The Miseducation of America’s Nurse Practitioners

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TheLoneWolf

TheLoneWolf

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When I put out an ad to hire a new PA/NP, I had about 15+ NP applications. Nearly all the NPs were straight out of school with no experience. Not one was even an orthopaedic nurse prior to school. 🫣

My wife saw a new NP at her pcp appointment when she had a bad cough. My wife basically told the NP what to order.
 
Insurance companies somehow find a way to decrease my anesthesia billing reimbursement every year but they haven’t figured out how to bill less for midlevel provider care? Unbelievable. Half this stuff could be fixed by NP billing receiving lower compensation and less profits for the hospitals. Disincentivize midlevel creep.
 
DrOwnage said:
Insurance companies somehow find a way to decrease my anesthesia billing reimbursement every year but they haven’t figured out how to bill less for midlevel provider care? Unbelievable. Half this stuff could be fixed by NP billing receiving lower compensation and less profits for the hospitals. Disincentivize midlevel creep.
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Don’t you believe in equal pay for equal work?
 
I once worked with a surgeon who had a nurse first assist. She got her NP degree online. Then she was supposed to do clinicals. She worked in the OR twice a week and 2 days a week in the surgeons office. How did she do clinicals rotations working 4 days/week? The only time she was out of the OR was for one month to do a primary care rotation with a "functional medicine" doctor. Her degree is worthless.
 
I have been so giddy since reading this article yesterday. Been on Reddit and IG seeing what people are saying. Many NPs support this but many are butthurt. The Physician for Patient Protection is somewhat behind this and it’s part of the group that I originally came here to support seven months ago when people started jumping on my ass. These NPs are out here killing and maiming and clueless and egotistical. Not all but too many of them. The old school ones are good but times have changed. Now these youngsters want the shortest route that will make them the most money. And when we speak about it we are called elitist. Give me a break. Patients are shamed for asking for a physician and denied physicians in many instances. It’s disgusting.
Anyway the PPP group is on FB and these are the things that are discussed if anyone is interested.
 
makemoney2024 said:
I have been so giddy since reading this article yesterday. Been on Reddit and IG seeing what people are saying. Many NPs support this but many are butthurt. The Physician for Patient Protection is somewhat behind this and it’s part of the group that I originally came here to support seven months ago when people started jumping on my ass. These NPs are out here killing and maiming and clueless and egotistical. Not all but too many of them. The old school ones are good but times have changed. Now these youngsters want the shortest route that will make them the most money. And when we speak about it we are called elitist. Give me a break. Patients are shamed for asking for a physician and denied physicians in many instances. It’s disgusting.
Anyway the PPP group is on FB and these are the things that are discussed if anyone is interested.
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Me too. Remember when devry ads were everywhere and they were pushing these useless IT degrees during the tech boom? This is the same thing.
 
secretasianman said:
Me too. Remember when devry ads were everywhere and they were pushing these useless IT degrees during the tech boom? This is the same thing.
Click to expand...
And this is a series. There are gonna be two more parts to this to follow. I can’t wait. I am so sick of patients being mismanaged.
I literally tell patients in my FPA state to get a physician because they are not on the proper medications for all their health issues. I just tell them to pick up the phone call the hospital operater and ask for the FM of IM clinic and ask to be seen specifically by a physician bc they are being mismanaged. Just because it’s a rural place doesn’t mean these people don’t deserve good care. And one of the NPs has been at it 20 years and still sucks.
I don’t care if they call me an NP hater but these standards are in the toilet. I think it mostly comes from social media and nurse creators pushing this RN/NP aesthetic showing them making good money as they go up in degrees and that’s all these damn people want anymore. Money. Screw the patients.
 
Wow………..

Adtalem isn’t a household name, but its previous moniker, DeVry University, was, thanks to its ubiquitous advertising. DeVry listed on the New York Stock Exchange in 1991, and by 2010 it was a for-profit education juggernaut offering business and technology degrees on campuses in 26 states. But it was plagued by class-action lawsuits and investigations and eventually drew rebukes from government agencies. In 2016 the Federal Trade Commission settled a $100 million suit alleging DeVry’s ads were deceptive, and the Department of Veterans Affairs suspended the school from one of its education programs. Amid the crisis, the company changed its name to Adtalemin 2017 and the next year sold DeVry University, whose enrollment had cratered, for zero dollars.

