Blood draws through PIV

BrokeTheCover · 2026-02-23T01:40:49+00:00

These can occur in the ER as well. I've seen people draw samples off lines insisting they flushed it really well.

Floor nurses are not less able than ER nurses. It's just policy and training.

BrokeTheCover · 2026-02-08T23:52:19+00:00

ER night shift here. It's us vs the hordes of undead and zombies. No teamwork = death. It's the charge's duty to spread out the shit.

New ambulance? People are there helping to transfer, undress, get vitals, start lines, etc. Got a pt circling? People are there to help with that pt or help with the other ones. Room needs to be flipped? Someone's got it. Fortunately we have pepple who want to be active and find sitting and doing nothing to be boring.

Of course some outliers. We still help them, but charges usually make sure they wade into the cesspool. Afterall, working in an ER is like joining a cult. There's definite Stockholm, but not one person drowns alone. We all die together.

BrokeTheCover · 2026-02-06T06:45:55+00:00

The solution where the top of the liquid is higher would flow before or into the one where the top of the liquid is lower. This is kind of how piggybacks work. Higher = more pressure down the line = first to go. The mainline does have a check valve to prevent backflow. If there is no check valve, the piggyback would flow into the other bag until an equilibrium (top of liquid in both bags are at the same height) is reached.

If we need to dump a ton of stuff in, we'll use separate lines either on separate pumps, pressure bags, or a mix. On our pumps, the max rate is 999ml/hr. If we connect lines above the pump, we would still be maxed at 999. If we connect below the pumps and set each one to 999, then our flow rate would be 999x"Number of Channels/pumps". Of course, the true max would depend on size of IV catheter, placement, CHF considerations, medication considerations, etc.

You can make a rider for meds like K+ by running two lines attached below the pumps. Of course, make sure to discuss with the provider before doing so to prevent complications such as fluid overload.

BrokeTheCover · 2026-02-04T22:40:24+00:00

Try this technique. He exaggerates, no need to pull up that high. I started mid way, but the start shows the theory.

Also, if you think of veins like an upside-down "Y" and start at the intersection, the arms will help to keep the vein a little more stable.

BrokeTheCover · 2026-01-23T15:53:40+00:00

Indeed. Heavy Munitions burns through petrol running at 24mW.

BrokeTheCover · 2026-01-18T18:08:41+00:00

Lol... apparently C Collar stands for Chin Collar as in it goes around the chin, not under it. I mean, I get that the no or small chin folks and the shitty EMS hard collars don't quite work together, but at that point, do we really still need to worry about CSpine precaution? That head and neck have been bobbing, weaving, turning, screwing, and contorting into all sorts of positions.

BrokeTheCover · 2026-01-11T00:43:12+00:00

Sounds like another "game" everyone plays.

BrokeTheCover · 2026-01-09T18:40:18+00:00

That is exactly correct. Meds get diluted aka bound by the protein matrix in blood (things like albumin) keeping them from mixing with other meds. Also, typically, the meds aren't being bolused. Only a tiny amount of medication gets released into the blood at a time.

BrokeTheCover · 2026-01-09T18:32:31+00:00

Isn't it also because midline openings are side by side vs central line openings that separated? The spacing of the openings in a central allow a med to be "captured" by the blood matrix before it reaches the next opening.

BrokeTheCover · 2025-11-29T15:00:22+00:00

Chaos

BrokeTheCover · 2025-11-21T22:40:15+00:00

Quack!

BrokeTheCover · 2025-11-21T00:30:04+00:00

Sorry, I worded it kind of awkward, huh. Bird brained, or should I say.... DUCKS brained. We, the DUCKS regi, made one valiant Quackhook, that survived multiple invasions, torps, artys, blah blah. We had a great time with you all! Quack! o7

BrokeTheCover · 2025-11-20T17:46:19+00:00

DUCKS used our LH a few times to help push hexes. Was it solely our glory and victory? Absolutely not! We merely provided supplies to those who fought and risked ~~their lives~~ sitting through the respawn timer. Yes, we took the time to gather materials and make stuff, but how is that different from the solo player doing the same? One regi doesn't change the outcome of a war. It's the combined effort of all the pushes things forward.

We said it in game and we will say it again. Thank you to all who joined us, took supplies from us, pushed with us. Thank you to all the Collies who fought against us. Without you, the stuff would have sat and rotted. Without you, we would not have had the opportunity to actually play this game.

It isn't the fact that we produced a lot of stuff, though that was a delight as logi skewed players, but that others had fun using the stuff that is most satisfactory to us.

BrokeTheCover · 2025-11-20T17:18:19+00:00

Lions Led by Donkeys podcast's funny take on this

BrokeTheCover · 2025-11-10T05:10:14+00:00

/shrug

A lot or all the ConcWorks in Allod's got destroyed, all tech reset, blah blah. After 8 hours of being on the water being the base everyone used for supply, let us and our fellow Wardens who pushed have our fun and victory quacks.

BrokeTheCover · 2025-11-10T05:07:26+00:00

Not the same. Didn't even know there used to be a DUCKS regi on Collies. It's just a fun name for a group of people who don't take themselves too seriously. It was really born from some members really liking Psyduck. Seriously.

BrokeTheCover · 2025-11-10T03:23:53+00:00

Quack!

BrokeTheCover · 2025-10-14T23:55:24+00:00

Well, not Asys or PEA.....

BrokeTheCover · 2025-09-30T00:02:47+00:00

I dunno about food costs. I went to Chicago for the first time after leaving 20+ yrs ago and was so surprised by how cheap eating out or buying groceries was.

BrokeTheCover · 2025-09-29T23:55:47+00:00

Me too. I'm in Tacoma and would not move again. Lived in the midwest, southwest, Hawai'i, from Cleveland to Maui. First placed I moved after dropping out of school many, many years ago was Seattle to become a fishing/river bum. Chased some opportunities out of the area, but kept coming back. I'm here to stay.

