CRNA horror stories

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Physio Doc 2 Be said:
Sorry, I thought you meant to make one bag up for the day. My objection to drawing up 1 vial of 10mg/mL and making 1 100cc bag for the day and then using it for every patient is very simply that I don't know how to assign that in terms of charge for the patient. If I do that before first starts and then used the bag to make a stock and then used new, fresh syringe from that each day, I wouldn't know how to charge any patient. So I'd have to make a new bag each case. I could easily make the bags for each case, but that is another charge as well for the patient. Certainly one to consider. Thankfully with good labeling, handoffs, and physical separation of the drug from the other syringes (I also lay out all the drugs I'm going to use for case --- with protamine being the exception. I don't draw that up until we're rewarming) I've never had an issue. That said, I'm not opposed to making a bag for each case. As was suggested above, one bag for the day would make me uncomfortable.
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Phenylephrine 1% costs about $3 a vial. It's nothing compared to the cost of surgery, anesthesia, and hospitalization. I wouldn't worry too much about its charge.

You commented earlier about not wanting bubbles in your syringe of 10mg/ml phenylephrine. Why does that matter? You're going to inject it into a plastic bag.

Anyway, you may trust your labelling, but in the heat of the moment, if someone else is in your room and has a hypotensive patient, they may reach for any syringe with a phenylephrine label on it and inject before reading the dosage. Yeah, people with experience will recognize that a syringe with just 1ml of phenylephrine is wierd, but some people may not think twice about it. If you think about the Swiss cheese model for medical errors, this is a hole you can easily patch.
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Chloroform4Life said:
Phenylephrine 1% costs about $3 a vial. It's nothing compared to the cost of surgery, anesthesia, and hospitalization. I wouldn't worry too much about its charge..
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If the concern is having a single phenylphrine source for the day because it is a billing issue, it doesn't matter whether the 10mg/ml phenylephrine is placed in a 3ml syringe or a 100ml bag. He has to throw both away for each patient.

A vial of phenylephrine is used per patient in both scenarios.

Basically his argument is that he does not want to use a small saline bag because he thinks 2 small syringes (3ml and 1ml) are cheaper.
 
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Jesus Christ if you need a phenylephrine bolus just take the concentrated vial and pull 0.1 ml out with a 1cc syringe then shoot it into a 10cc saline flush syringe that's well labeled. Leave the remaining 0.9ml in the original vial for next case.

Now can we get back to some juicy CRNA gossip already?
 
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I was on night float when this happened, but I came in and got report that I had to be the go to person for any questions of an MH patient intubated in the ICU from a case earlier in the day.

A CRNA got a break from another CRNA I think they gave report that the BP was high. Both CRNAs kept increasing the minute ventilation since the EtCO2 was high, and they both kept increasing the des since the BP was high and more gas means lower BP, and the patient was warm, so the bair hugger was on room temp, I think. The attending saw what was happening by the time the minute ventilation was something ridiculously high and the EtCO2 was over 80 (I believe) called an all call to that OR and ran in and started the MH protocol. (I wasn't there when it happened (my friend was), so I don't know the total details and numbers, but I thought CRNAs learned how to recognize MH.)

The patient survived. We had an M&M about it. I don't know if anything happened to the CRNA.
 
Ashers said:
I was on night float when this happened, but I came in and got report that I had to be the go to person for any questions of an MH patient intubated in the ICU from a case earlier in the day.

A CRNA got a break from another CRNA I think they gave report that the BP was high. Both CRNAs kept increasing the minute ventilation since the EtCO2 was high, and they both kept increasing the des since the BP was high and more gas means lower BP, and the patient was warm, so the bair hugger was on room temp, I think. The attending saw what was happening by the time the minute ventilation was something ridiculously high and the EtCO2 was over 80 (I believe) called an all call to that OR and ran in and started the MH protocol. (I wasn't there when it happened (my friend was), so I don't know the total details and numbers, but I thought CRNAs learned how to recognize MH.)

The patient survived. We had an M&M about it. I don't know if anything happened to the CRNA.
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Hahahaha wow
 
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So that CRNA was just chillin with an ETCO2 in the 80s just thinking "we can blow this off, nothing to see here." Un-f*cking believable.
 
