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Respiratory Therapy Driven

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

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Kids Site about the Human Body
2008-06-02 10:07:00
The picture on my last post came from this site:http://www.thehumanbody.ecsd.net/It' s a site made from a 2nd grade class and here's is what it says it's about:The Human Body A Telecollaborative Project for St. Mary's Grade 2 Class with Mrs. Vaage and Mrs. NugentI though it was a pretty neat site, there is a gallery of pictures of the human body drawn by the kids and in there are little articles about the different body parts written by the kids. Fun little site I thought I would share.
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Nebulizers or MDI's inline with a Ventilator?
2008-06-02 08:40:00
Here at my hospital we seem to go through streaks of how we give medication to patients on ventilators. For a couple of months we might use MDI's and then we might just switch over to Nebulizers inline for a couple of months, and it is normally the same doctor who will oversee these patients on vents, it would be our pulmonologist who does it.Tonight I just came back from being off for 2 days and we now have 3 ventilators running and all three of them are getting nebulized medications. One of the vent patients used to be getting MDI treatments but has now been switched over to nebulizer treatments. So I got to thinking which is better? Could this just be because he has Xopenex ordered as one of the medications along with Atrovent? Shouldn't be the reason we carry these by MDI also I have heard, even though I have yet to see a Xopenex MDI here at this hospital.Doing some reading online and my own personal experience I have found different pro's and con's of using either a ne...

Pixie Dust...What can it do for us?
2008-05-29 11:33:00
There is a article at CNN.com about some stuff coined "Pixie Dust" which is being experimented with on soldiers who have a amputated body part like fingers, arms, legs or toes but not heads. This is being trialed at Brooke Army Medical Center (BAMC) in San Antonio Texas where I took my Respiratory Training.You can read the article here: Pixie DustThis pixie dust is supposed to give the body a salamander effect and trick the body into regenerating the missing body part. The powder forms a microscopic "scaffold" that attracts stem cells and convinces them to grow into the tissue that used to be there."If it is next to the skin, it will start making skin. If it's next to a tendon, it will start making a tendon, and so that's the hope, at least in this particular project, that we can grow a finger," Wolf said.This is pretty interesting, how could this help our profession? Could this "pixie dust" help regenerate lungs destroyed by smoking, improving quality of life for COPD patient...

Protocols Do Work.
2008-05-29 09:55:00
Today I had to come into work early due to the requirement of the monthly Staff Meeting. Ohh what fun, but I did actually gain some information this time that I thought was pretty interesting.If you have read one of my earliest posts I talked about a Therapist Driven protocol that we had implemented at my little hospital about 7 months ago. This protocol had to do with us the RT's assessing patient and then being able to adjust nebulizer, MDI and Oxygen therapy's as we deemed needed. Well we are now done with the testing phase of the implementation of our therapist driven protocol and a letter from our director is out to the doctors with surveys to see if we continue with this type of therapy.There are some statistics that we pretty interesting that were compared from this 6 months of the protocols being in use and the 6 months prior to the protocols being in use. These stats were pretty interesting and pointed in favor of using these protocols and making them law. The only a...
More About: Work , Protocols

Stop and put you hand on that person.
2008-05-25 12:21:00
I'm coming up on my re certification of my CPR card very soon and I was looking around on the guidelines at the American Heart Association to see if there are any new changes, and wow did I see something different:Hand s Only CPR.There are only 2 Steps to save a person's life:1) Call 9112) Push hard and fast in the center of the chest.So I started looking around a little bit and from what I understand is that this simplifies the process for the standard layperson. Just make a phone call and press that chest.This is just for a adult who was witnessed collapsing not someone who possibly has been down for awhile or a drowning victim. So basically if you see someone collapse just start pressing that chest. Easy right.One of the big things I see this helping is the though of most people that they don't want to put their mouth on a strangers mouth for fear of disease, this is understandable and this technique removes that problem. Also this is a very simple process so the person who...
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Here's you card....Duhh
2008-05-24 09:42:00
Ring Ring (RT Department Phone ringing)Me: Respiratory Therapy, can I help you?Nurse: I have a patient who wants to take his MDI, he has 2 in his med cabinet but only had orders for one of them but he wants the other, can I give it to him?Me: What is the order for?Nurse: Albuterol 2 puff, may take on own.Me: What is the name of the other mdi medication he has?Nurse: Ventolin.Me: (Laughing to self) Ok Ventolin is albuterol, it's the a commercial name of albuterol.Nurse: Really, I've never heard of it.Me: Yea it's like how acetaminophen is the same a Tylenol, or ibuprofen is the same as Motrin only cheaper.Nurse: Ok I got it, so which one can I give him?Me: (Duh look no face) Which ever one he wants.Someday people will understand.
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Miracle, sure it is, but something is missing.
2008-05-24 08:43:00
I ran across this new article here from Newsnet 5 talking about a woman who was clinically dead but miraculously came back to life and all was well.Here is the article, for you RT's out there you might find something out of the ordinary, or which I have given a hint by making the area's bold. This will also all into line a bit with my previous article about respiratory mishaps in movies and TV shows.Woman Wakes Up After Family Says Goodbye, Tubes PulledCLEVELAND, Ohio -- A West Virginia woman was being transferred to the Cleveland Clinic after walking the line between life and death. Doctors are calling Val Thomas a medical miracle. They said they can't explain how she is alive. They said Thomas suffered two heart attacks and had no brain waves for more than 17 hours. At about 1:30 a.m. Saturday, her heart stopped and she had no pulse. A respiratory machine kept her breathing and rigor mortis had set in, doctors said. "Her skin had already started to harden and her fingers cu...
More About: Miracle , Missing