Adtalem held on to a lesser-known asset, Chamberlain University, which trained thousands of nurses a year. And to fill its DeVry-size hole, Adtalem turned to Walden University, a campus-free online university based in Minneapolis. In announcing the 2021 completion of its $1.5 billion acquisition of Walden, Adtalem touted the school’s ability to address “rapidly growing and unmet demand for healthcare professionals in the U.S.”
“That’s absolutely a false statement,” says Raea Thompson, a current Walden student in Tomball, Texas, who served in the US Air Force before becoming an in-flight nurse in helicopter ambulances. “The only thing Walden does is give you an Excel spreadsheet” with precepting locations that other students have used, she says. “They’re not placing you anywhere. They’ll do coaching calls and talk to you about how to approach a potential preceptor. I’m sorry, I’m a grown adult. I know how to talk to them. I need a job.”
Steele, who ran Walden’s nurse practitioner programs for eight years, says she developed concerns as it grew. Before she left in 2020, the school had more than 15,000 NP students and fewer than 20 full-time faculty, she says, and made up the difference with hundreds of part-time teachers who weren’t always qualified: “Most of the people we hired had never taught before.” She says she was fired after raising concerns about Walden’s failure to mentor and train its part-time teachers.

The minimum undergraduate grade-point average for incoming students was 2.5—not high enough, in Steele’s view, to guarantee all applicants were of high quality. The school became “all about the money,” she says. “I don’t think we ever refused anybody.” Steele worries about the impact Walden’s graduates will have on America’s patients.
 
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sloh said:
Wow………..

Adtalem isn’t a household name, but its previous moniker, DeVry University, was, thanks to its ubiquitous advertising. DeVry listed on the New York Stock Exchange in 1991, and by 2010 it was a for-profit education juggernaut offering business and technology degrees on campuses in 26 states. But it was plagued by class-action lawsuits and investigations and eventually drew rebukes from government agencies. In 2016 the Federal Trade Commission settled a $100 million suit alleging DeVry’s ads were deceptive, and the Department of Veterans Affairs suspended the school from one of its education programs. Amid the crisis, the company changed its name to Adtalemin 2017 and the next year sold DeVry University, whose enrollment had cratered, for zero dollars.

Adtalem held on to a lesser-known asset, Chamberlain University, which trained thousands of nurses a year. And to fill its DeVry-size hole, Adtalem turned to Walden University, a campus-free online university based in Minneapolis. In announcing the 2021 completion of its $1.5 billion acquisition of Walden, Adtalem touted the school’s ability to address “rapidly growing and unmet demand for healthcare professionals in the U.S.”
“That’s absolutely a false statement,” says Raea Thompson, a current Walden student in Tomball, Texas, who served in the US Air Force before becoming an in-flight nurse in helicopter ambulances. “The only thing Walden does is give you an Excel spreadsheet” with precepting locations that other students have used, she says. “They’re not placing you anywhere. They’ll do coaching calls and talk to you about how to approach a potential preceptor. I’m sorry, I’m a grown adult. I know how to talk to them. I need a job.”
Steele, who ran Walden’s nurse practitioner programs for eight years, says she developed concerns as it grew. Before she left in 2020, the school had more than 15,000 NP students and fewer than 20 full-time faculty, she says, and made up the difference with hundreds of part-time teachers who weren’t always qualified: “Most of the people we hired had never taught before.” She says she was fired after raising concerns about Walden’s failure to mentor and train its part-time teachers.

The minimum undergraduate grade-point average for incoming students was 2.5—not high enough, in Steele’s view, to guarantee all applicants were of high quality. The school became “all about the money,” she says. “I don’t think we ever refused anybody.” Steele worries about the impact Walden’s graduates will have on America’s patients.
Click to expand...
Yeah I started reading it thinking "yeah, yeah, just telling us more of what we already know" but ended up quite surprised by the numbers quoted.
 
sloh said:
Wow………..

Adtalem isn’t a household name, but its previous moniker, DeVry University, was, thanks to its ubiquitous advertising. DeVry listed on the New York Stock Exchange in 1991, and by 2010 it was a for-profit education juggernaut offering business and technology degrees on campuses in 26 states. But it was plagued by class-action lawsuits and investigations and eventually drew rebukes from government agencies. In 2016 the Federal Trade Commission settled a $100 million suit alleging DeVry’s ads were deceptive, and the Department of Veterans Affairs suspended the school from one of its education programs. Amid the crisis, the company changed its name to Adtalemin 2017 and the next year sold DeVry University, whose enrollment had cratered, for zero dollars.

