Z gets to stay up all night..

[eelo]

I'd like to know what you're doing up, eelo?? Dosen't anybody sleep around here?!?

Actually, I'm spending time IM'ing my oldest daughter, who is currently deployed to Kosovo. Her shift was over and we were talkin...... ;-)

Also, daughter #2 (you know that one) hadn't entered all her coursework into PharmCas for this year's app cycle, so we were tackling that incredibly tedious job together. I told her that she should be happy she's only got the one Bachelor's degree, and not two BS, two MS, from eight different colleges like her dad. Now THAT would be a horrible application to file.....

Besides.... some of the threads get really, really interesting at night. ;-)

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[tussionex]

man, everyone is having a more interesting day than i am!

spent shift #1 as follows:
- data entry
- compounding 5% albumin, since we have used up this month's allocation 2 weeks ago
- 9 versed drips
- 7 fentanyl drips
- 1 nimbex drip
- CVVH/CRRT

shift #2 commences now..

hey...for all the students...when do you use nimbex in a ventilated patient?

 

[Doctor M]

man, everyone is having a more interesting day than i am!

spent shift #1 as follows:
- data entry
- compounding 5% albumin, since we have used up this month's allocation 2 weeks ago
- 9 versed drips
- 7 fentanyl drips
- 1 nimbex drip
- CVVH/CRRT

shift #2 commences now..

hey...for all the students...when do you use nimbex in a ventilated patient?

You working a double? You have internet at work? you get to mix stuff? My job suck

 

[tussionex]

You working a double? You have internet at work? you get to mix stuff? My job suck

yep, 14 hours of fun!

we have internet that we're "discouraged" from using.

my techs usually mix most of it, but they were swamped, so i helped.
it actually was quite refresing...it's nice to actually make something and not be chained to the computer all day!

 

[ZpackSux]

Has anyone asnwered the Nimbex question yet??

 

[pharmboy30]

Has anyone asnwered the Nimbex question yet??

can use in patients with renal and hepatic dysfunction?
broken down in plasma or something like that.

 

[ZpackSux]

Pregnant mama

 

[pharmboy30]

I've been playing NCAA 08 a bunch too. The people online can't handle Slaton, White, and Devine in the backfield all at the same time. I can put up 350 yards rushing on ANYBODY.

Is it lame I just found an unwrapped NCAA 06 for PS2 in my pile with my old dvd's? I almost bought 08 the other day but I still haven't played my Call of Duty 3 that I bought months ago....

 

[tussionex]

can use in patients with renal and hepatic dysfunction?
broken down in plasma or something like that.

nope....guess again...

 

[ZpackSux]

nope....guess again...

Pregnant MaMa!!

 

[ZpackSux]

can use in patients with renal and hepatic dysfunction?
broken down in plasma or something like that.

Hoffman elimination...I believe... even with renal and hepatic dysfunction, it would be safe to use.

 

[ForcedEntry]

hey...for all the students...when do you use nimbex in a ventilated patient?

Is this a trick question?

NIMBEX is an intermediate-onset/intermediate-duration neuromuscular blocking agent indicated for inpatients and outpatients as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation in the ICU.
source

 

[ZpackSux]

Is this a trick question?

No...Nimbex is slightly different than other NMB.

 

[tussionex]

No...Nimbex is slightly different than other NMB.

Z, i wasn't even thinking of that...but good point...

i was going for when it would an adjunct to regular sedation....as in, why would a patient be less able to tolerate a particular means of ventilation?

 

[ZpackSux]

Z, i wasn't even thinking of that...but good point...

i was going for when it would an adjunct to regular sedation....as in, why would a patient be less able to tolerate a particular means of ventilation?

I'm not sure if patient can tolerate any ventilation... they just have no choice but to have the tube stuck down their throat...

But Nimbex is Pregnancy Risk Factor B...other NMBs are C.

So what's the answer?

 

[tussionex]

high frequency oscillatory ventilation....gotta get the good "wiggle"!

regardless of vent type, i think i'd have to be sedated! then again, some people live trached on a vent, at home, for years...guess it's whatever ya gotta do to survive!

 

[ZpackSux]

high frequency oscillatory ventilation....gotta get the good "wiggle"!

regardless of vent type, i think i'd have to be sedated! then again, some people live trached on a vent, at home, for years...guess it's whatever ya gotta do to survive!

Good Lawd...

What the heck is that??

I better ask some pulmonologists about it... or my beloved ICU pharmacists.

 

[tussionex]

go find a friendly pulmonologist....oscillators are really cool; they're like little jackhammers of air[they run on a piston]...and they make an awesome, very creepy-medical-movie noise!

they use them once in a while in adults who remain hypoxic on regular vents, and all the time in babies [apparently, their lungs have a different elasticity/surfactant compared to adult lungs]

the "jackhammer" forces very small tidal volumes into the pt's lungs at a very fast rate that's counter-intuitive to our natural way of breathing, hence the nimbex! the babies seem to tolerate it...i'm not sure why, i think once again it has to do with the way their lungs are developed/not developed

http://rds.yahoo.com/_ylt=A9iby55sWadGI0UAyECjzbkF/SIG=126i9pn25/EXP=1185458924/**http%3A//www.childhealth.ca/files/Oscillator_web.jpgfreaky, huh?