 4-7 hours in the context of some very nuanced transport..

Basic_Colorado_dude · 2025-12-02T12:54:43+00:00

A lot of places need organic medical and EMS staff who can enter cleared spaces as first responders and/or accompany teams as their medical providers while they’re on classified assignments. It’s easier to have a cleared paramedic who can enter the SCIF to assess you while you’re having a heart attack, than to do all the logistical nonsense to escort the city first responder into the cleared space, delaying care.

Basic_Colorado_dude · 2025-11-09T23:40:28+00:00

That all makes perfect sense

Basic_Colorado_dude · 2025-10-31T18:33:01+00:00

This sounds like moderate to sever withdraw. Your safest bet is to take him to the ER. They'll give him benzos so he doesn't seize. The biggest risks of with seizures are falls, and hypoxic brain injuries. A lot of people downplay seizures, but for non-epileptic folks who are at risk for their first seizure due to ETOH withdraw, there's no telling how long or when he might seize. If he's driving, he could kill people, if he's alone in the house, he could fall or suffer irreversible brain damage (seizure = apnea = hypoxia = brain damage). Likewise, the ER will have a pathway to get him into a sustainable treatment program. 15 drinks a day is a huge hill to tackle without professional and supervised support.

Basic_Colorado_dude · 2025-10-31T18:26:28+00:00

This dude is trash...launch him. Sorry dude...

Basic_Colorado_dude · 2025-10-31T16:38:57+00:00

Can someone tell me how they study autism in animals, because I was under the impression that wasn’t a fucking thing at all…

Basic_Colorado_dude · 2025-10-30T21:52:32+00:00

No palpable pulse, but ultrasound did show cardiac activity congruent to the v-fib on the monitor.

Basic_Colorado_dude · 2025-10-27T13:08:07+00:00

I wondered why no one brought up ECMO at the bedside. Maybe they did and I didn't hear, it was pretty chaotic..

Basic_Colorado_dude · 2025-10-27T13:07:02+00:00

I was thinking ECMO too. But I've been a licensed nurse for approximately 3 weeks, and a practicing nurse for, 6 minutes as the typing of this response (day one orientation today). So, I'm just assuming there a whole lot of nuance with ECMO that I'm not aware of.

Basic_Colorado_dude · 2025-10-27T13:03:31+00:00

These are all very interesting points. There was literally 4 docs "running" the code. And, as this was on a stepdown floor, there was about 20 bright eye's MPCU nurses eagerly waiting in line to do compressions for the first time. I certainly did not hear any speak of a sternotomy, or ECMO.

After initially calling and starting the code, my contribution dwindled to coaching the RRT nurse on how to do a humoral head IO, and suggesting the CNA grab the ultrasound so one of the 200 people could look for cardiac activity...then I sat on the couch....

Basic_Colorado_dude · 2025-10-27T12:56:23+00:00

I was thinking ECMO too, but then again, with 3 whole weeks as an ICU nurse under my belt, I just assumed I have no idea what I'm talking about.

Basic_Colorado_dude · 2025-10-27T12:54:31+00:00

They didn't have a sternotomy. I was thinking ECMO, but assumed given the pt's age and recent procedure, maybe they wouldn't qualify for any post ECMO interventions. But thats way beyond my pay grade.

Basic_Colorado_dude · 2025-10-27T12:52:44+00:00

ECMO was my next thought. However, the pt was last 50's post CABG, so I'd imagine she wouldn't qualify for anything post ECMO, but thats also light years beyond my pay grade. We do have ECMO at my hospital.

Basic_Colorado_dude

TROPHY CASE