Adtalem held on to a lesser-known asset, Chamberlain University, which trained thousands of nurses a year. And to fill its DeVry-size hole, Adtalem turned to Walden University, a campus-free online university based in Minneapolis. In announcing the 2021 completion of its $1.5 billion acquisition of Walden, Adtalem touted the school’s ability to address “rapidly growing and unmet demand for healthcare professionals in the U.S.”
“That’s absolutely a false statement,” says Raea Thompson, a current Walden student in Tomball, Texas, who served in the US Air Force before becoming an in-flight nurse in helicopter ambulances. “The only thing Walden does is give you an Excel spreadsheet” with precepting locations that other students have used, she says. “They’re not placing you anywhere. They’ll do coaching calls and talk to you about how to approach a potential preceptor. I’m sorry, I’m a grown adult. I know how to talk to them. I need a job.”
Steele, who ran Walden’s nurse practitioner programs for eight years, says she developed concerns as it grew. Before she left in 2020, the school had more than 15,000 NP students and fewer than 20 full-time faculty, she says, and made up the difference with hundreds of part-time teachers who weren’t always qualified: “Most of the people we hired had never taught before.” She says she was fired after raising concerns about Walden’s failure to mentor and train its part-time teachers.

The minimum undergraduate grade-point average for incoming students was 2.5—not high enough, in Steele’s view, to guarantee all applicants were of high quality. The school became “all about the money,” she says. “I don’t think we ever refused anybody.” Steele worries about the impact Walden’s graduates will have on America’s patients.
Click to expand...


Reminds me of dollar store knock off junk in intentionally similar packaging to the higher quality items at departments stores.
 
centdoc said:
Devry got hit by the govt for false advertising, so they just changed their name.
Click to expand...

How could they not? The whole operation couldn’t be profitable without essentially committing fraud. They required upfront payment of tuition (presumably money loaned to these people by the feds).

I’ve literally had people tell me they were training to be a RN when in reality They were getting an LPN certificate.

There is plenty wrong with higher education and non profits but I certainly don’t see for profit institutions serving the public or the people it purports to educate.
 
ProRealDoc said:
So basically all you need to get into an NP program is a keyboard or a pen to fill out the application.
Click to expand...
It is a joke. They do it online while working full time. Don't even always buy the books. Scanty "clinicals". Most of them know it's a legal scam.
 
Arch Guillotti said:
It is a joke. They do it online while working full time. Don't even always buy the books. Scanty "clinicals". Most of them know it's a legal scam.
Click to expand...
It really is a joke. We have IV hydration-vitamin infusion-weight loss drugs-ketamine-hormone therapy clinics popping up all over the place, all run by NPs.
 
jwk said:
It really is a joke. We have IV hydration-vitamin infusion-weight loss drugs-ketamine-hormone therapy clinics popping up all over the place, all run by NPs.
Click to expand...
They have just as much right to sell snake oil and scam the public as anyone else.
 
  • Haha
Reactions: jwk
MidwestRadOnc said:
I remember the time the nurse practitioner felt my neck and told me I had severely enlarged cervical lymph nodes (my submandibular glands)
Click to expand...

Before we met, my wife once went to the ER for abdominal pain. She saw an NP who palpated her abdomen and said “well I can feel your appendix and it feels normal, so that’s good”.

This was a stupid statement, but it was even more stupid because my wife had already had an appendectomy.
 
Arch Guillotti said:
It is a joke. They do it online while working full time. Don't even always buy the books. Scanty "clinicals". Most of them know it's a legal scam.
Click to expand...
Rampant cheating abound. Cheating on their silly papers and their ridiculously easy tests. And of course you can get your inexperienced NP friend to be your preceptor to get your hours.
At least some of them are speaking up against this and trying to bring awareness to it.

But I love how they love use the term “imposter syndrome” when the reality for these young NP is they are completely incompetent. “Incompetent Syndrome”!! The brainwashing is soo deep.
 
dozitgetchahi said:
Before we met, my wife once went to the ER for abdominal pain. She saw an NP who palpated her abdomen and said “well I can feel your appendix and it feels normal, so that’s good”.

This was a stupid statement, but it was even more stupid because my wife had already had an appendectomy.
Click to expand...
Damn. Literally they make it up as they go!! I mean does this person know what comes first, the large or small intestine! WTAF???

Ok I used to think medicine had quite a bit of narcissistic sociopaths, now I see nursing is giving us a run for the money.
 
jwk said:
Exactly what they do with the anesthesia DNPs. Absolutely zero additional clinical education with that 3rd year. Just fluff and political crap.
Click to expand...
At least they still have standards even though they have added a year of BS.
 
