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Respiratory Therapy Driven

Respiratory Therapy Driven
Blog about life and information of a Respiratory Therapist

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Sometimes it gets busy.
2007-11-10 11:39:00
I've been off for 3 days now and I walk into work at the beginning of my 12hr shift with a note on the desk that says "Come down to ICU and join the fun!", now this is probably not a invitation to a party in the ICU I'm thinking. Nope it isn't after I answer the phone right after I read this it's a coworker wanting me to come on down asap, ok let me just hang my jacket up at least and grab my stethoscope and off to the ICU I go.In I walk and there my coworker is getting things ready for the Doc to intubate a patient. I can hear this patient outside of the doorway...wow major fluid issues, then I look, puffy like the stay puff marshmallow man and gray, yep this is gonna be fun. We finish getting the intubation stuff ready and the Doc slides the tube in, I place the CO2 tester on and give that first breath and it takes all my hand strength to get a breath in, wow is this patient tight...then I see it, pink frothy and bloody THICK secretion up the tube. Yep that could be a problem,...
More About: Busy

Lets Lighten it up a bit.
2007-11-06 11:19:00
Ok so that last post was a bit on the downer side so now I have to lighten up the mood a bit with a anecdote from my wife and where she works. She is a ER nurse at a much bigger hospital than mine.Anyways I thought this was hilarious.A nicely dressed lady in her late 30's comes in complaining of stomach pains. My wife goes in to get her history and information about the complaint and the patient goes on telling her that she and her husband drank a big the night before and started playing around and her husband decided to try something new and use a beer bottle as a ----- on her and she awoke this morning with stomach pains. So off the xray she is sent for a abdominal series and the xrays come back to show a bottle cap insider of her. Yes the husband used a unopened bottle that seemed become open, OUCH I would think and where the hell did the beer go. Ok now that isn't the funny part. So the doctor does in to do a pelvic exam to get the bottle cap out, and after the exam he comes b...

How low can you go
2007-11-06 10:38:00
So I'm going around doing my oxygen rounds (for the RT students, this is the fun time you get to check on all the patients who were or are on oxygen, mainly for charging purposes and sat checks), and I come upon this patient who has been in the hospital for awhile and notice that she looks awefully purple grayish in color, especially her lips. Now mind you this is in the middle of the night so the lights are off of course its 4 am. I proceed with my check by saying "Mrs. Namewithheldduetohippa I need to check your oxygen saturation levels" for which she complies and gives me the regulation oxygen check finger into my pulse ox device. After looking at the flow meter to see what flow she is on I look at the pulse ox and WHOA it's 52%!!!! So quickly I turn on the light, damn she really is purple grayish and not red in her lips at all. This lady has been on a 10-15 liter high flow nasal cannula and she had decided to take it off. I then ask her if she had been the one to take it off, ...

The Calm Before the Storm
2007-11-05 11:56:00
Only 2 patients tonight, one a Q4 and one a Q2, yep nice and quiet. This actually give me 2 more nebulizer treatments I have to do than the last shift I worked, of course the Q2 isn't as bad as this person is thought to be, but no protocol is wanted on him so I kind of feel bad waking this patient up and taking loudly just to keep him awake and deep breathing. So ok he is wheezing and sats do drop without O2 so there is a need for something.Wow ER just paged for a EKG....Turns out nothing exciting, patient just left 10 days ago and has a Doctor appointment tomorrow oh and yep EKG was fine, doc says it's probably musculoskeletal pain, now get out of here and go home.There has been some lazy shifts lately for my old RT department but isn't that how this job goes the patient load ebbs and flows like the tide. Feast or famine, you either run all night or you might sit all night and chat with the nurses or better yet blog about it.Over my time in the profession I have noticed some ...
More About: Storm , Calm

Vaseline and Oxygen: Flame On
2007-11-03 16:59:00
I have been told before that you cannot mix oxygen and vaseline together because they can cause a flame and cause problems. How many others of you have heard this information, maybe this should be put on a new Myth Buster's show.So I started looking around a bit and have came across some posting on nursing sites about whether this is a myth or not. I have found numerous references to this article, "Dispelling the petroleum jelly myth," in the November 1998 American Journal of Nursing but I have no way to access this article and cannot find a good free source for this. If anyone out there has access to this I would be interested to hear or see the information in this article.Information I have found out about this being a combustible subject is that when a patient used a thin layer of petroleum jelly on their lips due to dryness from the oxygen that the oxygen from a oxygen device to provide the patient with oxygen can cause the petroleum jelly can cause a gas that when combined ...
More About: Oxygen , Flame , Vaseline

