No fancy label here 😉 but I sure do make my own stinky bathroom spray. It’s beyond easy. .
Do you have any idea how many chemicals are in febreze!? Or a bathroom spray? According to the @environmentalworkinggroup, most of them score anywhere from a C all the way to an F!!! (They are rated A for better F for worst) They have fragrances which little tip, means you have no idea what’s in that. They do not need to disclose all their ingredients. They can exacerbate asthma and other lung conditions, they HIDE odors momentarily they do not eliminate, they can cause allergic reactions, and more! I personally can’t stand the way they smell. This was one of our biggest reasons for pulling our first born out of day care when we were financially ready to take the hit of working less. One time my husband picked him up and the room was saturated with cheap #dollarstore febreze. It was horrible. We found out after complaining that day, they aren’t even supposed to be using it. .
The easiest thing to eliminate in your home is the sprays. This spray is a 2oz aluminum spray I got off @amazon . I use filtered water from the fridge and put about 20 drops of #essentialoils in it. It seems like a lot but it’s not being used on my skin. It’s literally to cover up the stinky bathroom smell. And it works. I actually sprayed it in my cloth diaper bag tonight because it had a little stink to it and I’m not washing until tomorrow. I don’t add any preservatives to this one , occasionally I’ll add witch hazel to it. Guys, my bathroom smells like Christmas right now 🤣 because those who know me know I used Siberian fir !
Each day is a humbling reminder that no matter what barriers to healthcare we must overcome, there is no greater satisfaction than educating and learning from my patients, colleagues, and all of you! 🙏🏽👨🏽⚕️
Most of what I post on social media is meant to be educational, but from time to time, I try to catalog milestones in my training. In this case, it's receiving my official board certification in critical care medicine. 💉🤓😷☺️
Over the next week, I'll be presenting at our departmental Grand Rounds and submitting my research abstract for the Society of Cardiothoracic Anesthesia annual conference next May in Chicago! Looking forward to finishing these two tasks, so I can get back to studying echocardiography for my critical care ultrasound certification mid-January! 📚
As always, thank you all so much for the support, questions, and words of encouragement! 🙏🏽
Aconteceu hoje a última reunião do Sapiens MI de 2018. O aluno Gil Mário Carvalho apresentou um artigo sobre valor-P, abordando sua aplicabilidade em ensaios clínicos, e o aluno Rafael Brito apresentou seu novo projeto de pesquisa. Foi também discutido o andamento de todas as linhas de pesquisa do grupo.
Terminamos o ano com muitos de nossos projetos apresentados, escritos e submetidos a revistas e congressos. Esperamos continuar produzindo mais conhecimento e pesquisa em 2019!
7 303 hours ago
“You breathe without thinking … I just think about breathing.”
Life is ALL about perspective. How often do you slow down and imagine yourself in someone else’s shoes? Sometimes just thinking for a moment about how the pathophys is affecting our patients is enough to make a difference in the care we provide, particularly with those who suffer from pulmonary issues such as cystic fibrosis. ⠀ ⠀
powerful words & image from @saraillamas
Throwback circa 2009– my first “real” job was as a Registered Respiratory Therapist for ER & Adult ICU. For those of you that are unfamiliar, RTs are crucial in the hospital. They respond to Rapid Response Team/ Code Blue calls, are champion baggers, perform art sticks, intubate/extubate, help manage ventilators and weaning off life support, provide breathing treatments, and attend high risk deliveries of babies. Basically they are all things Airway. I spent 4 years as at RT, and it has absolutely made me a better nurse based on those situations and watching amazing nurses do their thing. Make friends with your RTs. They’ll be there to help when your patient crumps on your shift. Plus, they don’t mind suctioning all those secretions that most RNs are afraid of 😷😷🤣🤣 #albuterolfixeseverything#intubatedandsedated#RRT#CriticalCare#ICU#BSN#NurseW1se#healthcare#registerednurse#neonatalICU#NICURN#nightshift#teamwork
Open Tracheostomy Tube Placement. #ICU week 2 of 2. This patient suffers from respiratory failure. After 7 days on the #ventilator without any progress the Critical Care Team consulted general surgery to place a #tracheostomy tube. Given the patients multiple medical issues we elected for an #open techniques instead of a percutaneous one. A 8 cuffed Shiley trach was used in case someone was wondering. The small window at the end of the video is monitoring Carbon dioxide return, which helps confirm placement in the trachea.