Getting into PA school is hard. Getting into NP school is essentially filling out an application. NP schools are money making. Open up an online school for cheap, charge the same amount as in person, and nurse gets to work a full time job.

NP online especially is a joke. But if you can keep a full time job and take on line courses, then I would too if I were a nurse.

It is scary how an NP who does an online course can be hired for the same job as a PA who went through a much more hands on program.
 
The NP thing makes a mockery out of our system.

I know of NP students that have NP preceptors that just sign on these clinical hours for them.

Medical students/residents would not even think about something so egregious.
 
Last edited:
I am posting this here because I don't want to create another thread.

Here is something that happened to me recently.



Have guys/gals given more than 1 mg of Narcan before?

I was the hospitalist on call and I got called to the recovery room by ortho surgeon because a patient would not wake up after a hip surgery.

Went there and saw RNs/anesthesiologist/AA working on patient. MAP in the high 40s but other vitals were ok. Blood sugar/gases were ok.

Patient has history of ESRD, narcotic abuse etc...

Presented with hip fracture. Was given 2mg of dilaudid right before he was taken to the OR. No drug screen performed.

I dont know what type anesthesia was used.

I asked if they gave narcan and they said yes. 0.2 mg

I told them to administer 1 mg ASAP. RN/Anesthesiologist/PAA asked [challenged]me multiple times if I really want give 1mg. I had to raise my voice a little when RN was taking too long to do it. Started him on pressor as well.

Needless to say patient woke up immediately after he got the med and MAP became >120, while he was on his way to get a head CT.

I have given that dose before iboth as a resident and as an attending.

I have seen other physicians give 2 mg before. I am not sure what was the issue
 
Last edited:
Splenda88 said:
I am posting this here because I don't want to create another thread.

Here is something that happened to me recently.



Have guys/gals given more than 1 mg of Narcan before?

I was the hospitalist on call and I got called to the recovery room by ortho surgeon because a patient would not wake up after a hip surgery.

Went there and saw RNs/anesthesiologist/AA working on patient. MAP in the high 40s but other vitals were ok. Blood sugar/gases were ok.

Patient has history of ESRD, narcotic abuse etc...

Presented with hip fracture. Was given 2mg of dilaudid right before he was taken to the OR. No drug screen performed.

I dont know what type anesthesia was used.

I asked if they gave narcan and they said yes. 0.2 mg

I told them to administer 1 mg ASAP. RN/Anesthesiologist/PAA asked [challenged]me multiple times if I really want give 1mg. I had to raise my voice a little when RN was taking too long to do it. Started him on pressor as well.

Needless to say patient woke up immediately after he got the med and MAP became >120, while he was on his way to get a head CT.

I have given that dose before in both as a resident and as an attending.

I have seen physicians give 2 mg before. I am not sure what was the issue
Click to expand...
The Narcan vial I've seen is 0.4mg in a 1ml vial. For minor overdose I've given 0.04mg at a time (the vial would be diluted in 10ml) and quickly titrated to effect. For arrest-type overdose I've given 0.4mg at a time - sometimes needing 2-3 doses. So 1mg at a time sounds OK except that you might put them into hyper-acute withdrawal. But that's better than having under-treated overdose!
 
Last edited:
kidthor said:
The Narcan vial I've seen is 0.4mg in a 1ml vial. For minor overdose I've given 0.04mg at a time (the vial would be diluted in 10ml) and quickly titrated to effect. For arrest-type overdose I've given 0.4mg at a time - sometimes needing 2-3 doses. So 1mg at a time sounds OK except that you might rapidly put them into acute withdrawal, which it sounds like you did.
Click to expand...
I see. The pressor probably made the withdrawal looked worse.

I went to a crazy residency where we pushed high dose of narcan all the time.

I was afraid they were playing around with someone that could go into arrest at any minute. I figured out the surgeon called me because he thought they were taking too long. They called me at 6pm and the surgeon dictated his note at 5pm.

It was also amazing that the surgeon did not know anything about the patient; could not even tell me his name.
 
Last edited:
Splenda88 said:
I am posting this here because I don't want to create another thread.

Here is something that happened to me recently.



Have guys/gals given more than 1 mg of Narcan before?

I was the hospitalist on call and I got called to the recovery room by ortho surgeon because a patient would not wake up after a hip surgery.