Google Health.
2008-05-21 17:12:00
Just a quick post here about the recently released:Google Health I've been playing around with it a bit and it does seem like it could some in pretty handy and informative for someone who uses medications and has multiple medical problems.You can put in your medications here and it will show indications, contraindications and possible problems if you have incompatible medications, which is good so you don't become like Heath Ledger.One thing I'm not to sure of on this site is the ability to upload your medical records to the site. I'm thinking some kind of privacy issues here, but on the other hand it's Google and if they do share your information you can definitely win a large sum of money from a lawsuit.Overall it looks very promising as all Google products seem to be, I do like the idea of all my information, calendar's, email and other information in one place. Google is a well respected name and is probably trustworthy. It's probably something that could help people ke...
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High off Inhalers?
2008-05-19 12:03:00
I ran across a article in Science Daily that is talking about teens misusing inhalers (MDI's) to get a buzz or get high off of them."Asthma inhaler misuse is prevalent in the adolescent population, particularly among antisocial teens, US study findings indicate."I find this interesting because I'm wondering how many puffs off of a MDI do they have to do before the feel any effects of being high?There was a study conducted to get an idea of how prevalent this actually is and the results were kind of surprising:"Brian Perron (University of Michigan, Ann Arbor) and Matthew Howard (University of North Carolina at Chapel Hill) conducted a cross-sectional survey with face-to-face interviews assessing substance use, psychiatric symptoms, and antisocial behaviors among 723 adolescents in residential care. Over 26% (193) of adolescents were diagnosed with asthma, 91.2% of whom had received a prescription for an inhaler. Almost a quarter of the 373 adolescents who had used a prescribed or ...
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Bronchospasm or something else?
2008-05-19 09:04:00
Over at the Respiratory Cave, Freadom has a group of "Olin's" which are a listing of all the magical properties that Ventolin is supposed to have, but we all know better now don't we as RT's, and hopefully most RN's who look at our RT blogs have learned from us on what breathing treatments can REALLY cure. Actually our breathing treatments can really cure .. (drumroll please) .. is NUTTIN!!! No really it cannot cure anything, it can only help ease the discomfort of a symptom which would be a bronchospasm. Thats right Ventolin or Albuterol only really relieves bronchospasms.So what am I getting at here, well I'm going to show different problems that we are called for that this wonder medication cannot really do anything for because it's not a bronchospasm issue. Please feel free to comment and criticize to your heart's content if you disagree with me on this topic. But really some things we cannot help a whole lot with Albuterol.Congestive Heart Failure - the fluid needs t...

I always thought is was A.B.C.
2008-05-16 12:04:00
One basic principle that was driven home to me as a medical professional in either of my schools, be it my Combat Medic course, EMT course or Respiratory Therapist course has been the concept of the ABC's, also known as Airway, Breathing, Circulation. This has always been understood my be to be there order of importance when it comes to a person in medical need. Yes this is supposedly for mainly first responders and emergency situations.Now in the Emergency Room I would think that this would come into play, because well its a emergency room. Unfortunately I have noticed at many places, and a lot where I work that I will get a call the the ER for a patient that needs a breathing treatment. This usually tells me that there is a person in the ER that is having some type of difficulty breathing, and if you look at the ABC though process it would be number 2 on the list, because if they can breath in a nebulizer tx the airway must be somewhat patent.Here is my issue that I see more ...
More About: Thought

Healthcare Workers Week? HUH.....
2008-05-15 09:39:00
Is it just here at my hospital or is everyone celebrating Health care Workers Week 2008? Tonight there was cake and other food items being brought around to the different departments for this particular week. This happens to be Health care workers week 2008, now I don't remember a version of this for 2007 or any year prior to this year. Is it a new thing we get to add on to our calendar as a hospital worker.Really this isn't a bad thing, we got cake, pens, sticky notepads, and from what the hospital grapevine is saying we are getting a rolling cooler that can hold 36 cans of your favorite beverage. You can't get much better than that. Maybe this can make up for nothing being done for us up here in my small hospital for Respiratory Care week 2007.Has anyone ever stopped and looked at all the so and so special weeks, months and days there happens to be in a hospital? Seriously there are a lot and just for an example here are some of them I see posted on walls and flyer's:Nur...
More About: Healthcare

