Paralytic Monitoring and Care - Paralytics (Part 3) - ICU Drips
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- Опубліковано 1 сер 2024
- In this third lesson on paralytics, we take a look at the special monitoring and assessing that we do for these patients on these medications, as well as some of the special care that is required when taking care of these patients.
We start off talking about the way we ensure that they are getting the appropriate amount of these medications, and that is through doing peripheral nerve stimulation, and specifically covering the train of four. It is important that we understand what our results here mean as well as that we have the electrodes correctly placed for assessment.
We move on to talk about some of the assessment and care that goes in to our patients once they are coming off paralytics. We specifically address the issues of muscles weakness and the things we look for and check to ensure that our patients are recovering fine after these medications and hopefully have avoided the myopathies and disuse atrophies that they can develop.
Finally we cover a last couple points that are essential to know when you have patients who are being paralyzed.
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Arterial Blood Gases: • Arterial Blood Gases (...
ECG/EKG Rhythm Interpretation: • ECG/EKG Interpretation
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Check out the rest of the videos in this series here: ua-cam.com/play/PL2oVjKTYocdPLrS0odnyih8wf6zZ7WfVW.html
Don't forget to check out these other great series of lessons that we have available!
Hemodynamics: ua-cam.com/play/PL2oVjKTYocdMBZlcIcWlESbOFFaGugQS2.html
Shock: ua-cam.com/play/PL2oVjKTYocdPP0K8Fi49GfUgprICS-xMf.html
Arterial Blood Gases: ua-cam.com/play/PL2oVjKTYocdMz1qF-3iS6iUZ-R_fKbeJw.html
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Heart Failure: ua-cam.com/play/PL2oVjKTYocdNdFoS31yGhylKwib9lRf73.html
Endocrine System: ua-cam.com/play/PL2oVjKTYocdO74cmXgmKjexoq59j93-Wv.html
OR these individual lessons!
Blood Tubes - Order of Draw: ua-cam.com/video/mAmwdDdbkUI/v-deo.html
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Good videos for Refreshers and some new info. I highly recommend
Awesome to read this Elizabeth! Thank you so much!
thank you for this awesome video,it is so easy to understand,very useful
Awesome to hear! Thank you Urai.
Great resource thank you
Appreciate that!
thank you
You're welcome
Thx
You're welcome! Glad you liked the video!
Exactly! Dry mouth and dry eyes.🎯
I really love your videos. Very informative!!
I would like to know if for instance the patient has 4 twitches and the intensity is 6 Amp. Would it mean that patient is not well paralyzed and requires an increased dose of the paralytic?
So it depends what your goal is? If its just to suppress coughing, then if it has achieved that goal with 4 twitches, then no you wouldn't need to. But if it is to immobilize the patient and your goal is 2-3 twitches per order, then yes. Hope that helps.
Thanks :-)
You're welcome!
Good one
Thanks for the visit
gread job.
Thank you!
Would these paralytics have any effect on smooth muscles of the gut and affect GI motility?
Nope! Beauty is they impact skeletal muscle, not smooth or cardiac.
🎉🎉🎉🎉🎉🎉excellent
Nice presentation. Pls use brighter colours...sometimes its difficult to read. Though ur explaining it nicely
Thanks for the feedback!
So this might be a dumb question, I’m currently a nursing student that also works as an aide in an ICU. When you went over how these medications can cause atrophy of the skeletal muscles, because they are blocking ACH receptors (if I understood correctly), does preforming ROM on these patients still do anything to prevent atrophy of their muscles? Or, because of the way these medications work, does it really not do anything? Thanks!
Nope, not a dumb question! So ROM won't help to prevent atrophy, but is very important to prevent contractures and stiffening. Definitely important to be doing for all non-mobile patients.
@@ICUAdvantage follow up to this, and I appreciate your answer, would doing ROM break down muscle? And, would these medications inhibit the rebuilding of muscles? Would doing ROM as contribute to muscle atrophy if we’re breaking them down? Thanks again! Let me know if my question doesn’t make sense.
Titration off? Help! How do we safely titrate paralytics down?
great Stuff! I subscribed! May I ask for the references that you used?
Awesome! Welcome aboard! Honestly these videos are a mix of personal experience, how my hospital (or others I've worked) do it, as well as some research material across a range of critical care books and online.
What conditions warrant paralytic outside of the operating room? Deep sedation isn’t enough?
I talked about some of the indications in Part 1
Can you tell how to do a baseline tof before the paralytic drip
Yes, I actually covered that in a recent video on ToF here: ua-cam.com/video/kqUAgtV3Bb4/v-deo.html
Thank you so much for the lecture! Great info but too much fluff in the beginning of the presentation and throughout. Can condense into 5 mins easily.
Man, if you knew how hard I tried to make my videos shorter. Some people want to quick and easy, some people like the longer explanations. I honestly set a goal of 12 minutes for each video. Unfortunately I rarely achieve that goal! ☹
For the algorithm
Thank you!