Went there and saw RNs/anesthesiologist/AA working on patient. MAP in the high 40s but other vitals were ok. Blood sugar/gases were ok.

Patient has history of ESRD, narcotic abuse etc...

Presented with hip fracture. Was given 2mg of dilaudid right before he was taken to the OR. No drug screen performed.

I dont know what type anesthesia was used.

I asked if they gave narcan and they said yes. 0.2 mg

I told them to administer 1 mg ASAP. RN/Anesthesiologist/PAA asked [challenged]me multiple times if I really want give 1mg. I had to raise my voice a little when RN was taking too long to do it. Started him on pressor as well.

Needless to say patient woke up immediately after he got the med and MAP became >120, while he was on his way to get a head CT.

I have given that dose before iboth as a resident and as an attending.

I have seen other physicians give 2 mg before. I am not sure what was the issue
Click to expand...


I have personally never given more than 120 mcg. Giving 1mg would be very unusual in our PACU. Especially with a normal blood gas in a patient with a history of opioid abuse and likely opioid tolerance. How was the postop pain after giving 1mg? You can give more but you can’t take it back. If they’re not peri-arrest from opioid overdose, I wouldn’t start with that much.
 
The whole point of a slow titration is to avoid a sympathetic explosion resulting in complications such as myocardial ischemia, stroke or SCAPE. 1mg is a bit ambitious and narcan is easy to work in over 10 minutes. No point in bolusing that much unless the patient is comatose on the sidewalk in San Francisco.
 
DrOwnage said:
The whole point of a slow titration is to avoid a sympathetic explosion resulting in complications such as myocardial ischemia, stroke or SCAPE. 1mg is a bit ambitious and narcan is easy to work in over 10 minutes. No point in bolusing that much unless the patient is comatose on the sidewalk in San Francisco.
Click to expand...
^^ This is the correct answer, IMO. I would not choose a 1 mg dose right off the bat for those exact reasons.
 
DrOwnage said:
The whole point of a slow titration is to avoid a sympathetic explosion resulting in complications such as myocardial ischemia, stroke or SCAPE. 1mg is a bit ambitious and narcan is easy to work in over 10 minutes. No point in bolusing that much unless the patient is comatose on the sidewalk in San Francisco.
Click to expand...
I see what you are saying; we had a almost similar case (anesthesia again) last month in which the patient coded after she was given only 0.4 while everyone was waiting for her to wake up. Cardiologist showed up yelled at everyone and gave 2mg once and ROSC achieved immediately (though BP shoot up). I have seen that twice and did not want to take that chance.

Indeed that guy SBP shoot up to ~200, but he was also also on levophed that I just started. I stopped the levo gave 10 mg labetalol and his BP gradually went down.
 
Splenda88 said:
I see what you are saying; we had a almost similar case (anesthesia again) last month in which the patient coded after she was given only 0.4 while everyone was waiting for her to wake up. Cardiologist showed up yelled at everyone and gave 2mg once and ROSC achieved immediately (though BP shoot up). I have seen that twice and did not want to take that chance.

Indeed that guy SBP shoot up to ~200, but he was also also on levophed that I just started. I stopped the levo gave 10 mg labetalol and his BP gradually went down.
Click to expand...


If patients are needing that much narcan, something is very wrong with your anesthesia department.
 
Narcan (naloxone) is a lifesaving medication that reverses the effects of an opioid overdose. It’s available as a nasal spray and injection.

The Narcan nasal spray dosage for adults and children is 1 spray in one nostril. The injectable Narcan dosage is 0.4 mg to 2 mg in adults, and 0.1 mg per kg body weight in children.

After administering Narcan for an overdose, call 911 to report the overdose and request help. You can continue to give Narcan every 2 to 3 minutes until the person becomes responsive or resumes breathing, or until emergency help arrives

This is from the manufacture
 
Splenda88 said:
I am posting this here because I don't want to create another thread.

Here is something that happened to me recently.



Have guys/gals given more than 1 mg of Narcan before?

I was the hospitalist on call and I got called to the recovery room by ortho surgeon because a patient would not wake up after a hip surgery.

Went there and saw RNs/anesthesiologist/AA working on patient. MAP in the high 40s but other vitals were ok. Blood sugar/gases were ok.

Patient has history of ESRD, narcotic abuse etc...

Presented with hip fracture. Was given 2mg of dilaudid right before he was taken to the OR. No drug screen performed.

I dont know what type anesthesia was used.

