Can you do this in the SICU
The fellow tells you they'll review the stat 12 lead for chest pain after they gets back from the noon conference...
What is no, he'll review it immediately, and if there are changes suggestive of AMI, he will call AMET to activate the cath lab.
Bonus: Why do we active AMET?
These pieces of airway equipment must be in every room...
What is Ambu bag AND Mask?
Provider says "give one of neo" that is this amount...
What is 1mL or 100mcg of phenylephrine? (not a whole syringe)
The patient has a PA catheter. Cardiac output is performed.....
What is q4 hours if ordered? (as per Routine Care Protocol, SICU Addendum)
Restraint notes are written....
What is with each order? (initiation, renewal, change)
Fun fact: restraint type does not matter- behaviors do (i.e. someone can be in soft restraints for violent indications)
The order says draw blood cultures x 2 from tunneled R IJ and non-tunneled R IJ...
What is never?
Your patient is suddenly bradycardic on the vent. The problem could be....
What is mucus plug, take vent off and bag patient?
The patient is reporting pain sooner than the medication is due. The provider placed a non-med nursing communication to "give fentanyl early".
What is page provider back?
Performed every change in caregiver and with rhythm changes.
What is AirStrip? per the Critical Care Routine Care Protocol
Your trached patient wants to talk. They have a Passey-Muir Valve...
What is ask RT to assist?
The patient is ventilated and a bedside trach is being performed. The surgeon asks you to push anesthesia.
What is No? SICU should be alerted and at bedside.
Your patient has BMI of 37 and going for a trach. This protocol is initiated upon their return....
What is a high risk trach including green sheet?
Oxycodone 10mg is ordered for pain scores of 7-10. Fentanyl 50 mcg is ordered for breakthrough pain. Your patient reports a pain score of 6.
What is call the provider? Breakthrough meds are only used "if pain not improved with other PRN pain medications." The fentanyl pain scores needs adjusted or a new medication needs ordered.
Orders and care required when using the meditherm include
What is: order to use; order with goal temperature; document core temp at initiation and q4; confirmatory temp q4?
Additional discussion: Forced air warming blanket for hypothermia does not require a core temperature (recommended), but requires an order with the set temp and q1hour temps & skin checks; secondary source temp q4hours.
Atracurium, Propofol, and/or Fentanyl. Which scale goes to which med (and is it possible?)
What is Train of Four, RASS and Pain score?
You are requested to remove a chest tube....
What is no
The patient has a laryngectomy and is apneic....
What is infant mask & adult ambu bag over stoma not mouth?
Bonus: What needs placed at head of bed?
This group of medications require specialized PPE to protect you as a caregiver. Signage is posted at the head of the bed by the RN.
What is hazardous drugs? Includes both chemo and non-chemo (i.e. most transplant meds).
You are cooling a patient that has end stage liver disease who experienced a cardiac arrest on the med-surg unit. The provider orders an esophageal probe.
What is this is potentially contraindicated?
Contraindications include esophageal stricture, history of esophageal cancer, esophageal perforation, and end-stage liver disease and varices.
Oxycodone 5-10mg is ordered q 6 for moderate pain or severe pain. You give 5mg at 2pm, at 3pm pain score is 8/10. You can give this amount and anticipate the next dose would then be available at.
What is 5mg at 3pm with the next dose at 9pm?
The blood pressure tanking. The patient has #18 in right forearm and levophed is ordered.
What is yes...but: Levophed/norepinephrine is first line therapy for septic shock, but should be in a central line.
Your vent is alarming high pressure, HR is 200, SBP 200 O2 sat dropping. Your steps are....
What is take pt off vent and bag?
Your patient has a PCA: a dual sign is required and the pump is rate verified at these times.
What is Dual Sign: Initiating any continuous opioid infusion, Changing opioid doses, When a patient is transferred from another unit (receiving unit checks)?
What is Rate Verified: Q4 hours?
Recommend to rate verify prior to transfer to med-surg/progressive care
This medication is given if patient is suspected of having Malignant Hyperthermia
What is Ryanodex (Dantrolene Sodium) found in the MH in the G3 ORs? Malignant Hyperthermia guidelines on PPM
You had given your patient phenylephrine 30 minutes ago for a low BP. You're traveling and found you forgot the neo in your pocket, the BP is low again.
What is call the provider?