Friday, July 31, 2009
Thursday, July 23, 2009
Wednesday, July 22, 2009
Some Tweets on Obama's Health Care Conference
tracycoyle gee, from what I am reading, Obama doesn't think we need hospitals or surgeons....can we try Obamacare on Medicare patients first?
InPlace2 @jescocom I have been Dem all my life & I have never seen such lousy leadership I'm a citizen not a politician & I don't like or trust obama
rfarlow Rt @TheFlaCracker Do I like obama asking himself stupid retorical quest that no 1 wld ask, then answers them? No. Does he do it a lot? Yes
boxerpaws56 RT @wikiworf: RT @SamiShamieh: If Obamarescued the economy, why do we have to spend the rest of the stimulus money? #obamafail #tcot
DallasAinsley Look up incompetence=Obama-Ignorant, not qualified-over his head. Not very intelligent
JKonwinski Tired of seeing Obama on tv!!
goliath0519 I have come to the conclusion that Obama's health plan totally sucks ass
mpillette I agree. The plan Obama is promoting is insane. Must keep up the good fight
exposeliberals RT @steveshamy: Baracktologist | RT@RightWingArtist: Obama is like a rectal exam he says its for our own good but no one wants it
djsportland @drewhastings Obama is a giant assbag and he is so full of himself I can't stand it. It's only a few trillion bucks I guess
Rocafort Please prove Obama is and loves america. To date I have felt no love for us in his heart. So far quite the opposite
infantry1 If President Obama is serious about health care reform, he hould begin with the sick state of the economy and give Chase Bank an enema
billhobbs Obama: "Taking profit motive out will incentivize the insurance companies to do better." Obama is an idiot - or playing Americans for fools
Izuhhbel Obama had a news conference on health care tonight and it's not on the trending topics. Yet the Taco Bell Chihuahua is. So sad. Seriously
Obamapocalypse RT @TexasRV Obama is now apologising to himself in the mirror for bombing tonights prime time sales pitch
Thursday, July 9, 2009
Wednesday, July 8, 2009
Thursday, July 2, 2009
PDA ligation
I just got home from almost a week in the NICU (2 more weeks till graduation, btw).
One of the many things I got to be a part of was a PDA ligation on a neonate.
What is it:
The ductus arteriosus is a temporary fetal blood vessel that connects the aorta and the pulmonary artery before birth. The ductus arteriosus should be present and open before birth while the fetus is developing in the uterus. Since oxygen and nutrients are received from the placenta and the umbilical cord instead of the lungs, the ductus arteriosus acts as a "short cut" that allows blood to bypass the deflated lungs and go straight out to the body. After birth, when the lungs are needed to add oxygen to the blood, the ductus arteriosus normally closes.
However, when it does not close, a PDA ligation is needed.
How to diagnose PDA:
Diagnosis is most often made by detecting a heart murmur heard through your stethoscope. Tests such as a chest x ray,and ECG determine the severity of the PDA.
************
When I found out I was going to get to go in on the ligation I was waiting on it all day! It's kind of like when you were a kid on Christmas Day waiting and waiting....and waiting... for mom and dad to say you could open gifts. It was like Christmas for me! But when you're waiting on the one and only neonatal cardiology surgeon in town, you're on his time.
I compare the RT department here to a fishbowl because it is surrounded by windows so that if you go into the department you are still able to see babies and their vitals.
Anyway. I was sitting in the fishbowl reading (I may or may not have been starting to nod off because all the lights are dim in the NICU)when I thought I overheard someone say "PDA" my head popped up and I looked around to see if anyone else heard it or if I was just dreaming. I figured if they did they would start walking over to that neonate. Because, after all, who HASN'T been waiting on this all day?! Nobody acted like something freaking cool was about to happen, but I walked out there anyway. And guess what! It was time!!!!!! I saw the nurse starting to scrub up to prep the patient. YYEEEEEEEES! I went and got the RT I was following because I was too scared to be in there without him in case something happened. I didn't want to shit my pretty greys anatomy scrub pants(shutup).
We scrubed up: gown, gloves, chef hat, mask. This is now a sterile area. No more fun and games.
People in the room: a few scrub tech people, anesthesiologist and his carts with goodies, RN, me and my RT, and the surgical cardiologist.
The baby gets turned to his side and secured in a comfortable position. Everything gets draped with blue sheets. *Anything blue is sterile. Don't touch it. The ceiling and windows will crash in, fighter jets will land right beside you and you will be taken hostage due to your ignorance*
The anestheologist gives his meds so the baby is comfortable and doesn't feel any pain.
