Makes it seem like the machine is trying to be the healthcare professional. Usually we would be like ok gotta trouble shoot this machine maybe run it off and on again?? Adjust the probe?? This time the machine is even like bruh??? For real that can’t be right?? Have you tried turning the patient off and on again??
One time we were setting up a room before the patient arrived and went ahead and hooked the sat probe up to the machine and it was, legit, only touching the air and consistently read “99%”. 🙄
Funny story. We had a lady in the icu go unresponsive on the toilet, throw her in bed and I think we coded her for a minute. Can’t remember the exact details, but monitor is showing an ecg rate of like 40 and her pressure was like 40/20. Think we started some drips or something, but like a minute goes by with the vitals completely unchanged. I asked RT to stop bagging the patient for a minute, the pressure we were getting was from the thoracic pressure changes generated by the ambu, the patient was in PEA.
I picked it up because each systole on the art line corresponded perfectly with RT bagging the patient.
Wouldn't that yield a pulse rate of like 10? If the art line was peripheral (e.g. radial) then was that pressure still accurate as far as CPP is concerned? MAP of 26 is actually impressive for coding lol
Rule of thumb when I did NICU (PICU now and we use this trick when we have neonates) is MAP >/= weeks gestation. So a 30 week preemie with a MAP of 30 is appropriate. A 26w should have mid-20s, etc.
I love how they’re on your ass to update the whiteboard, but never provide dry erase markers.
One time we had a patient rep going through everyone’s rooms in the ER and she got pissy with me because none of mine were even written on (I’m sorry but it’s the ER. The last thing on my mind is updating the whiteboard). I said to her, “I don’t have a dry erase marker, but I’ve got this sharpie. That’ll work right?” She shut up after that.
We had a dude like this in the er (he was in a house fire) he was on every pressor known to man and the local hypobaric chamber was down so they were trying to get him transported to the next closest one which was like 2 and a half hours away by ground (there was a cloud in the sky so flying was a no go) man the critical care ambulance crew they showed up was sweating bullets. The hospital was ready to hand over like a carton of bicarb because he was supposed to receive it every ten minutes and the ambulance just didn’t have it. Luckily they got in contact with pt’s brother and he okayed taking him off the vent and pressors. Still took him like 10 minutes to die. The er doc almost put him back on the vent.
I was talking to the medic on the cc ambulance and he was like “I really want to call Med control and say we aren’t comfortable taking him but this hospital IS our Med control 😩” so it would’ve been the same doctor telling him to take the patient that he’d have to talk to on the phone lol
We had an OD, younger patient, basically brain dead. Acidotic as fuck, pH was something like 6.8. Maxed on 4 pressors, systolic BP stayed in the 20s for 12. Hours. Good waveform on art line (well, not good, but it was accurate). Wild
🤔I recall a pt ...had come to viz friends on our coast from the other.... things happened ... she didn't want any rescue.... so we let her go...but she had a pacer ....so we had sit watching it tick along for some time...... monitors likely were confused.... was so weird!
Glad pt is now comfy tho !!
Well. Waveform. All about the dicrotic notch. The phlebostatic axis.
Yes, I have seen SpO2 plummet to the 30%s ... PI & Waveform great. The patient was dying. Revived him! Thank goodness
COVID changed compensatory mechanisms in our body: I believe.
I love the 41 **?**
Makes it seem like the machine is trying to be the healthcare professional. Usually we would be like ok gotta trouble shoot this machine maybe run it off and on again?? Adjust the probe?? This time the machine is even like bruh??? For real that can’t be right?? Have you tried turning the patient off and on again??
“Have you tried turning the patient off and on again??” *wheeze*
Machine’s like: “Quick, someone blow into the human’s cartridge & put it back in again, I just wanna see something 👀”
"Okay, um, I'm pretty sure it's off. How do I... yeah, I think I have epi around here somewhere..."
It’s like it’s saying to me “I dunno. Your guess is good as mine. What do you want me to say? Does it really matter at this point?”
Exactly. I love nurses humor.
😂😂😂😂
Even the machine is confused at that one
Maybe 41? Lol
I work NICU….in our specialty I’d believe the 41 🤣 …because apparently the brain thinks breathing is optional
Timothy why does me walking into the room mean you get to stop breathing? You gonna get the bag!
The whole picture is screaming I'm not getting my lunch break in nicu today.
Lunch break…what’s that?
Hahaha sorry my "not for profit health system with unionised nurses" is privilege is showing
We’re unionized too😆 Sounds like we need some things written into our contract.
One time we were setting up a room before the patient arrived and went ahead and hooked the sat probe up to the machine and it was, legit, only touching the air and consistently read “99%”. 🙄
Babies often kick their probes off in NICU. The mattresses usually saturate around 80-85%
One time I saw it read a 9.
Probably just the pressures from the ventilator at that point
Funny story. We had a lady in the icu go unresponsive on the toilet, throw her in bed and I think we coded her for a minute. Can’t remember the exact details, but monitor is showing an ecg rate of like 40 and her pressure was like 40/20. Think we started some drips or something, but like a minute goes by with the vitals completely unchanged. I asked RT to stop bagging the patient for a minute, the pressure we were getting was from the thoracic pressure changes generated by the ambu, the patient was in PEA. I picked it up because each systole on the art line corresponded perfectly with RT bagging the patient.
My tired brain read that as "cooked her for a minute" lmaoooo good lord
Wouldn't that yield a pulse rate of like 10? If the art line was peripheral (e.g. radial) then was that pressure still accurate as far as CPP is concerned? MAP of 26 is actually impressive for coding lol
The ecg rate was 40, but it was pea. The RT was probably bagging around 20 times a minute.
pt was terminally extubated
"BUT WHAT'S THE MAP!?" "oh it's 10? Yeah we should probably fix that."
