Situation: There is an issue with the disposition of ED patients paralyzed for intubation and subsequently determined to be terminal wean candidates.
Background:
The ED and Palliative Care nursing and attending staff are unfamiliar and uncomfortable with determining or interpreting a train-or-four. Some of these patients have received longer acting non-polarizing paralytics. The staff is also uncomfortable with an intubated and paralyzed patient on the pallet of care unit.
Assessment:
Some patients may not require a critical care consult. They merely would need an ICU nurse or a Critical Care attending to determine if the paralytic has worn off. These patients will need to be housed in the ICU until they are no longer paralyzed and
Background:
The ED and Palliative Care nursing and attending staff are unfamiliar and uncomfortable with determining or interpreting a train-or-four. Some of these patients have received longer acting non-polarizing paralytics. The staff is also uncomfortable with an intubated and paralyzed patient on the pallet of care unit.
Assessment:
Some patients may not require a critical care consult. They merely would need an ICU nurse or a Critical Care attending to determine if the paralytic has worn off. These patients will need to be housed in the ICU until they are no longer paralyzed and