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Another quarter down only ONE MORE to go 😀 3 mo Another quarter down only ONE MORE to go 😀
3 more months until graduation!! 🎓👩🏻‍🎓
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⏰ 2,200 hours of clinical experience down and some more to go BUT
⠀⠀⠀⠀⠀⠀⠀⠀⠀
The countdown begins 🎉
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#crna #srna #srnalife #srnaproblems #nurseanesthesia #nurseanesthetist #nurseanesthesiologist #anesthesiology #nurseanesthesiology #futurecrna #srnatocrna #nurseblog #icurn #crnaweek #nurseanesthesia #crna #crnaschool #srnatocrna #nurseanesthetists
I highly do not recommend tag-teaming a case with I highly do not recommend tag-teaming a case with your friend cause you will end up dying from laughter at each other the entire time. 🫀💉 @ed.tee 
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#crnaschool #arewedoneyet #futurecrna #futurecrnas #srna #srnalife #srnaprobs #srnaproblems #nurseanesthesia #nursesweek2022 #nursesweek #anesthesia #aneathesiaschool #nurseanesthetist #nurseanesthesiologist #operatingroom #scrublife
PROPOFOL FACTS🤍😴💤 Did you know the last 2 PROPOFOL FACTS🤍😴💤
Did you know the last 2 slides? 🤓
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Don’t forget to save this for later!
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#propofol #milkofamnesia #anesthesia #anesthesialife #crnaschool #srna #srnalife #srnaprobs #srnatocrna #futurecrna #icunursing #icunurse #icunurses
Nurse Anesthetist loaaaaadingggggg… ⠀⠀⠀⠀ Nurse Anesthetist loaaaaadingggggg…
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4.5 months til’ the title!! 🎓
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#futurecrna #crna #nurseanesthetist #anesthesiaschool #nurseanesthesiologists #nurseanesthesiologist #srnalife #srnatocrna
I thought I’d be all coordinated and wear this c I thought I’d be all coordinated and wear this cap for dental cases, then the OR nurse asked me if there were butt cracks on my cap & now I’ll never unsee it 😂 🍑 looks like this is my new endo cap 💩

#crnaschool #srna #srnalife #scrubcap #scrubcaps #mallampati #futurecrna #anesthesia #anesthesiaschool #icunurse #gastrointestinal #dentalanesthesia
I’ve been seeing so many versions of what happen I’ve been seeing so many versions of what happened with #radondavaught that me & my roommate found the official court documents & photo evidence for those who are interested in what happened in the words of RaDonda herself. In general, don’t ever trust what comments you read on social media, & read the facts before forming your opinion, regardless of what stance you take. This is an unfortunate circumstance for everyone involved & I am so SO ready for the nursing profession to start to feel passionate and empowered again. 😕 Swipe to read, what do you guys think?
Let’s talk about blood transfusion! 🩸⁣ ⁣ Let’s talk about blood transfusion! 🩸⁣
⁣
𝐩𝐑𝐁𝐂𝐬 ⁣
🔴 Transfusing 1 unit of pRBCs raises Hgb ~ 1g/dL & Hct by 2-3%. This provides a good estimate of where you should be at without drawing labs.⁣
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🔴 There are 𝘢𝘥𝘥𝘪𝘵𝘪𝘷𝘦𝘴 that increase the shelf-life of blood. ⁣
- 𝐂𝐢𝐭𝐫𝐚𝐭𝐞: anticoagulant. You don’t want your blood clotting in the bag! It inhibits calcium. Keep this in mind if giving multiple units, could lead to hypocalcemia. ⁣
- 𝐃𝐞𝐱𝐭𝐫𝐨𝐬𝐞: substrate for glycolysis for energy (ATP). This prevents the RBC from using the oxygen they’re transporting to the tissues. ⁣
- 𝐏𝐡𝐨𝐬𝐩𝐡𝐚𝐭𝐞: a buffer that prevents acidosis⁣
⁣
🔴 Although these additives are great to prolong banked blood, they also come with consequences the longer the blood sits there. ⁣
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𝐑𝐢𝐬𝐤𝐬 include:⁣
- ↓ 𝐩𝐇 = ↑ lactic acid = bad⁣
- ↑ 𝐊 (keep in mind for renal fail pts). Hyperkalemia can result from an impaired RBC cell membrane that happens with stored blood, causing K to leak out. ⁣
- ↓ 𝟐,𝟑 𝐃𝐏𝐆 = ↓O2 release to the tissues. Which is the whole point of RBCs right. To deliver oxygen to the body. This is why with ECMO patients we used to ask blood bank for our blood to be <10 days old, to get the max benefit for these sick hypoxic patients. ⁣
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🔴What does 𝘭𝘦𝘶𝘬𝘰𝘳𝘦𝘥𝘶𝘤𝘵𝘪𝘰𝘯 mean? You’ll see this a lot on your blood bags. Leuko = WBC, reduced. This reduces/removes WBCs from pRBCs. This decreases the risk of febrile transfusion reactions & other adverse effects. ⁣
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💾 Save this post for reference! Want more posts like this? Let me know in the comments 👇🏼
It was a cool day. I remember the first time an an It was a cool day. I remember the first time an anesthesiologist went to intubate and he let me peek at the vocal cords when I was 15. I fell in love with anesthesia that day. 

