the 5 minutes huddle*
Credits to Michael Garchitorena, RN IV for this OR mock/simulation presented at the Medical Surgical Center. The simulation begins with the patient in the OR bed supine. He has received a local anesthetic (digital nerve block) bupivacaine0.25% mixed with lidocaine1% plain for intraoperative pain control from attending surgeon. The surgical team (SURGEON, RN CIRCULATOR, SCRUB,... Continue Reading →
Quantitative pupillometry uses automated infrared devices to measure pupil reactions to light, focusing on metrics like the Neurological Pupil Index (NPi) and quantitative pupillary light reflex (qPLR). It provides quick and accurate measurements that aid in diagnosing brain function and identifying potential issues, while advanced algorithms detect subtle changes in pupil responses. This method minimizes... Continue Reading →
Unlocking communication is one of the most vital parts of healing after a neurological event. When a stroke, brain injury, or illness damages the brain's language centers, it can cause aphasia—a condition that affects how a person speaks, understands, reads, or writes, without impacting their intelligence. Because language pathways are complex, aphasia presents differently depending... Continue Reading →
The "9-hour extended window" is a time frame for giving clot-busting drugs to patients with acute ischemic strokes, allowing treatment beyond the usual 4.5-hour mark. This method uses advanced brain scans to find salvageable tissue instead of just focusing on how much time has passed since symptoms started. The 4.5-Hour Rule vs. The 9-Hour Window... Continue Reading →
A DWI/FLAIR mismatch is a useful MRI finding that helps confirm if someone is having a hyperacute ischemic stroke (within the 4.5 hours). It shows that there's still some brain tissue that can be saved, which is very important to helps doctors figure out which parts of the brain are damaged beyond repair and which... Continue Reading →
Monocyte distribution width (MDW) is a blood test approved by the FDA that checks the variation in size of monocytes, which are a type of white blood cell, when they react to infections from bacteria, viruses, or fungi. This test is important for quickly identifying sepsis, assessing patient risk, and ensuring timely care in the... Continue Reading →
TRALI (Transfusion-Related Acute Lung Injury) and TACO (Transfusion-Associated Circulatory Overload) are two major reasons people sometimes get into trouble after a blood transfusion, both leading to breathing issues that can arise within about 6 hours. What are the differences? TRALI is non-cardiogenic pulmonary edema, which basically means the lungs get messed up due to an... Continue Reading →
You might have seen Dr. Haycock use the VNER index score to calculate for second dose vasopressor support. Here is the breakdown. Case report: An 85 YO female with a history of HF with preserved EF came in for respiratory distress with labile blood pressure resulting in the initiation of norepinephrine after a small bolus... Continue Reading →
Alzheimer's disease and stroke are major health issues that often affect older adults, significantly reducing their quality of life. As people get older, the chances of developing these conditions rise, leading to problems with memory, thinking, and physical abilities. Unfortunately, with aging, stroke risk also increases. A few medications treating Alzheimer's disease have been linked... Continue Reading →
Clinical Scenario: Hypertensive patient brought in by ambulance for hypertensive urgency. She's been coughing x 2 days with a recent diagnosis for pneumonia. BP 198/120, HR 130's, 10L 02 with a saturation of 92%. Hypoxia affects people with lung problems like pneumonia, edema, or atelectasis even more. These issues put extra stress on the lungs,... Continue Reading →
