Yes, definitely interested in more on the train of 4. We don't seem to use that where I am.

@ICUAdvantage

3 жыл бұрын

Yes, definitely will be a future video!

Perfect! Thank you very much. Greatings from Germany

Studying for my CRNA school interview on Tuesday and I'm watching a ton of your videos to prepare. Thanks for being awesome! Keep making more ICU medication videos

@ICUAdvantage

Жыл бұрын

Right on man and congrats and best of luck on the interview tomorrow. You got this! Glad you've found the videos helpful!

Thanks for your very informative videos. The research you do for your videos are appreciated.

@ICUAdvantage

3 жыл бұрын

Absolutely my pleasure!

This is great. Thank you so much looking forward to more videos!

@ICUAdvantage

3 жыл бұрын

Thank you Debora!! I will keep them coming ;)

Thanks for this video!! I’m so glad you liked added this because I wanted to know more about Roc since we use it a lot in MICU🙏🏾

@ICUAdvantage

3 жыл бұрын

Awesome! Glad to hear this was a good one for you!

The video is so clear and helpful! Thank you so much xx

@ICUAdvantage

3 жыл бұрын

Great to hear this! You are very welcome.

Love your teaching as always. Thank you 😊.

@ICUAdvantage

3 жыл бұрын

You are too kind! Thank you!

Superb! Thanks.

@ICUAdvantage

3 жыл бұрын

Awesome, thank you!

You’re the best! Love all of the content you put up.

@ICUAdvantage

3 жыл бұрын

Awesome! Glad you are liking it!

Great lesson on Roc.

THANK YOU!!!!!!!!!!!!!!!!!!!!!!!!!!!!! How are you so damn smart and explain things very clearly and just EVERYTHING

@ICUAdvantage

3 жыл бұрын

LOL well I'd argue that I'm no different than anyone else who has been doing this for years. I do ensure that I do some research and planning before each video so I can try and hit all the points appropriately 😊

Thanks for the video! Looking forward to the Tof one.

@ICUAdvantage

3 жыл бұрын

Wow, a lot of people asking for this. May need to move it up the list :)

Thanks for the great video!

@ICUAdvantage

3 жыл бұрын

You are very welcome Michelle!

Thanks!

@ICUAdvantage

2 жыл бұрын

Thank you so much Mark!

cant wait for the TOF this good stuff always!

@ICUAdvantage

3 жыл бұрын

Yes, def on the todo list! And lol Morgan! Unfortunately not my area of expertise! haha That term is taking me way back!

This is incredibly helpful! You explained this really well and very much nursing focused. I can't find any other channel as good as yours. I am currently in critical care nursing program. Would love it if you could do a video on other paralytics (e.g. sux) as well, if you haven't. Thank you for what you do!

@ICUAdvantage

3 жыл бұрын

So great to hear this Bonnie! I'm really happy you have found the channel and are finding the videos helpful. I don't have any other paralytics yet as a part of this single med focused "CC Meds" series. I do have a playlist in the "ICU Drips" series, with a 4 (?) part discussion of paralytic infusions. I will be working to cover many more meds individually focused like this over time though. 😊

@bonniehuang8696

3 жыл бұрын

@@ICUAdvantage thank you I will for sure check those iv drips series out! My colleague did a presentation on CRRT using your videos. Super impressive. Keep up the amazing work and thanks again!

Thanks Eddie

@ICUAdvantage

3 жыл бұрын

You're welcome Justin!

You’re super great at explaining 🤩

@ICUAdvantage

2 жыл бұрын

Thank you! 😃 I really appreciate that.

Roc has been a big one during the pandemic with all these covid ARDS thanks ,:)

@ICUAdvantage

3 жыл бұрын

Yes and even running in short supply!

Great content as always. I'd be interested to hear your real life experiences with these medications, especially in emergency situations. Could be vid's by themselves or tagged onto the end of other ones.

@ICUAdvantage

3 жыл бұрын

Interesting idea...

Thank u very much boss

@ICUAdvantage

3 жыл бұрын

My pleasure! :)

Quite informative vedio 👍👍

@ICUAdvantage

3 жыл бұрын

Thank you. Glad you liked it!

Had my first patient on a Roc drip with pressors/sedation/vented (I’m new to the ICU) and did a neuro exam at the start of shift with no pupillary reflexes and fixed at 4mm bilaterally. I asked my preceptor if that was typical for paralytics and he dismissed it as it wasn’t a big deal. It made me nervous the rest of the day as I had 0 twitches with TOF on his ulnar and facial nerves even between titrating Roc down every few hours. Lo and behold, he coded twice on my shift and I’m wondering if he was already brain dead when I received him.

