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Word to the Wise IV

Posted by GruntDoc on April 25th, 2006

…via the in-house code team…

When your patient is extubated (no longer on the ventillator), make sure to cancel the PRN paralytic order.

 

Just sayin. 

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This entry was posted on Tuesday, April 25th, 2006 at 3:35 am and is filed under Amusements, Medicine. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

9 Responses to “Word to the Wise IV”

  1. Moof Says:
    April 25th, 2006 at 10:11 am

    … voice of experience? *blink*

  2. beajerry Says:
    April 25th, 2006 at 10:55 am

    That depends on the ‘niceness’ of the patient.

  3. Nicole Says:
    April 25th, 2006 at 11:50 am

    Another helpful tip. When you take someone off sedation for a weaning trial and they fail, don’t forget to turn the sedation back on. I can’t tell you the number of times I’ve been called to re-intubate someone (at 2am) who took it upon themselves to remove their ET tube a little early. Then the ICU team tells me “we turned off sedation this morning but they failed the trial and we didn’t put sedation back on.”

  4. Judy Says:
    April 25th, 2006 at 4:35 pm

    No kidding on the paralytic. We don’t use Pavulon in the NICU any more, but a combination of (Thank God ET) CPAP, a new RN and a first year resident made for one really dicey couple of minutes. At least all we had to do was turn the IMV back on. I think the resident eventually went into another specialty. I know the RN didn’t last long in the NICU.

  5. EJ Says:
    April 26th, 2006 at 12:41 pm

    HAHAHAHAHAHAHA. Seriously?

  6. Ged Says:
    April 27th, 2006 at 12:07 am

    Please tell me you’re kidding. I mean, we cancel pancuronium orders as routine but… jeez.

  7. GruntDoc Says:
    April 27th, 2006 at 2:36 am

    I wish I was kidding. Good news it was recognized immediately, but the bad news was a crash reintubation.

  8. Judy Says:
    April 27th, 2006 at 1:23 pm

    The NICU order was “Contact HO before giving.” The nurse did. Doc said OK without thinking. I think we may have gone to a “double-check before giving” all Pavulon orders after that.

  9. Kim Says:
    May 4th, 2006 at 1:11 am

    Ummmm….and you would paralyze someone who was NOT intubated, why?
    Meaning, wouldn’t someone question that order on an extubated patient? Hopefully?

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