Practical Pointers: Discover Shortcuts Devised by Colleagues (February 2006)
Saddle Up for Jugular Venous Pressure Assessment
A problem frequently encountered when you tilt the examination table to measure jugular venous pressure is the tendency of patients to slide down the table when the back is elevated more than 15 degrees. A simple solution is to have patients fully extend their legs and place their heels in the stirrups (standard on most exam tables). With this support, patients can usually be comfortably tilted as much as 50 degrees. However, use of this technique with persons who weigh more than 280 lb may damage the stirrups.
— Dennis Bauman, MD
Columbus, Ohio
Cleaner Catch Urine in Girls
When a young girl provides a urine specimen, have her sit backwards on the toilet after wiping with cleansing cloths. By spreading the legs further apart and changing the tilt of the pelvis, this position decreases the contact the urine has with the labial folds and thus reduces the chances of a contaminated sample. It is also effective in older girls and women and can be used whenever hip or mobility problems do not preclude the necessary hip abduction.
— Karla Giramonti, RN, MS, FNP
Albany, NY