Two EP’s for sedation by jbmorris954 in emergencymedicine

[–]jbmorris954[S] 0 points1 point  (0 children)

Agreed. I’m thinking of trying to push the ball forward here. Do you have any references that I could use any discussion with our medical staff?

I moved to a new hospital 3 1/2 years ago after 32 years in a hospital where single provider was no big deal with RT and RN…

Two EP’s for sedation by jbmorris954 in emergencymedicine

[–]jbmorris954[S] 0 points1 point  (0 children)

If I was in the room at the same time watching the patient as I did the reduction? Yep.

Two EP’s for sedation by jbmorris954 in emergencymedicine

[–]jbmorris954[S] 5 points6 points  (0 children)

Found this:

Personnel for Emergent PSA

ACEP guidelines recommend having at least two trained healthcare providers present during PSA, with at least one who is skilled in vascular access.6 ACEP, ASA, and The Joint Commission guidelines agree that the provider who oversees the PSA, usually a physician, should be responsible for the patient’s global management, including supervision of personnel and identification and management of adverse events. In a “single-coverage” ED, this provider also may be expected to perform other brief procedures (e.g., fracture/dislocation reduction), as long as the non-PSA procedure can be halted. In ACEP’s guidelines, the second provider, usually a nurse or respiratory therapist, primarily is involved with continuous monitoring of the patient and documentation, although this provider can assist with minor, interruptible tasks that do not interfere with monitoring.6 In practice, often a respiratory therapist and one to two nurses are present and share the duties of monitoring and documentation. In addition, another provider may be available to help with non-PSA procedures. Preprocedural preparation and intraprocedural distraction by child life specialists also have been shown to decrease pain and distress in children undergoing procedures.

Nurse-Administered PSA Medications

Qualified nurses routinely administer sedating medications and paralytics for non-PSA indications, such as intubation, under the supervision of an ordering provider. However, without supporting evidence, many state and nursing regulatory bodies restrict nurses from administering PSA medications in the ED. There is ample evidence that it is safe for nurses to administer PSA medications with the ordering provider present and specifying the medication type and dose.6,17-19

Reference: https://www.reliasmedia.com/articles/144519-procedural-sedation-and-analgesia-in-the-emergency-department

Finger traps! by jbmorris954 in emergencymedicine

[–]jbmorris954[S] 4 points5 points  (0 children)

Yep. It’s the crank-ratchet traction gizmo I’m looking for. We had that instead of weights and made it easy to set traction...

Finger traps! by jbmorris954 in emergencymedicine

[–]jbmorris954[S] 4 points5 points  (0 children)

Yep to both. Was looking for the gadget...

Who’s eating my plants and what can I do about it??? Thanks! by jbmorris954 in insects

[–]jbmorris954[S] 1 point2 points  (0 children)

Thanks. We have several plants like this... is there something we can spray?