So I just passed registry, and I’d like to ask a few questions before I get into this stuff. First of all, I ask that no one berate me for asking questions. The old saying goes the only stupid question is one you don’t ask. I’m just trying to learn and be the best I can. It’s not necessarily that I don’t know the answer to these things, it’s just that I know there are lots of people that are much smarter and more experienced than me on here and I’d like to hear other peoples way of thinking to incorporate it into my own. With that being said, here’s the questions.
So what’s yalls determining factor for solu medrol in asthma and COPD? I guess mine is sorta if they are having an exacerbation and have taken multiple breathing treatments with no relief, that’s probably a good reason to give it. If they take one and feel mostly relieved then probably not? Then also if they have something else such as an upper respiratory infection or pneumonia, then probably still give it so the COPD doesn’t complicate that more, correct? If they have CHF, I probably wouldn’t call that an absolute contradiction, but definitely a consideration. If their lungs are full of fluid then probably not. The COPD isn’t their main problem.
For pain medications our protocol is written like this. For fentanyl, 25-100mcg IV, may be repeated every 5-15 minutes as needed up to 200mcg. There is a lot of range and leeway in that. I’m assuming base that off their vitals, size and level of pain? If they’re larger, have perfect vitals, and their arm is turned sideways then probably err towards the higher doses at the more frequent amounts. If it’s little ole granny that twisted her ankle then the opposite. I guess that’s something that comes with experience? Our seizure protocol is worded similarly. I guess the same goes for it?
What is yalls determining factor generally speaking to whether they are in significant enough pain to warrant pain meds if they don’t have an obvious injury. I like to go by vitals, but that is definitely not always accurate. I feel like that’s probably a comes with experience thing too, right?
And lastly, for basically any ALS medication, specifically pain meds, solu medrol, anti emetics etc., what do you do if they are already on that med or a similar class medication? What point do you draw the line of giving vs not giving?
I know this is a lot, and once again I ask for no negativity please. It’s not that I don’t know the stuff, I just want to get multiple peoples opinions and learn everything I can. I’m still very early in this career and I want to learn as much as I can to excel at it.
So what’s yalls determining factor for solu medrol in asthma and COPD? I guess mine is sorta if they are having an exacerbation and have taken multiple breathing treatments with no relief, that’s probably a good reason to give it. If they take one and feel mostly relieved then probably not? Then also if they have something else such as an upper respiratory infection or pneumonia, then probably still give it so the COPD doesn’t complicate that more, correct? If they have CHF, I probably wouldn’t call that an absolute contradiction, but definitely a consideration. If their lungs are full of fluid then probably not. The COPD isn’t their main problem.
For pain medications our protocol is written like this. For fentanyl, 25-100mcg IV, may be repeated every 5-15 minutes as needed up to 200mcg. There is a lot of range and leeway in that. I’m assuming base that off their vitals, size and level of pain? If they’re larger, have perfect vitals, and their arm is turned sideways then probably err towards the higher doses at the more frequent amounts. If it’s little ole granny that twisted her ankle then the opposite. I guess that’s something that comes with experience? Our seizure protocol is worded similarly. I guess the same goes for it?
What is yalls determining factor generally speaking to whether they are in significant enough pain to warrant pain meds if they don’t have an obvious injury. I like to go by vitals, but that is definitely not always accurate. I feel like that’s probably a comes with experience thing too, right?
And lastly, for basically any ALS medication, specifically pain meds, solu medrol, anti emetics etc., what do you do if they are already on that med or a similar class medication? What point do you draw the line of giving vs not giving?
I know this is a lot, and once again I ask for no negativity please. It’s not that I don’t know the stuff, I just want to get multiple peoples opinions and learn everything I can. I’m still very early in this career and I want to learn as much as I can to excel at it.