Early on in clinical, I would think of that moment sometimes & wonder how he was able to do that so gracefully. I remember being so overwhelmed with intubating - how was he able to keep that perfect view for so long and so casually? I felt like I had seconds before I would lose my view and struggle to find it again. I felt like that would never be me and that I was a failure. 

I remember being asked by preceptors to explain each step of what I was doing during induction, and how my mind would literally black out cause I was trying so hard to focus on the tasks. How could they expect me to say everything out loud and the rationale plus answer their questions during such a critical moment? 

Today there were 2 nursing students shadowing in the OR, & my preceptor told me to explain everything I was doing & then I did. And when I went to intubate I got my view & asked them both if they wanted to see & then they did. And idk if I’m emotional because I’ve had 3 hours of sleep or cause that was just kinda cool because I finally felt competent enough to do what that MD did 15 years ago but yeah it was a good day.
Let’s talk about heparin! A commonly used antico Let’s talk about heparin! A commonly used anticoagulant 🩸
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🩸 Heparin is derived from 🐄 lung & 🐖 GI mucosa 🥺
🩸 It binds to antithrombin (a natural anticoagulant circulating in our bodies already) and amplifies it 1000x 💪🏼
🩸 The official definition of 1 unit of heparin is….the volume of heparin-containing solution that prevents 1mL of citrated 🐑 blood from clotting for 1 hour following the addition of 0.2mL of 1:1000 CaCl. Phew how’s that for a definition!😮‍💨
🩸 The typical VTE prophylaxis dose is 5000u SQ BID/TID
🩸 You monitor heparin via your PTT or ACT. 
🩸 Normal PTT: 25-35 sec
🩸 Normal ACT: 90-120 sec
🩸 To reverse heparin you give ➡️ Protamine!
🩸 Protamine is derived from salmon sperm 🥴
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💾 Save this post for later!
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#nursingeducation #medicaleducation #crnaschool #srna #srnalife #srnaproblems #anesthesia #anesthesialife #icunurse #icu #icunurses
Student budget = 5 bikinis under $15 😱👙 Whic Student budget = 5 bikinis under $15 😱👙 Which one is your fave 1-5?! I’ve linked them all in my bio under shop my gram - free ship + returns 🛍

Sassy Anesthesia

Crash cart
Nursing

My First Code Blue

March 26, 2018March 26, 2018

Code Blue. The two most anxiety-provoking words to any nurse. When you’re a new nurse, the thought of your patient coding is always a lingering fear. When’s it going to happen to me..? Will I freeze? What if they don’t make it?

If you think your patient is headed towards a Code Blue, keep investigating. The take-home is, YOU know your patient best. Trust your instincts FIRST, and then take other’s opinions second in regards to your patient. I learned this very well after my first code blue, which goes as follows.

It was 4 months after I got off orientation. Brand new little me struggling to stay afloat in the ICU. I don’t remember exactly what my patient was in for since this was years ago, but I believe he had gone for possible stent placement that day. He was an older guy, and they weren’t able to stent him. They compared his coronaries to concrete. He was stable when I came on, and I’m doing my little assessment while the family was in the room talking.

I overheard them saying how they didn’t believe the doctors when they said he was doing okay. The family knew something was wrong. To me, the patient appeared stable. Vitals in check, good mobility and strength, and was talking with his family. Alert. I told the family he was doing well (regret number one), and that he may just need some blood pressure medicine if his blood pressure were to drop.

The family left and as I expected, his blood pressure did drop. I called the doctor and we started levo. Problem solved.