SitraAchra said:
So that CRNA was just chillin with an ETCO2 in the 80s just thinking "we can blow this off, nothing to see here." Un-f*cking believable.
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I'm not sure what the thought process was with all that happening! I wish I knew.


JobsFan said:
so their outcomes are as good as an anesthesiologists then
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Yeah, sure, the attending was just there because the hospital requires it... otherwise, that CRNA could practice on their own in the state where this happened (as residents were told by them when I was there). It's all good... :eek:
 
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True story.
2009.
Surgery center. Me, My boss Rob and a crna at the surgery center left.
Good ole Bobby the boss tells me to go give a crna a break. Its at the end of the day. 240pm or so. I go give her a break. SHe tells me about the case and tells me she wont be long.
I chat the surgeon up, make some last minute trades on my blackberry hoping this bitch comes back soon.


Except she never comes back. Do I say anything? Nope. Why? Cuz Im making XXX/per hour after 3 pm. i figured she was taking an extra long break.

The boss comes into my room at 330 and says where is Sally CRNA. I look at him, shrug my shoulders. (I dont know, and I dont give a fuc cuz im making money) as im pushing the reversal.

Guess where sally was? any guesses?
hint; she is not alive
 
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criticalelement said:
True story.
2009.
Surgery center. Me, My boss Rob and a crna at the surgery center left.
Good ole Bobby the boss tells me to go give a crna a break. Its at the end of the day. 240pm or so. I go give her a break. SHe tells me about the case and tells me she wont be long.
I chat the surgeon up, make some last minute trades on my blackberry hoping this bitch comes back soon.


Except she never comes back. Do I say anything? Nope. Why? Cuz Im making XXX/per hour after 3 pm. i figured she was taking an extra long break.

The boss comes into my room at 330 and says where is Sally CRNA. I look at him, shrug my shoulders. (I dont know, and I dont give a fuc cuz im making money) as im pushing the reversal.

Guess where sally was? any guesses?
hint; she is not alive
Click to expand...

Lemme guess, injected herself with narcotics.
 
criticalelement said:
True story.
2009.
Surgery center. Me, My boss Rob and a crna at the surgery center left.
Good ole Bobby the boss tells me to go give a crna a break. Its at the end of the day. 240pm or so. I go give her a break. SHe tells me about the case and tells me she wont be long.
I chat the surgeon up, make some last minute trades on my blackberry hoping this bitch comes back soon.


Except she never comes back. Do I say anything? Nope. Why? Cuz Im making XXX/per hour after 3 pm. i figured she was taking an extra long break.

The boss comes into my room at 330 and says where is Sally CRNA. I look at him, shrug my shoulders. (I dont know, and I dont give a fuc cuz im making money) as im pushing the reversal.

Guess where sally was? any guesses?
hint; she is not alive
Click to expand...
Well that's certainly horrible.


--
Il Destriero
 
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Doctor4Life1769 said:
Lemme guess, injected herself with narcotics.
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you are a winner... sally went into the bathroom and indeed injected herself with narcotics.. I wont tell you where.... and fell and hit her head against the sink... blood everywhere... what a scene. I spent the next four hours with the boss dealing with the aftermath.
 
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ZzzPlz said:
Yup we have a winner for biggest CRNA horror story
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To be fair, I've heard plenty of stories about MDs in similar situations....addiction is one of the few things that is likely equal between MDs and CRNAs.....
 
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criticalelement said:
you are a winner... sally went into the bathroom and indeed injected herself with narcotics.. I wont tell you where.... and fell and hit her head against the sink... blood everywhere... what a scene. I spent the next four hours with the boss dealing with the aftermath.
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What? Like where she physically injected herself or where this event happened?

Is there some crazy lady-part vein that I don't even know about?
 
criticalelement said:
you are a winner... sally went into the bathroom and indeed injected herself with narcotics.. I wont tell you where.... and fell and hit her head against the sink... blood everywhere... what a scene. I spent the next four hours with the boss dealing with the aftermath.
Click to expand...
Man, these threads always take a bit of a turn for the childish and petty ...

But dude, what the hell is wrong with you?

You want to bash CRNAs for doing dumb stuff in the OR, go ahead, I guess. But drug abusers come in physician and nurse flavors, and every death is a tragedy.

I'm just going to go ahead and close this thread before the last shred of class exits the building.
 
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