@ICUAdvantage

3 жыл бұрын

You rightfully should be concerned if you are getting no twitches. Also, what did they come in with? Was a brain injury or anoxic injury a possibility for that patient? I hope you can see some other paralytic drips and see that pupillary light reflex is still present. Same goes for paralytics given post intubation. Check it and see. Ensure you have a good light.

@BilboTBaggins

3 жыл бұрын

A roc drip. Honestly I have never heard of such a thing and I've been in the cvicu for the last 3 years. Interesting thought

@kikomagana1990

2 жыл бұрын

Roc drip? Holy shit

Thanks for your educative classes requesting if you could do targeted tempeture management in ICU.thank you for your updates highly appreciate.

@ICUAdvantage

3 жыл бұрын

Yes TTM is on the todo list!

Hi Eddie, I binged watch your videos and I find it very useful especially for a nurse outside the US who seeks a job there. Question, is there any way to check the effectiveness of Roc aside from TOF? Here in our hospital in the Mid East, we are not using that. I feel concerned that I am not helping my patient due to this. 🙁

@ICUAdvantage

3 жыл бұрын

Hi Cess! Glad to hear these are helpful for you! Sorry for the slow response. To you question, I am not aware of another way to truly check effectiveness. We can kind of assess things like reduction of spontaneous breathing, loss of cough, no observable movements, etc, but I don't know if these would let us know if we've gone too far with blockage.

Hi Eddie, thanks so much for this video. Can u please do a whole video on TOF. I had a pt in a prone position and Rocuronium Drip started on the pt and whilst get report I said I’m not taking the pt without a TOF and it was a big issue

@ICUAdvantage

3 жыл бұрын

You're very welcome Agnes. In that situation, why was it a big issue? Its really important to have that done, before hand and then checked regularly to ensure 1) that we are paralyzing too much and 2) that we are paralyzing enough. Not sure why it wouldn't have been being done nor why it was such an issue to have it.

@agnesboachie3021

3 жыл бұрын

Eddie, the pt was on the Rocuronium drip without a TOF?

Hi, can you teach on IABP, the concept and waveform?

@ICUAdvantage

3 жыл бұрын

Yes! It's on the todo list!

🔥

@ICUAdvantage

2 жыл бұрын

TY!

Can you post a video about, thorough and efficient, end of shift nurse progress notes for icu

@ICUAdvantage

3 жыл бұрын

Hmmm.... I'll see if I can include that on the todo list, but honestly I haven't worked anywhere doing progress notes is many years.

Do paralytics have an effect on pupil reactions?

Make a video about hypertensive emergencies in the ICU

@ICUAdvantage

Жыл бұрын

Its on the todo list!

As a student this really enhance my knowledge for a code Thank you Can you be my RN preceptor to finish my last 129 clinical hours if your in the state if California?

@ICUAdvantage

3 жыл бұрын

Happy to hear it was helpful! Unfortunately I am not in Cali!

Does Roc or nimbex have an effect on the muscles of the gut and/or bladder? A general concern for patients on a continuous drip over a long period of time:

@ICUAdvantage

3 жыл бұрын

Great question. So NMBAs should have minimal if any effect on smooth muscle. There doesn't seem to quite be a consensus, but it seems as probably not much impact. That said, the immobility can lead to slowed gastric motility.

In our institution , doctors prefer not to dilute Rocuronium or Atracurium when given as continuous infusion, so it will be more effective according to them. What do you think? Does that matter?

@user-ho7ob2qj4m

3 жыл бұрын

and how then its given? I mean just full perfussor with Rocuronium? and secondly,for how long has been given continuous infusion at your place? in my clinic its just always as bolus every 1-2 hours, depends from miorelaxant.

@sourcandy1143

3 жыл бұрын

@@user-ho7ob2qj4m yes, just Rocuronium in the perfussor . The infusion continues for several days depending on the case .

@ICUAdvantage

3 жыл бұрын

I personally have never heard this. We have always used diluted paralytics without any issue. It seems to work just fine and the doses are as expected. Sometimes we just do repeated push doses, but if that is going to go on, then we move to the drip.

Why is it that pupillary reaction is not affected by the roc?

@ICUAdvantage

3 жыл бұрын

Different neurotransmitter/receptor activation than skeletal muscle. Same for cardiac muscle.

*succ had entered the chat*

I can't find the notes for this topic. Any help?

@ICUAdvantage

2 жыл бұрын

Good catch. That one got missed. It is there now though! :) And thanks so much for your support Vosk!

CCRN