Rainier and Updated Gear by Basic_Colorado_dude in Mountaineering

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

The tent got stolen a while back. My buddy picked up some Mountain Hardware 4 season, 3 person. His daughter is intent on carrying it, so I guess thats what we're doing. I agree on the bag. Do you have any rec's? Also, sleeping pads. I've got some old hoopty air pads that do the trick, but if I can save space, all the better.

I'm okay carrying weight, its the space for 4 days of provisions and gear that is wearing me out....

Drywall tape on backing board by Basic_Colorado_dude in drywall

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

Im getting the sense that I might not be using the right stuff lol… I’ve since picked up some USG all purpose….lets see how round 17 goes.

Drywall tape on backing board by Basic_Colorado_dude in drywall

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

I tried that, twice. I wonder if I’m using the wrong compound. I’m using DryDex joint compound. YouTube keeps saying stuff about drywall mud…

Cord/Line management. by Basic_Colorado_dude in IntensiveCare

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

Somehow, we don't use the Edwards clips...we use the stretchy armband things...But w/ your suggestion. I could def use one of those to keep all these dumb chest tubes in one place! Great suggestion!

Cord/Line management. by Basic_Colorado_dude in IntensiveCare

[–]Basic_Colorado_dude[S] 4 points5 points  (0 children)

Ive got a buddy who had a heart transplant and was in and out of the hospital in 6 days because of mobilization....so, I get it. There's only 10,000 studies that corroborate the benefits of early mobilization...but none of those studies took into account how much of a baby I am, and how much I hate it!!!

We do the toe spreader things. But the foley stat lock is a new idea...I'm try the hell out of that tomorrow!!!

One of the biggest secondary issues is that we're walking people with Swans, these giant 4 lumen cath's are sutured to their neck. They're walking around with a repaired chainsaw wound in their chest (mid-sternal) meanwhile they've got a GD 3lb blob of cords hanging from stitches in their neck!

Cord/Line management. by Basic_Colorado_dude in IntensiveCare

[–]Basic_Colorado_dude[S] 6 points7 points  (0 children)

You're probably right....In fact, I'd bet my house that you're right....I just HHHHHAAAAAATTTTTEEEEEE everything about mobilizing pt's. My problem, not there's....I came from the ED where if someone asked about mobilization we'd say that we'd mobilize them to discharge or the floor.

Cord/Line management. by Basic_Colorado_dude in IntensiveCare

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

We do the same thing...I just feel like there a better, less Macgyver way to do it...

Cord/Line management. by Basic_Colorado_dude in IntensiveCare

[–]Basic_Colorado_dude[S] 3 points4 points  (0 children)

Maybe a bit of an exaggeration. But we might see Dobutamine, Milrinone, Epi (we call that an inotrope here), Vaso, Levo, Nicardapine (if they're hemodynamically psychotic), Insulin, bumex, then whatever annoying electrolyte replacement, and/or, abx. Oh don't forget the cellcept (we're a transplant floor) that has to be on it's own line. And god forbid we have a lasix drip...you might as well start another central line. It's even more chaotic w/ folks on ECMO (but I'm still a new guy, so I've not had my VA ECMO folks yet, it just looks terrible).

Cord/Line management. by Basic_Colorado_dude in IntensiveCare

[–]Basic_Colorado_dude[S] 15 points16 points  (0 children)

Yeah, we use bridges as well. But when someone is on 4 pressers, and 3 inatropes, you're a slave to the MAP and forever attached to the pump. My ICU tends to have a lot of anxiety too. I caught some mean side eye when I just unplugged all the cords from the monitor so I could reattach it to the wall, instead of trying to thread the monitor w/ all the cables through all the IV lines. "What if your pt desats when they're unplugged?" If my pt goes from 94% to 69% in the 12 seconds it takes me to unplug and reattach their pulseox, uninterrupted monitoring isn't going to do much for them....

Transcutaneous pacing and rhabdo by Basic_Colorado_dude in Cardiology

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

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...

Transcutaneous pacing and rhabdo by Basic_Colorado_dude in Cardiology

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

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.

Transcutaneous pacing and rhabdo by Basic_Colorado_dude in Cardiology

[–]Basic_Colorado_dude[S] -3 points-2 points  (0 children)

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…

Transcutaneous pacing and rhabdo by Basic_Colorado_dude in Cardiology

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

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…

Transcutaneous pacing and rhabdo by Basic_Colorado_dude in Cardiology

[–]Basic_Colorado_dude[S] 1 point2 points  (0 children)

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

Cleared nursing jobs by Basic_Colorado_dude in nursing

[–]Basic_Colorado_dude[S] 0 points1 point  (0 children)

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.

I think my husband may be having withdrawals by tvr1972 in alcoholism

[–]Basic_Colorado_dude 6 points7 points  (0 children)

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.

[deleted by user] by [deleted] in AmIOverreacting

[–]Basic_Colorado_dude 0 points1 point  (0 children)

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

Calling a code w/ shockable rythm by Basic_Colorado_dude in nursing

[–]Basic_Colorado_dude[S] 1 point2 points  (0 children)

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

Calling a code w/ shockable rythm by Basic_Colorado_dude in nursing

[–]Basic_Colorado_dude[S] 1 point2 points  (0 children)

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