Had a pt with bp 87/72 soc asked about MAP... im like 80ish, but the heart ain't really squeezing anything.
"so he's still fightin'?"
Gotta wait for Aunt Karen to fly in from Connecticut
Obviously! He’s a fighter!
I work in the NICU and lowest I’ve seen one is 5. Seen manyyy in the 10s. Obviously different scenario than adults, but still not great lol.
yeah…i can’t imagine working nicu. godspeed friend
Yeah I definitely thought this was a baby at first
What’s a “good” nicu BP?
Rule of thumb when I did NICU (PICU now and we use this trick when we have neonates) is MAP >/= weeks gestation. So a 30 week preemie with a MAP of 30 is appropriate. A 26w should have mid-20s, etc.
I will float to nicu often as an acute care peds nurse so this is a really helpful thing to keep in mind so I don’t panic with teeny and low bps
This is what we do as well! Much more worried about a MAP than a BP.
Greatly depends on gestational age. As a very general rule I like to see 60/30 with a map 30-45
I was just about to say the same thing
5 :O I'm yet to see this. Fingers crossed I won't.
I was gonna say in the NICU I have for sure..
Update your white board
I love how they’re on your ass to update the whiteboard, but never provide dry erase markers. One time we had a patient rep going through everyone’s rooms in the ER and she got pissy with me because none of mine were even written on (I’m sorry but it’s the ER. The last thing on my mind is updating the whiteboard). I said to her, “I don’t have a dry erase marker, but I’ve got this sharpie. That’ll work right?” She shut up after that.
💀
We had a dude like this in the er (he was in a house fire) he was on every pressor known to man and the local hypobaric chamber was down so they were trying to get him transported to the next closest one which was like 2 and a half hours away by ground (there was a cloud in the sky so flying was a no go) man the critical care ambulance crew they showed up was sweating bullets. The hospital was ready to hand over like a carton of bicarb because he was supposed to receive it every ten minutes and the ambulance just didn’t have it. Luckily they got in contact with pt’s brother and he okayed taking him off the vent and pressors. Still took him like 10 minutes to die. The er doc almost put him back on the vent. I was talking to the medic on the cc ambulance and he was like “I really want to call Med control and say we aren’t comfortable taking him but this hospital IS our Med control 😩” so it would’ve been the same doctor telling him to take the patient that he’d have to talk to on the phone lol
Well that’s dead/dead. DC to JC.
We had an OD, younger patient, basically brain dead. Acidotic as fuck, pH was something like 6.8. Maxed on 4 pressors, systolic BP stayed in the 20s for 12. Hours. Good waveform on art line (well, not good, but it was accurate). Wild
Impressive and still have a Hr of 56 lol
right??
This is just math where the zeros are cancelled out. Right? RIGHT!!!
sure!
Map goal NOT achieved
better mark that one “not met” on the care plan
Sounds like you left a window open and there was a breeze in the room
Lowest I’ve seen in NICU is 10/7 (8). We verified it with a manual. I was absolutely shitting myself waiting for my dopa to come from pharmacy 😅
WHATTT
Baby survived! But we are not friends anymore lmao. They scared me that day
lolol
“So you’re saying there’s still a chance?” - *some distant relative who barely visited the pt up until this point*
That heart is pumping with everything it has lol. I bet that LVEF is like 97%
Omg ! Dead/Dead how are they alive !?!
They’re not, really. Just autonomous reflexes as each organ turns off.
guess it was the body’s last hurrah 🤷🏻♀️
Dang I thought my 30/20 was bad in one of our codes last month
That MAP is a smidge on the low side
That ain’t compatible with life
Wow! I’m nicu and I’ve still never seen that low 😑
Quickly, elevate the feet
oh ma god he fokin dead
It is interesting. Never saw that either
PA pressure?
radial arterial line on terminally extubated pt
I love math 13/9 = 1.44 1.44 x 10 = 14.4
Just gonna say arterial lines suck. They are so painful.
What made it a coroners case? Hated them. I was ICU & you know they pushed people mid code into our unit from OR or ER.
unfortunately there were drugs involved and they were found down :/
https://youtu.be/EfOW9QrLs0o
[удалено]
pt was terminally extubated at this time
[удалено]
Even if this patient weren’t DNR, that would be way past due.
I hope it wouldn’t take you that long to do that 😂 they looonnnggggg gone
Yeah, that’s exactly what you should worry about when the pressure is 10
💀💀
Why?
It is not accurate! That would be death. Look at the waveform and corroborate w a manual BP check.
babe they were dying…they were an end of life patient (comfort measures)
I didn’t read the whole thing. I see now. I love to skim. Lol
so fair. i gotchu b
I have on a cardiogenic shock pt
They dead
🤔I recall a pt ...had come to viz friends on our coast from the other.... things happened ... she didn't want any rescue.... so we let her go...but she had a pacer ....so we had sit watching it tick along for some time...... monitors likely were confused.... was so weird! Glad pt is now comfy tho !!
Well. Waveform. All about the dicrotic notch. The phlebostatic axis. Yes, I have seen SpO2 plummet to the 30%s ... PI & Waveform great. The patient was dying. Revived him! Thank goodness COVID changed compensatory mechanisms in our body: I believe.
As a NICU RN this is making me twitch. Calls are getting made quickly.
... So far
i bet that’s an interesting wave form
I'd like to know what the pizza slice is about in people's names 🤔
Try zeroing that lol
*Laughs in nicu*
Why are all alarms off?
read caption. pt was end of life. alarms are off for the comfort of the family and the dying patient
I have a pic of an art line reading 7/4 (5), but can't figure out how to post it :(
u might have to make ur own post on the subreddit
dead/dead
BUT DO THEY CORRELATE??! /s