Speaking of hypoglycaemia, years ago we started giving our diabetics a small
juice box before the FA to avoid that sugar crash. I haven't been taken down
by 250 lbs of dazed confusion since (the patient was a lot bigger than I am,
and trying to ease him down to the floor as he fainted then seizured wrenched
my bad back).
Anyone else use this or a similar method?
Plus a wintergreen lifesaver for those that are just queasy - helps get rid of
the metallic taste of the dye and the rest of the session goes fine.
Lori
Lori Guerette, CRA COA OCT-C
May you find your marbles,
And recall the carefree joy of childhood
On Mar 11, 2017, at 7:48 AM, Patti Kish <photohomer@xxxxxxxxxxx> wrote:
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