I asked if they gave narcan and they said yes. 0.2 mg

I told them to administer 1 mg ASAP. RN/Anesthesiologist/PAA asked [challenged]me multiple times if I really want give 1mg. I had to raise my voice a little when RN was taking too long to do it. Started him on pressor as well.

Needless to say patient woke up immediately after he got the med and MAP became >120, while he was on his way to get a head CT.

I have given that dose before iboth as a resident and as an attending.

I have seen other physicians give 2 mg before. I am not sure what was the issue
Click to expand...
I give it in 4 mg blasts not infrequently but the setting is different (ED, patient often shows up unresponsive/not breathing).
If it's a 911 call, police and medics will generally have given them up to 8 mg intranasal and 8 mg IV or IM by the time they get to me.

If it's a still breathing overdose, we often give anywhere from 0.04 to 0.4 mg.
 
Splenda88 said:
I see what you are saying; we had a almost similar case (anesthesia again) last month in which the patient coded after she was given only 0.4 while everyone was waiting for her to wake up. Cardiologist showed up yelled at everyone and gave 2mg once and ROSC achieved immediately (though BP shoot up). I have seen that twice and did not want to take that chance.

Indeed that guy SBP shoot up to ~200, but he was also also on levophed that I just started. I stopped the levo gave 10 mg labetalol and his BP gradually went down.
Click to expand...
Just to clarify, someone was breathing for the patient in this situation?
And presumably doing chest compressions?

Because sometimes you still have to percolate the narcan around a bit.
 
TooMuchResearch said:
I give it in 4 mg blasts not infrequently but the setting is different (ED, patient often shows up unresponsive/not breathing).
If it's a 911 call, police and medics will generally have given them up to 8 mg intranasal and 8 mg IV or IM by the time they get to me.

If it's a still breathing overdose, we often give anywhere from 0.04 to 0.4 mg.
Click to expand...
We had these cases all the time when I was at a major trauma center.

I had the feeling the ortho surgeon called me after he see these guys were playing around with a patient with a SBP of 60s who was not moving at all.

I was surprised when the surgeon called me. I said why is he calling me for someone in the recovery room? Shouldn't anesthesia take care of that?
 
Last edited:
TooMuchResearch said:
Just to clarify, someone was breathing for the patient in this situation?
And presumably doing chest compressions?

Because sometimes you still have to percolate the narcan around a bit.
Click to expand...
No one was breathing for him. RR 10-12 and he was on NC (don't remember how many liters)
 
Splenda88 said:
We had these cases all the time when I was at a major trauma center.

I had the feeling the ortho surgeon called me after he see these guys were playing around with a patient with a SBP of 60s who was not moving at all.
Click to expand...


Couple thoughts and questions for that case.

1. 2mg of dilaudid would be a lot for hip fracture on an opioid naive patient. In a opioid abuser it’s anybody’s guess. Did he receive any additional opioids during the case?

2. What was the respiratory rate and pCO2?

Trying to determine severity of overdose.
 
Last edited:
Splenda88 said:
I see what you are saying; we had a almost similar case (anesthesia again) last month in which the patient coded after she was given only 0.4 while everyone was waiting for her to wake up. Cardiologist showed up yelled at everyone and gave 2mg once and ROSC achieved immediately (though BP shoot up). I have seen that twice and did not want to take that chance.

Indeed that guy SBP shoot up to ~200, but he was also also on levophed that I just started. I stopped the levo gave 10 mg labetalol and his BP gradually went down.
Click to expand...

Splenda88 said:
No one was breathing for him. RR 10-12 and he was on NC (don't remember how many liters)
Click to expand...


So that patient had PEA arrest with a RR 10-12 and adequate oxygen saturation? To me the picture doesn’t add up. Could there have been another cause of PEA arrest?
 
nimbus said:
Couple thoughts and questions for that case.

1. 2mg of dilaudid would be a lot for hip fracture on an opioid naive patient. Did he receive any additional opioids during the case?

2. What was the respiratory rate and pCO2?

Trying to determine severity of overdose.
Click to expand...
RR-10-12

pCO2 was high normal

He is not opioid naive. He is actually an opioid/benzo/amphetamine abuser, but we did not know what was in his system already before he got 2mg of dilaudid.
 
nimbus said:
So that patient had PEA arrest with a RR 10-12 and adequate oxygen saturation? To me the picture doesn’t add up. Could there have been another cause of PEA arrest?
Click to expand...
He did not have PEA arrest, but had a GCS of 3.

Anyway, the guy is ok now.
 
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