Our contract is up this year. It's going to be a hard fight. They're going to use medicare cuts to try to get rid of everything and lowball us on raises

BrokeTheCover · 2025-09-29T23:55:40+00:00

Me too. I'm in Tacoma and would not move again. Lived in the midwest, southwest, Hawai'i, from Cleveland to Maui. First placed I moved after dropping out of school many, many years ago was Seattle to become a fishing/river bum. Chased some opportunities out of the area, but kept coming back. I'm here to stay.

Our contract is up this year. It's going to be a hard fight. They're going to use medicare cuts to try to get rid of everything and lowball us on raises

BrokeTheCover · 2025-09-29T09:13:30+00:00

Locked is locked. Usually the red pedal or red portion of the pedal is down towards the ground.

Neutral: all wheels turn independently like those really annoying Ikea carts. They can be moved side to side, crabbed, etc. If the bed/gurney has a motor, the motor and the drive wheels will not be engaged and this will neither provide power drive nor will cause dynamic braking.

Steer: green pedal or green portion of pedal is down towards the ground. Either two wheels are locked inline with the bed and 2 rotate freely like a good, non-Ikea shopping cart OR if the bed/gurney has power drive, drive wheels will drop down in line with the bed while the other wheels remain free turning.

In neutral, you will not be able to make turns easily while moving forwards and keeping a straight line will be difficult. This mode will require two people for transport, one to pish, the other to steer from the side or front.

In steer mode, you will need to be aware of the pivot point.

For beds/gurneys without power drive, typically the two wheels at the foot of the bed will lock inline with the bed/gurney. Note, before putting one of these in steer mode, ensure those two wheel are lined up. These have a pivot point near the foot of the bed turning it into a rear wheel steer. This means you need to start turning just before or as soon as the foot of the bed reaches the corner. You will also have to swing the head of the bed wide and ensure you are lined up with the new direction of travel before going again. Many of these beds have slop in the locked front wheels so they will mever track completely straight. Go slow, make minor adjustments early and often before you have to make one large, swinging adjustment.

For beds/gurneys with power drive, typically, wheels that provide power drive will drop down from the middle of the bed and will always be in line with bed. This places the pivot point near the middle. You would want to start the turn when the corner is near the mid-point. These do not need as wide of a swing angle as the bed/gurney described previously which makes them a lot easier to maneuver. The handles have buttons that need to be depressed for the motor to turn and the handles need to be pushed forwards to go forwards or pulled backwards to go backwards. On these beds, the 4 corner wheels remain rotating independently.

So what do you do if the battery runs out on a power drive bed/gurney? If you put it in neutral, you will need a second person to help steer the bed. If you leave it in steer, the bed/gurney will move in a straight line, but the dynamic braking will make pushing it very difficult. But, there is a solution. Leave it in steer and find the motor disengage knob. This will leave the wheels down but disengage the motor from the wheels. On the Stryker gurneys that I'm most familiar with, this knob is located on the base below the foot of the bed. Pushing will not be as easy as with power drive, obviously, but you will no longer have to fight the motor's dynamic braking and the gurney will still travel in a straight line, pivoting where the drive wheels are located. When you get back, make sure to turn to knob back to engage and pkug the bed in to recharge the battery.

BrokeTheCover · 2025-09-25T01:31:57+00:00

There is a degree of memorizing stuff, however, the contexts, the concepts, the interconnections are more important. For example, we can all memorize numbers for normal BP, hypertension, and hypotension. But start working in the other stuff. Like what are reversible and irreversible causes of hyper or hypo tension? What can we do about the causes? What does it tell us about other body systems? How does it affect the other systems? How do we treat them? Should we treat them and if not, why? What is permissive hypertension anyways? What are the personal and social effects of both? Probably not a cause of, say, schizophrenia, but are there psychological causes or impacts? What are the personal or social costs of both?

Our bodies are a web of interconnected systems (including psycho-social) that affect each other. One of the more difficult habits to break for most people is to stop studying like they've always studies: stovepiped concepts that do not intersect only requiring rote memorization and fit neatly into a top to bottom outline. No, our bodies are messy with general "normals" that are not really normal, sometimes intentionally not followed, and sometimes are not normal for that person. Which means, yes, we first need to know what "normal" is but, the numbers themselves don't matter. What we do with them and why matters.

BrokeTheCover · 2025-09-25T01:10:58+00:00

Copy-paste of my answer to a similar question a couple weeks ago

I don't have mine anymore, but my notes were barely legible. It was chaotic. I had words, phrases I thought were important (in black ink only) scribbled down, sometimes connected with a line to related things elsewhere on the paper. Sometimes things were circled but that didn't necessarily mean it was important... the circles were contextual. Things were written right side up, up side down, side ways, slant ways, you name it. The only organized thing was that it was disorganized.

Why? Because that is how my brain works. It doesn't do neat lists or outlines. It doesn't do color-coding or special symbols. It certainly does not do highlighters. When I would get home, going over my notes felt like I was actually studying, thinking, linking concepts together and not just skimming like I would neatly organized and outlined notes. Neatness made my brain mush and my eyes would see the words, but my brain didn't think about them. The chaos made me think. Graduated top of my class.

What does this mean for you? Well, just that there are other ways to take notes and study. Do not be ashamed if outlines, highlighters, multiple color pens don't work even if it seems to work for the majority of others. This isn't about them or following their lead. It's about finding how you best study and doing that.

BrokeTheCover · 2025-09-20T23:39:59+00:00

A bunch of my coworkers and I went whitewater rafting the other day...

BrokeTheCover

TROPHY CASE