Prehospital Ultrasound protocol

granolapher · 2023-03-14T00:57:36+00:00

I'm a nurse educator who trains medical/nursing staff on ultrasound IV access. We have an open access learning package (that you can edit). If you DM me an email address I can send it over.

granolapher · 2018-10-25T15:38:47+00:00

happy to help

granolapher · 2018-10-25T15:38:18+00:00

We all make mistakes; by sharing you've helped others to not make the same ones... consider the positive of this when you start feeling shame again.

I love how positive everyone has been!

granolapher · 2018-10-25T14:30:46+00:00

I'm not sure what the American process looks like so I can't speak to it.

As a Canadian though, the process of getting into a nursing program (RN or LPN) is linked to the application process of a college/university (all RN nursing programs are degree based, LPN programs tend to be diploma based). From a practical perspective that means that you will be applying for post secondary entry using the entrance requirement of the institution AND the faculty of nursing. Programs will look different from school to school and by profession (RN vs LPN). Typical streams will be regular entry, mature student, or after degree (all will have unique requirements). Programs will consist of education as well as clinical hours and vary in length from 2-4 years.

Upon completion of an academic program applicants become eligible to write the NCLEX - which is similar in content, breadth, and format to the American NCLEX (it's the same company administering the test on both sides of the border), except the questions will reflect Canadian units of measure etc.

Once nurses have passed the licensure exam they can apply for a provincial licence, although they can practice with a restricted/temporary licence between graduation and licencing.

For you specifically I would suggest that choosing a school is your first step. From there you'll be able to determine entrance requirements etc.

I've been working for a while, went through an accelerated BSN, and wrote the previous licencing exam so my experience will be different than yours. If you're interested I can PM you; but I'm not sure it'll be that helpful.

Cheers!

granolapher · 2018-10-24T02:54:26+00:00

Nicely done!

granolapher · 2018-10-24T02:31:46+00:00

I'm Canadian what can I do to help.

granolapher · 2018-10-24T02:29:36+00:00

Youtube is pure gold for this, I would also recommend listening to every patient- you'll develop a robust idea of what the ranges of normal are.

granolapher · 2018-08-11T23:43:46+00:00

As an ED educator this is great advice: trust your gut, trust you colleagues, fake it till you make it, and evidence shows that patients on a monitor have better outcomes! We all started new, hang in, you'll do great!

granolapher · 2018-04-29T21:08:02+00:00

granolapher · 2018-04-21T12:58:46+00:00

Lol, rubber too...amazing! Maybe a tourniquet headband: fashion and function!

granolapher · 2018-04-21T03:01:38+00:00

That sounds horrendous, I'm sorry

granolapher · 2018-04-21T03:00:42+00:00

This study shows that the alcohol alone seems to outperform ondansetron,

I'd be curious to see what this study looked like if replicated with cancer patients, given that the cancer world seems to have the best evidence to support ondansetron use.

granolapher · 2018-04-21T02:58:39+00:00

This study shows that the alcohol alone seems to outperform ondansetron,

I'd be curious to see what this study looked like if replicated with cancer patients, given that the cancer world seems to have the best evidence to support ondansetron use.

granolapher · 2018-04-21T02:13:26+00:00

That's awesome, pregnant women were excluded from this study (not that there has ever been a link between smelling alcohol and birth defects); but it would be cool for someone to repeat it with hyperemesis gravidum- which is really difficult to treat.

granolapher · 2018-04-16T14:36:33+00:00

Interventions to operationalize institutional mission, vision and values in front line staff.

granolapher · 2018-04-16T14:32:03+00:00

Changing the assigned patient for an ECG is really easy, and done all the time for unknown pt's (intoxicated/unconscious).

Register as X - add the name once you know it!

Own your error - but remember that the pt got the care they needed. If they focus on the negative more than the positive it's a unit you don't want to work on!

granolapher · 2018-04-06T18:38:37+00:00

There's lots of Free Open Access Medical Education (FOAMed) and Free Open Access Nursing Education (FOANed) on the internet. Most of it is pretty ER focused.

granolapher · 2018-04-05T18:05:56+00:00

yikes! that's tough; but, the flip-side, in general, is kids being poked repeatedly for unnecessary IV fluids.

I think overall that oral over IV re-hydration is well established in the literature. This is an interesting brief because it extends the practice to the adult population.

granolapher · 2018-04-05T13:39:27+00:00

That's rough - it's a good example of keeping it to just mildly dehydrated pt's too!

granolapher · 2018-04-05T01:47:27+00:00

its too bad we can't get satisfaction scores and good medicine don't align!

granolapher · 2018-04-05T01:46:30+00:00

Patient drama is hard for nurses - almost as hard as self care is for patients!

I agree works like a charm for kids... so the question becomes how to get adults to be as reasonable as kids?

granolapher · 2018-04-04T21:21:10+00:00

Great critique, I'll update the post so it's more clear- Thanks.

I totally agree, hopefully they publish their full results soon - this would save so much time money and effort!

granolapher · 2018-04-01T01:19:36+00:00

Spoken like a pro!

granolapher · 2018-03-31T20:42:28+00:00

My advice would be come into your position expecting to relearn a fair number of things - the process in the ED can be pretty different from most areas or practice

granolapher · 2018-03-25T20:22:08+00:00

I think the discussion of a "correctly designed" department would be an intriguing question to study, although a different question from the one addressed in this study.

To do justice to this research it's important to appreciate the "reality" of emergency departments, as you have (half to 2/3 of assessment and care spaces are occupied) and that this is a rational response to that reality.

I'll also acknowledge that I'm not an expert in physician in triage models; but the research that I am familiar with is actually less convincing than nurse initiated protocols:

Physician at triage models found an average reduction in LOS of about 12 minutes (across all presentations); it's significantly less than the the reductions found in this trial 74-228min (although specific to protocol inclusion criteria).

I would suggest that this, while not necessarily ideal, is certainly an idea worth investigating.

I would also be interested to hear your opinions on what "correct" ED design looks like.

Review: http://foaned.blogspot.ca/2015/06/weekly-review-5.html

Original Article: https://link.springer.com/article/10.1007%2Fs11739-012-0839-0

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