ETT's and Emergency drugs ready for every case

[proman]

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Pharmacy, by policy. Remi is mixed as needed. Usually in 60 cc syringe of NS.

What's their guaranteed turn-around time? Or do you make syringes while you wait? Peds cardiac is the only time we use syringe pumps (because that's what the PICU uses).

 

[IlDestriero]

What's their guaranteed turn-around time? Or do you make syringes while you wait? Peds cardiac is the only time we use syringe pumps (because that's what the PICU uses).

We use syringe pumps for everyone. In an emergency, res/fellow puts order in, I call, it's ready when the tech gets there. It's rare that I have to order anything emergently. You usually see the ship sinking well before she's going under, I do anyway. That's one more reason to keep a close eye on your rooms when you are double covering. I don't understand how some of the staff abandon their cases for so long. I don't trust anyone to detect anything, until thing get ugly.

 

[Licoricestick]

Pharmacy mixing all your drugs sounds very expensive and labour intensive. Would have to be an enormous system change for us. Our pharmacists and pharmacy techs aren't present in the hospital after 5pm and I can't see any of them being interested in shift work over a 24hr 7 day a week roster just to supply drugs to anaesthetics and maybe ICU.

That said, I can see the potential for a reduction in drug errors by the anaesthetist.

 

[jetproppilot]

Read post number 14 for the most pragmatic, most correct answer.

 

[Licoricestick]

Read post number 14 for the most pragmatic, most correct answer.

Maybe for those that are finished training or nearly done. But as I still have 3.5yrs of training to go, I think I am not only entitled to be a little underconfident but expected to be.

However, I hope I have enough sense to continue to reevaluate what I do as I go on.

 

[Dogdaze]

I actually still draw up atropine, because I do see bradycardia often enough for it to be worth my while.

As for the sux, I guess it depends on your practice. We only get narcs from the Pyxis. Nearly every other drug is located in the top drawer of my cart, and can be had in a few seconds.

In that case, it seems that you don't need to draw up atropine either...


If we're talking pedis: I have both sux and atropine both drawn up with an IM needle plus mutliple size ETTs.

For adults: I agree with the concept that having sux, ETT, +- ephedrine and phenylephrine (based on patient) shows humilty (vs. arrogance) and preparedness, not incompetence.

Just my $0.02

 

[Bertelman]

In that case, it seems that you don't need to draw up atropine either...


If we're talking pedis: I have both sux and atropine both drawn up with an IM needle plus mutliple size ETTs.

For adults: I agree with the concept that having sux, ETT, +- ephedrine and phenylephrine (based on patient) shows humilty (vs. arrogance) and preparedness, not incompetence.

Just my $0.02

I know I don't really NEED to draw up atropine, but I get enough looks as it is. If I don't draw SOMETHING up, it just looks like I don't care. I choose atropine because I use it in an emergent situation more often than sux.