Thursday, August 14, 2008

The story of B

It's not the book by Daniel Quinn...It's about the charge nurse I worked with one night (I was still in my orientation). Let's call him BAH.

Scenario: 10 year old patient who came in with abdominal pain, diffuse, persistent. Nausea. Patient vomited once in the ER. Given GI cocktail. No relief. IVF NS 600 mL/hr.

Easy IV start. Prominent veins on AC.

I used regular tube, and ran it around 2-3 drops per minute (600 ml/hr divided by four equals 150 drops per minute. Or 150 drops per 60 seconds. Or 15 drops in 6 seconds. Or 5 drops in 2 seconds. Or 2-3 drops in 1 second. And I am talking about MACRO drops.

BAH later on calls me into the med room and shows me a pediatric buret. Told me to use that on Pedi pts to avoid overloading. I'm an orientee, so I said...."Okay."

Okay convert that 600 ml/hr to microdrops and it turns to 600 microdrops per minute. Or 600 microdrops per 60 seconds. Or 10 microdrops per second. Can you count that fast? I cannot convert that to smaller units. So I made it fast drip using microdrop. Who can count 10 in 1 sec???

Both parents of this kid were MDs (physiatrists). They should have an idea of what's going on.

Later on, BAH, while seated behind the ordering MD, was lecturing me about how given the rate ordered, I should get the idea that MD did not want to overload pt with fluid (Duh....that's even a faster rate than what we give to many adults. I kept my mouth shut.). MD seemed ready to chuckle...

Anyway, later on, IV antibiotics was started. My fave co-RN started it for me but told me she would use a regular tube. I told her about the incident with BAH. She said, "Oh, BAH is stupid." So we were on the same footing there.

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