I so agree on those silly kidney basins. Will keep an eye on all that you have
mentioned in your discussion, Mr. Morrone.
________________________________
From: optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf of
Richard Morrone <rmorrone@xxxxxxxxxxx>
Sent: Friday, March 10, 2017 1:46 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: 10% vs 25% Fluorescein
Coy,
For what it's worth, I pulled these two studies on injection speed for you (see
attachments). If they don't attach, let me know, and I will email you
separately. Of course, the results are the opposite. I could not find
anything on adverse reactions based on the concentration of dye, nor have I
ever heard of any.
As to nausea and vomiting, I prefer the 1cc-per-second approach. I agree with
Lori that we have to look elsewhere for causes. There's the way that the dye
is similar to chemotherapy drugs in the crossing of the blood/brain barrier.
And frankly, I need all the fluorescence I can get to avoid hitting the patient
with higher flash levels. I've had the dye myself on 8 occasions as the
subject for testing camera systems or filters, etc. I got the nausea 4 times,
and on 2 of those 4 times I tossed my cookies. Same 5cc and 5-second push each
time.
Being a hypoglycemic myself, I have always suspected blood sugar as a
contributing factor.
I've been at this for 43 years, and throughout this time my incidence of nausea
has been more like 2 to 3%, with vomiting below 1%. All I can say is that I
try to provide a lot of levity to balance the hard work that I will be putting
the patients through. I have joked during a lengthy color montage prior to the
FA that my hobby before getting into this work was torturing small animals,
resulting in laughter and a playfully snide comment from the patient. The
nurses and I have our comedy act worked out as well. In this I play the foil
to the nurse and patient ganging up on me. All this distraction occurs without
missing a beat as we take care of business.
If the nausea hits we get the 13" wide pail (forget those silly kidney basins),
and the nurse places an alcohol wipe under the patient's nose and asks them to
breath deeply and slowly. The alcohol acts sort of like smelling salts or
ammonia capsule, but a lot milder. Between the alcohol, the attention and the
calming, we get through the nausea quickly and move on.
Richard Morrone, C.R.A.
On Friday, March 10, 2017 5:47 AM, "Egnatz, Thomas" <tegnatz@xxxxxxxxx> wrote:
I am posting this for Coy. Sorry about the delay, I have been off Optimal for
a month (new computer).
Tom
From: Cobb, Coy, VHACIN
Sent: Thursday, February 16, 2017 9:22 AM
To: 'optimal@xxxxxxxxxxxxx'
Subject: 10% vs 25% Fluorescein
Morning all
Would anyone know of any studies comparing 5cc’s of 10%, verses 3 cc’s of
25% fluorescein ?
Specifically, I’m looking for anything that addresses adverse reactions.
Coy Cobb COT CRA