Surgeon marks the spots on the babies skin with a marker.
Someone cleans and sterilizes exposed baby skin. Then it starts.
The area is cut open and the surgeon does his magic and uses the worlds smallest stapler to close the PDA. Then sews up the opening.
The whole time this is happening we are monitoring the patients vitals. If his sats start to drop or if his heart rate or blood pressure get out of normal limits we are perfectly positioned at the starting line to take off and do OUR thing. The babys sats do drop into the 70s and the bp raises. We change some settings on the vent and continue to monitor.
Everything slowly normals out.
Doc calls for chest xray.
Nurse tells another nurse (who is not scrubed up) to call radiology for cxr stat.
Surg techs start to pack up their stuff to go.
Radiology comes, I leave so I don't get nuked.
Film comes back. We look and you can see the little metal staple.
There was a very small pneumo on cxr. If the pneumo is large enough, a chest tube will need to be placed during the pda ligation. But we didn't have to do that this time.
Yes it WAS freaking awesome and I left with clean scrubs.
Some pictures I found for you:
One of the many things I got to be a part of was a PDA ligation on a neonate.
What is it:
The ductus arteriosus is a temporary fetal blood vessel that connects the aorta and the pulmonary artery before birth. The ductus arteriosus should be present and open before birth while the fetus is developing in the uterus. Since oxygen and nutrients are received from the placenta and the umbilical cord instead of the lungs, the ductus arteriosus acts as a "short cut" that allows blood to bypass the deflated lungs and go straight out to the body. After birth, when the lungs are needed to add oxygen to the blood, the ductus arteriosus normally closes.
However, when it does not close, a PDA ligation is needed.
How to diagnose PDA:
Diagnosis is most often made by detecting a heart murmur heard through your stethoscope. Tests such as a chest x ray,and ECG determine the severity of the PDA.
************
When I found out I was going to get to go in on the ligation I was waiting on it all day! It's kind of like when you were a kid on Christmas Day waiting and waiting....and waiting... for mom and dad to say you could open gifts. It was like Christmas for me! But when you're waiting on the one and only neonatal cardiology surgeon in town, you're on his time.
I compare the RT department here to a fishbowl because it is surrounded by windows so that if you go into the department you are still able to see babies and their vitals.
Anyway. I was sitting in the fishbowl reading (I may or may not have been starting to nod off because all the lights are dim in the NICU)when I thought I overheard someone say "PDA" my head popped up and I looked around to see if anyone else heard it or if I was just dreaming. I figured if they did they would start walking over to that neonate. Because, after all, who HASN'T been waiting on this all day?! Nobody acted like something freaking cool was about to happen, but I walked out there anyway. And guess what! It was time!!!!!! I saw the nurse starting to scrub up to prep the patient. YYEEEEEEEES! I went and got the RT I was following because I was too scared to be in there without him in case something happened. I didn't want to shit my pretty greys anatomy scrub pants(shutup).
We scrubed up: gown, gloves, chef hat, mask. This is now a sterile area. No more fun and games.
People in the room: a few scrub tech people, anesthesiologist and his carts with goodies, RN, me and my RT, and the surgical cardiologist.
The baby gets turned to his side and secured in a comfortable position. Everything gets draped with blue sheets. *Anything blue is sterile. Don't touch it. The ceiling and windows will crash in, fighter jets will land right beside you and you will be taken hostage due to your ignorance*
The anestheologist gives his meds so the baby is comfortable and doesn't feel any pain.
Surgeon marks the spots on the babies skin with a marker.
Someone cleans and sterilizes exposed baby skin. Then it starts.
The area is cut open and the surgeon does his magic and uses the worlds smallest stapler to close the PDA. Then sews up the opening.
The whole time this is happening we are monitoring the patients vitals. If his sats start to drop or if his heart rate or blood pressure get out of normal limits we are perfectly positioned at the starting line to take off and do OUR thing. The babys sats do drop into the 70s and the bp raises. We change some settings on the vent and continue to monitor.
Everything slowly normals out.
Doc calls for chest xray.
Nurse tells another nurse (who is not scrubed up) to call radiology for cxr stat.
Surg techs start to pack up their stuff to go.
Radiology comes, I leave so I don't get nuked.
Film comes back. We look and you can see the little metal staple.
There was a very small pneumo on cxr. If the pneumo is large enough, a chest tube will need to be placed during the pda ligation. But we didn't have to do that this time.
Yes it WAS freaking awesome and I left with clean scrubs.
Some pictures I found for you:
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