Ambulance Nurse

The first time I rode an ambulance back then was in the Philippines. We have a simple ambulance car with just have enough equipment for transporting a patient. As I can remember, it is always a bumpy ride with your patient who is very critical that needs care while traveling. Usually, patients were transferred according to their own choice or the patient needs a higher facility to take care of his/her condition.

Now, I am working in a country with a very good ambulance vehicle highly equipped with machines needed by the patient during transport. I am very ecstatic to experience riding their ambulance. This time, we took a patient from the airport sent by Medevac. Medevac means a transfer or evacuation of a patient going to the hospital through helicopter or airplane, along with nurses and doctors for critical patients.

Prior transport, you need to double check that all the equipment inside are functioning. Know the case and status of the patient you are going to send or fetch because you need to secure all fluids and medications needed.

Since the patient that we were going to fetch from the airport was unstable and ventilated, we rode along with the respiratory therapist and a Doctor aside from EMS staff.

As nurse inside the ambulance, of course, i got nervous of what might happen to the patient along the road. I had a colleague while taking the patient from the airport and transferring to the hospital, the patient crashed and they had to do CPR along the way. Thinking about it sends chills on me.

But thank God, we arrived at the hospital safe and the patient was sent directly to the ICU for management and treatment.

Happiness and satisfaction were what I felt that time since we transported the patient safe and nothing unwanted happened along the way.

just got another experience to share, thanks for reading. :)

The nurse transporter.

Why you need Magnesium in your Diet?

Magnesium is not commonly discussed in a diet specifically for its purpose and benefits to your body. Magnesium is a mineral usually present in the body. For critically ill patient,  it is very essential in maintaining good blood pressure and heart rhythm.

Nursing responsibility, we should always inform the Physician for its abnormal result. Patient monitoring and proper dosage and correction of this electrolyte should be followed along with the Doctor's order.

Normal magnesium level is 0.8mmol/L. For patients with heart problems, it should have a level of 1mmol/L. Patients in ICU, if magnesium level is low, it should be corrected as soon as possible to avoid complications according to Doctor's order/prescription. 

Why do we need to maintain its normal level?

Decreased in magnesium level or hypomagnesemia will result in having insomnia or inability to sleep, mental disturbances, irritability, anxiety and depression, muscle spasms, noise intolerance and increased level of stress.

Foods with high magnesium contents are  bananas, dark green leafy vegetables, dried fruits, fishes, beans, nuts, seeds, avocado, yogurt, dark chocolate and whole grains.

Enough amount of magnesium containing foods in a diet is a great way to maintain a healthy body.
Excessive or too much magnesium consumption might cause diarrhea since body will eliminate excessive magnesium.

If you have symptoms that might represents low magnesium level in the body, seek for Doctor's advice for treatment.

Why should you have more tomatoes on your diet

Tomatoes has many health benefits that can help maintain the wellness of a person. One serving of tomato-containing foods will have beneficial effect on your health.

Tomatoes contain vitamin A, vitamin C and vitamin K. Vitamin A helps to maintain good vision. Vitamin C aids in immune system and Vitamin K helps maintain the blood coagulation of the body by preventing excessive bleeding.   

Tomatoes contain antioxidants called lycopene. It is also rich in potassium which is usually found in bananas. Potassium aids in muscle function, especially in heart muscles.

For breastfeeding moms, when eaten, it should be cooked. It is known to increase the lycopene concentration into their breastmilk.

Other people doesn't like the taste of tomatoes for its sour-sweety taste. Try to cook for a better taste. But once you knew its beneficial effect in our body you need to love this fruit/vegie.

Fruit "slash" vegie since it has a debate if it is a fruit or a vegetable, nevertheless, it is very healthy to start your diet with tomato.

Have a fun and enjoyable meals with tomatoes!

Hyponatremia, our Nursing Responsibilities

I had a patient with severe electrolyte imbalance. Hyponatremia is not as simple as it is. Close observations and monitoring should be done for patients with this case. We usually think, hyponatremia is easy to correct, yes, but not all. It is very fatal if not treated well. 

This may cause demyelination leading to paralysis of the patient due to rapid correction of hyponatremia. Demyelination is neurological disease caused by severe damage of the myelin sheath of nerve cells in the brainstem.

For a patient, Mr. X with these laboratory results:

One might think, is this patient still alive? yes he is, thank God, He was found unconscious on his car and now needs critical management. This laboratory results usually represents Acute Kidney Injury if not Chronic Kidney Injury/ESRD since no known history for this patient upon admission.

On nursing side, i will be focusing on hyponatremia. Yes, the patient has a lot of imbalances that needs to be corrected but i will emphasize more on nursing responsibilities for severe hyponatremia.

These includes:

1. Electrolytes monitoring every 3-4hours.

2. Gradual increase of sodium level of at least 14-16mmol/L within 48hours, is the target goal.

3. When starting continuous renal replacement therapy, strict monitoring and reporting of laboratory
    results should be done, since CRRT may cause rapid correction of electrolytes which is not good
    for the patient. CRRT may be done for 6-12hours on strict reassessment as ordered by the
    Physician.

4. Proper IVF along with the right amount of free water should be followed as ordered by the
    Physician to avoid rapid correction of sodium.

5. Level of consciousness should be strictly evaluated.

With proper management, gradually, patient has improved, electrolytes, BUN and creatinine were corrected. He has gained consciousness and was extubated.

;-)

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Operating Room Nurse

A bladder stone was removed from patient.

                           

One of the things i missed and loved in nursing career was working in Operating Room as OR nurse. As an Operating Room Nurse you are expected to be always on the go. It has always emergencies any time. Successful operations were the only thing we could pray for, in an event that serious complications may arise if no immediate intervention will be done.  

Harmonious team in OR vastly affect the work flow. As a nurse, nursing skills, knowledge and attitude is important in achieving a good work flow inside the theatre.

There were on calls during the night, calls even in the middle of the night. But it is a satisfying job once you were able to help a patient survive during emergencies.