Around midnight, he started complaining of pain. He didn’t speak english, but was pointing to his chest. I had someone translate and ask him if he was having chest pain. He shook his head yes. Okay crap that’s not good. But we have emergency standing orders so I’m good right? I know this. He needs a stat EKG and my girl MONA. But as a new grad, I went to talk to my resource nurse first about my plan.

She asked me why I would want to order an EKG. Um, what? “He’s complaining of chest pain…”

“Well what does he rate his pain 0-10?”

“Uh, i didn’t ask that, he doesn’t speak any English.”

I mean come on… he’s complaining of chest pain… whether the guys a pansy or Iron Man, if someone mentions chest pain it’s a concern. But being new, I went with her opinion that he didn’t need one at that moment. Regret number two.

Now it’s around 0530, my shift is almost over. The dude’s been okay throughout the night. Then he gets his morning X-Ray and one lung is completely whited out. Uh. So I call the doctor right away to let him know. He’s says he’s on his way into work and he’ll see the patient first. Then my patient starts getting kinda sweaty and restless (hello hypoxia). This guy does not look good. He had wiggled his way down in the bed so I asked another nurse to help me boost. The nurse was like, “they don’t look good.” I said “I know.” This was another missed opportunity for a nurse to intervene.

It’s past six, and I’m getting really nervous at this point. This guy might code. Ok what do I do. I check where the code pedal is on the bed. Got it. I ask him again if he’s having chest pain and he says yes. The dayshift nurse has arrived. At this point I’m done, I order the stat EKG myself and go to grab morphine. I tell the oncoming nurse that this guy is gonna code. I’m pretty sure that’s what this looks like at this point. I see the resource nurse on her way out. I looked at her and was like, “my patient’s tanking!” She said, “does this mean I have to stay and help you?” Uh YEAH. I have no idea what I’m doing. I had never felt so helpless. Why is no one doing anything?

I go to grab the morphine. While I’m in the med room I hear the code bell go off. Oh God it’s happening. The dayshift nurse comes running in my direction to the supply room, “there’s no ambu bag in the room!” Nice Marissa. I’ll never forget to check for that at the beginning of my shift ever again. Regret number three.

I run into the room and somehow I knew where I needed to be. I had practiced this. I became the med nurse in the code and things were going well for me. The code lasted and lasted. All I could think during was I’ve been trying to tell people, I tried. Should I have done more? I don’t even know what’s happening. Why did this happen again?

We call it. My patient was gone. The crowd of people in the room disappear as fast as they had arrived. And now I have to go give report on my other patient. The doctor who was on his way in shows up.

Just like that everything’s back to normal. This is so weird. I start giving report on my other patient. In the corner of my eye I see the family walking down the hall. Oh my god I told them he was going to be okay. They see the post-code mess and the patient lifeless in the bed and start shrieking. “What happened to him?!” I can’t find words. Another nurse steps in and puts her arm around the woman and says, “I’m so sorry… he just passed.” She throws the nurse’s hand off of her and the entire family goes into the room and starts wailing. I continue finishing my report.

At the end of report I went in to talk with the family. I felt terrible. There were so many of them crying and yelling. The grandson was like, pounding the countertop in frustration. People are asking me to control the noise. I went in and told them that this had literally just happened, and I was so sorry. They kept saying they knew something was wrong. I guess I did too.

What I learned

I kept replaying the night over and over again and thought about what I could have done differently. At the end of the day, they already said his coronaries were shit and he didn’t really have any other options. So eventually this guy would have died anyways. However, I believe there were a lot of opportunities for myself and others to intervene before it got to a code situation.

  1. I should have gotten the midnight EKG. If there were issues then I would have called and medication could have been given at that time.
  2. At that early point in my career, I felt like I had done everything in my power. I had gone to the resource nurse for guidance, I had called the doctors throughout the shift. Everyone was aware of what was going on. So I felt good about that.
  3. The nurse helping me boost could have stopped and talked through things with me. Experienced nurses should always investigate a situation like that, and help when necessary. It was the end of the shift, and it was crunch time. Gotta make sure canisters are changed and blankets are tucked for dayshift.
  4. Lastly, I learned to ALWAYS trust your instincts. I knew something was wrong all night and I was right about wanting the midnight EKG and medication. Today, I would have laughed when they said no to the EKG and ordered it anyways. But being new, it really is hard to stick up for yourself when someone with thirty years of experience is telling you what to do. Experience does not equal knowledge. Remember this.