38 13034 days ago
I cried for about 95% of my commute to work last night. I’d learned that a pt who’d been on the unit >30 days had been withdrawn on and passed. Between the sense of loss, thinking of the devastation being experienced by his partner, and possibly some emotional lability that comes along with being on your third night shift in a row, these emotions completely blindsided me.
I started the shift in an awful mood.
I sulked around for several hours until my charge told me she’d watch my 1:1 pt/break me as the spouse of a pt I’d cared for the prior week (w/ an EXTREMELY bleak outcome) had mentioned during rounds how he hoped I’d stop by to say hi.
To be clear: I am NOT one of those nurses who spends HOURS chatting with family members. But somehow, this pt’s partner (M) and I talked together until past 2 AM! He showed me pictures of their life together and told me stories about the patient I knew to only be a vented, sedated Impella on CRRT and numerous drips post code. M asked me all of the questions I hope for EVERY family member to ask about their loved one.
As soon as I entered the room, I was overcome with that urge to cry again, but this time it was with tears of joy, gratitude, relief.
After spending 3 nights with this pt, I’d written off the possibility of a positive outcome; I knew that IF he walked away, he’d have some sort of lifelong side effect(s). I’d given up hope.
And yet here was my pt sitting up in bed, carrying on a conversation with his spouse, practically completely delined and free of any devices. It was an actual miracle. M and I had a nice long hug and chatted for a bit before he thanked me for being their “angel” and for the care I’d provided.
For the first time in a long time, I felt my WHY again. It’s so easy to get fixated on the negative outcomes, especially in a high acuity unit. But it’s these miracle stories that I’m so grateful to be a part of and that keep me going. And that doesn’t mean I won’t still mourn the loss of my sweet patients whose lives end far too early; but it will serve as a reminder to me to celebrate these victories without reservation and ALWAYS keep my hope burning bright. 🔥🔥🔥🔥
Yes folks It’s another Tako Tuesday!
This is an echocardiogram of a 60 year old lady with no medical history presenting with crushing chest pain and hypotension. She had a recent death in the family. .
EKG showed deep anterolateral T wave inversions. What you see here is:
1️⃣ A 3 chamber view of her echocardiogram. Can you pick up why she is in shock??
2️⃣ Still image in diastole with labels
3️⃣ Still image in systole with labels
Diagnosis: Takotsubo Cardiomyopathy complicated by SAM. The ole broken heart syndrome again! This case has been complicated by SAM (systolic anterior motion of the mitral valve) which sucks the anterior mitral leaflet into the LVOT (left ventricular outflow tract) which can obstruct the output from the LV and cause severe mitral regurgitation, both of which can lead to shock. This occurs because the distal ventricle is akinetic and the basal segments can be so hyperdynamic it sucks the leaflet towards the septum causing obstruction - which is the same thing you can see in HOCM patients.
The treatment of choice in this type of shock? IV neosynephrine for pure alpha action and IV esmolol to decrease contractility. We want to AVOID any increase in ionotropy or afterload reduction that will make the obstruction worse! Even an IABP can make these patients sicker.
Tag a friend who works in cardiology.
Have you ever seen a tako or SAM before? Comment or question below.
76 7628 hours ago
It’s crazy to believe that just two years ago, I was a Med-Surg nurse with absolutely zero critical care experience. All I ever wanted was to work in critical care and be a master of my domain. Well, that goal is ever changing and lifelong. Many of you have requested tips and suggestions for transitioning to the ICU. Below are some things that have helped me to transition and continue growing:
1. Read about common ICU principles you will come across before you start work. Brush up on the basics of the ICU. This includes: Intubation and ventilators, pressors, paralytics, and sedative drips, and common disease processes
2. Prior to the start of your critical care journey, otain your advanced cardiovascular life support (ACLS) and pediatric advanced life support (PALS). But dont just check them off your certification list, understand them! Every code follows these algorithms!
3. As you grow in your respective critical care field, find out what specialized training certifications and licensure are available for you to expand your knowledge and growth. Examples include, CCRN, TCRN, TNS, TCAR, and many more. -
4. Trust me on this one: You know nothing! Be an open bottle and let the knowledge flow in. -
5. And lastly, be patient. ICU is an art. The more you see, the more you realize this. .
Tag someone who wants to be an ICU nurse or needs to read this!