The Lungs have the Sound of Music.
2007-11-02 10:12:00
Breath sounds, breath sounds, breath sounds. We all know and love them and listen to them daily but did you ever stop and think that there is a certain breath sound that you really enjoy hearing?Fortunately tonight I have had the time to contemplate this and I came to the conclusion that there is a certain breath sound I really like the sound of. So much so that I much just try and get it onto my IPOD, or even better yet...as a ring tone.So I'm sure everyone is in suspense wondering what the breath sound is that I find audibly pleasing, well wait no more because my favorite breath sound is the great and powerful CRACKLES!!! Why this one? Well it has a deeper bass sound and there is a range of pitches in this sound. The beginning of the crackles there is a faint noise of the crackling, then it gradually increases to the loudest sound, which this process in the musical world is called a crescendo, and then the process reverses and its gone. During the crescendo of a breath sou...
More About: Music , Sound , The Sound of Music , Sound of Music , Lungs

A Stereotypical Patient
2007-11-01 10:23:00
Everyone has some patients who are just stereotypical patients. The ones who are they way they are because of how they are. What I am going to do is try and describe a type of patient that I have noticed at every place I have worked as a RT and the reason they are this way.Yep you might of guessed it, these types irritate me a bit because of what they could do to change their symptoms.They become short of breath with exertion.They most likely are diabetic.They are usually younger 30-50 years old.They have "Exercise Induced Asthma".They have hypertension.They seem to have back problems.They like to sleep and are become tired a lot.They like to order food at all hours, or have a stash of snacks in the room.They have decreased lung sounds.They get pneumonia a lot, or just plain sickly.They give a very lazy effort when asked to do a peak flow.They have that certain smell about them.They all seem to smoke.They seem to be on public aid.Now you ask what patients am I talking about here, we...
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Different Hospital, Different Rules.
2007-10-31 06:07:00
As you might have noticed that this blog is just ideas that come into my head or interesting things that I come across at my place of work. The idea behind "Diff erent Hospital , Different Rules " is about how hospitals differ on how the utilize their Respiratory Therapists. Now you might ask where do I get my knowledge about this, well it comes from the 6 different hospitals I have worked at in my almost 12 years as a RT and I welcome comments on other hospitals out there to on how they utilize their RT's.This might be more geared to new RT's or students to give them a idea how you will work in the real work, but also can give insight to RT's who have worked in the same place the entire time they have been a RT. I personally think it is interesting as to how many hospitals really don't have a clue on what we learn in school and what our scope of practice could be. Without further chatter, here is how mine are different.William Beaumont Army Medical Center, El Paso Tx - This wa...

You Heard What?
2007-10-29 15:38:00
A patient comes into the ER the other night with complaint of chest pain so I'm called down to do a EKG on the 35 year old with chest pain. I get into the room start to do the EKG and she becomes very shy about me putting on leads. Every lead I put on she quickly pulls up her gown and the lead falls off. "Sorry ma'am I have to get this back on could you please wait until we have the EKG done, I will go as fast as possible." So I finally finish and EKG is showing normal sinus rhythm and she going into this excruciating pain look and perfectly complaining "Owwww it's hurting right over my heart and very heavy right now with the pain going to my jaw and radiating down my arm." So I give the EKG to the Doc and she say this person has been here like 20 times in the last week, she is a nut case. Great so off I go.35 Minutes later I'm called to come down and do a nebulizer treatment in the ER and when I get there the Doc tells me it's in the same room as the nut case. I ask "Is...

Reading Chest Xrays
2007-10-28 07:22:00
I was thinking the other day that it would be nice to be able to read a chest xray better than I currently can so I set off to find some information on looking at different xrays and what I'm looking at. Now let me clarify that I'm talking about reading just chest xrays as this is most revelant to the job of a Respiratory Therapist, we don't really need to know if a patient has a tib/fib fracture of his left leg, that doesn't really help me out much. Well doing some searches here on the old internet I ran across a couple really good sites in my opinion on reading chest xrays so instead of writing a whole article and teaching a class on reading them because I'm not a pro at this here are a couple of sites I recommend.Wikipedia on Chest Xrays - Really good information article on chest xrays.Introduction to Chest Imaging - This many great image examples from the University of Virginia Med Program.Chest Xray Atlas - This has older images but also good explanation on what your looki...
More About: Reading

RT's vs. RN's
2007-10-27 08:27:00
I was out just searching around the old Internet when I ran across this discussion: Respiratory Therapist VS Nursing and it got me to thinking of the differences between the two. Now I know there are nurses who appreciate us RT's and on the flipside of the coin I know there are RN's who think of us as a highly paid nurses aide or trained monkey. So what are the differences between us? Who really works harder? So here I go with another list of the differences between RT's and RN's.You can become a RN in either 2 or 4 years of college. Wow you there are 2 and 4 years school's for RT also, along with the 8 month route with a commitment to the Military.RT's specialize, RN's don't but they can specialize. RT's know a lot about the Respiratory system, RN's know a little about a lot of different systems.RN's have a bunch of patients on a floor, RT's have a bunch of patients on a lot of floors. So we walk further.RN's make more money, that's a given but we seem to be creeping ...

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