Since that day, I have always been confident in regards to how I feel about my patients. Nurses get vibes you know? Trust them always. It’s better to be over-paranoid than too chill about critical situations. Be proactive and don’t second-guess yourself.

Codes get easier with experience. Get involved when you can, observe people’s roles, and debrief post-code. A code blue is only part of the end of life struggle we all see as ICU nurses. Stay tuned for a future post on how to deal with code status discussions and death/dying as a nurse.

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4 Comments on My First Code Blue

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4 comments on “My First Code Blue”

  1. Nalu
    June 11, 2018 at 11:52 am

    I stumbled on your IG account and blog. This post was truly riveting. You are right about getting vibes about patients – I always get a feeling when something’s off and I can’t put my finger on what it is. However, that resource nurse did let you down and you did what you could at the time. Thanks for sharing!

    Reply
  2. Taylor Thompson
    May 23, 2018 at 4:13 am

    Hi! I just found your Instagram and blog through another nursing Instagram account. I was reading through your posts and was sad to see there were only 3 pages! I learned so much from your code blue post and the Being new in the icu. I worked as a nurse intern in a Neuro icu and now will be starting orientation as an RN very soon. Please keep writing! I also love your travel posts and I think it’s amazing you don’t let anything hold you back from travel even if you have to work 8 nights in a row! You’re awesome girl, xoxo – Taylor

    Reply
    • lipstickandlifesaving
      May 23, 2018 at 10:32 am

      Aw thank you so much for reading! Posts like this keep me going! Thank you so much 🙂

      Reply
      • Katrina
        July 13, 2018 at 2:05 pm

        I second what Taylor said! I just read the majority of your posts on nursing and found them so helpful and encouraging. I did my preceptorship in the ICU and just graduated and passed NCLEX. I’m beginning my job search and reading your posts helped me identify that it’s okay at this early part of my career to go after a position in the ICU. I was thinking, “Who am I, I can’t just go straight to ICU as a new nurse”, but I was hooked from the moment I stepped foot in there. Do I think it will be easy? No way. But I’m willing to work my butt off and thank you for your insight! Please keep posting!
        – Katrina

        Reply

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Hi, I'm Marissa.

I'm a first year SRNA. Here you can find some education & motivation, along with a touch of sass to keep you sane in a difficult but rewarding career path. Thank you for stopping by!
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Another quarter down only ONE MORE to go 😀 3 mo Another quarter down only ONE MORE to go 😀
3 more months until graduation!! 🎓👩🏻‍🎓
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⏰ 2,200 hours of clinical experience down and some more to go BUT
⠀⠀⠀⠀⠀⠀⠀⠀⠀
The countdown begins 🎉
⠀⠀⠀⠀⠀⠀⠀⠀⠀
#crna #srna #srnalife #srnaproblems #nurseanesthesia #nurseanesthetist #nurseanesthesiologist #anesthesiology #nurseanesthesiology #futurecrna #srnatocrna #nurseblog #icurn #crnaweek #nurseanesthesia #crna #crnaschool #srnatocrna #nurseanesthetists
I highly do not recommend tag-teaming a case with I highly do not recommend tag-teaming a case with your friend cause you will end up dying from laughter at each other the entire time. 🫀💉 @ed.tee 
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#crnaschool #arewedoneyet #futurecrna #futurecrnas #srna #srnalife #srnaprobs #srnaproblems #nurseanesthesia #nursesweek2022 #nursesweek #anesthesia #aneathesiaschool #nurseanesthetist #nurseanesthesiologist #operatingroom #scrublife
PROPOFOL FACTS🤍😴💤 Did you know the last 2 PROPOFOL FACTS🤍😴💤
Did you know the last 2 slides? 🤓
.
Don’t forget to save this for later!
.
.
.
.
.
#propofol #milkofamnesia #anesthesia #anesthesialife #crnaschool #srna #srnalife #srnaprobs #srnatocrna #futurecrna #icunursing #icunurse #icunurses
Nurse Anesthetist loaaaaadingggggg… ⠀⠀⠀⠀ Nurse Anesthetist loaaaaadingggggg…
⠀⠀⠀⠀⠀⠀⠀⠀⠀
4.5 months til’ the title!! 🎓
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
#futurecrna #crna #nurseanesthetist #anesthesiaschool #nurseanesthesiologists #nurseanesthesiologist #srnalife #srnatocrna
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