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Thursday, July 10, 2008

Tricks

Some make-life-easier stunts I've picked in my playground:

  • fluimucil increases metabolism of diazepam. in case of diazepam toxicity, have some fluimucil available
  • lidocaine, may it be in spray or solution form, can be very helpful during simple insertions. mix a little of lidocaine to the ky jelly during NGT and IFC insertions and *spoof!* a swabe and discomfort free insertion process results. The patient might even request to see you again for being unable to thank you enough for the unbelievably comfortable experience.
  • request for an autograph. i.e. referral slips given to interns, denied medications, in-case-of arrest-please-withhold-all-life-saving-interventions-as-per-relative-request, controlled drugs yellow prescription, errors...etc..
  • always suction before feeding. position patient on modified semi-fowler's before NGT feeding
  • ways of assessing NGT patency: inspect the placement of the NGT - the first visible calibration should appear about an inch away from the nose and the second should be visibl as well, auscultate for bowel sounds, feel for the rise of abdomen upon introduction of air, make sure that the rubber of the asepto syringe that you press for the introduction of air returns to its unpressed form briskly-if not, suspect kinking.
  • don't mix trental and calcium drugs with feedings
  • oral anti-ulcer drugs can be powdered and used simultaneously with bactroban in treating bed sores
...more lessons soon..

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