Whoa It's been awhile, people are still nuts.
2008-05-10 07:36:00
OK so I have to apologize for not posting for like 2 months now, I became a little busy with life and this was put on the back burner. My hospital started blocking personal (BLOGS) sites from viewing on the internet so I wasn't able to log onto Blogger here and post anything because I usually did it from work. Home has been a bit busy and there just wasn't enough hours in the day to do much posting.So here I am posting again, my hospital set up a WIFI network for patient and others to use so I bring my laptop into work now and can have some time to post again. So stick with my I'm able to do this again.Now on to more pressing matters, OK so it's only what I think is a funny little story about a patient at work who really either had no clue, or she just wanted to be difficult and not have to the my therapy.We RT's here at my little hospital have to start and do Incentive Spirometers with every surgical patient for 4 times to make sure they are doing it correctly and acheiving...
More About: People , Nuts , Whoa

Compassion, Real or Fake?
2008-02-25 11:30:00
I've came across a observation that I have finally seemed to put my finger on and it deals with compassion towards our patients and with all health care workers that I have dealt with.First off how about a definition which I took off of Wikipedia:Compassion is an understanding of the emotional state of another or oneself. Not to be confused with empathy, compassion is often combined with a desire to alleviate or reduce the suffering of another or to show special kindness to those who suffer. However, compassion may lead an individual to feel empathy with another person.Now that that is out of the way I will continue.As health care workers we need to be able to show compassion and empathy towards people who are not feeling well or even dying. This is something we are told in school that we need to use is compassion towards our patients.Understand that not everyone in health care is able to show compassion and those are the one try entirely to hard to fake showing compassion. This is...
More About: Fake , Real

Do you have any Coupons?
2008-02-11 06:17:00
First off I want to say thank you for the kinds words about our accident, everyone is recovered now and things are finally back to normal, again thank you.Have you ever wondered what the patient is going to be charged for those great therapy's we provide for them?Well I have wondered that, and were I currently work the night shift RT does all respiratory charges for the day on the patients. I did a little digging and found a area in our computer system that allows me to see exactly what it costs the patient for their different therapys they have received, pretty interesting and a little fun to see how much people are up to on their bills for the stay they are currently in.So anyways here is what I have found for prices with respiratory therapy services here at my little hospital. Also keep in mind that some of these items I am told are package deals where more than one piece of equipment is included in the cost, what a bargain right...but I will try and distinguish which ones they ...
More About: Coupons

Gotta Love the Grand Caravan's
2008-02-03 07:30:00
Just a quick posting here tonight.I haven't been able to get around to posting lately due to an automobile accident my family and I had last Saturday.We were on the way home from my girls swim meet and traveling on a country road when our vehicle became caught in some slush and ice on the side of the road and started pulling our van off the road, my wife tried to keep up on the road but over corrected a bit and we flew across the road head first into a telephone pole breaking it in half. The back end of our vehicle flipped over and we were on the roof and then started rolling finally ending up on the passenger side of the vehicle.When we finally stopped I figured out that I really wasn't hurt but then became the scariest part of it, getting ready to look around and see if my wife and 4 kids were ok or horribly hurt, possibly even worse. First I looked up to see my wife hanging from her seat and she had blood running down her face and was very swollen but she was alert and talki...
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Friends Vs. Military Friends
2008-01-25 17:14:00
Ok so this doesn't have much to do with Respiratory or medical in general except it was sent to me from one of my Respiratory friends from the Military so I guess it's kind of Respiratory related.I thought this was interesting and actually very true as I'm closer with my Military friends than I am with my say High school Buds. Which is OK because really my military buds and I have been through much more together in my 10 years of service, hell we lived together in many different situations and places. So anyways here goes:Friends Vs. Military Friends1. FRIENDS: Tell you not to do something stupid when drunkMILITARY FRIENDS: Will post 360 degree security so you don't get caught2. FRIENDS: Call your parents Mr. and MrsMILITARY FRIENDS: Call your parents drunk as hell and tell them aboutThe fat chick you tried to pick up3. FRIENDS: Hope the night out drinking goes smoothly, and hope that noone Is late for the ride home.MILITARY FRIENDS: Know some wild shit will happen, and set up...

Nothing to do but keep busy.
2008-01-24 02:05:00
I am back out of a busy time at my place of business. We have gone from 8 patients with treatments through the night, 3 bipaps and 1 ventilator running back to just having one Q6 during the night now, actually only 4 patient with breathing treatments in the whole hospital, wow what a change huh.This got me wondering what do people do at their hospital when they have nothing to do? What are some things to keep you mind from total boredom?This list below are some of the things that I know of from different places I have worked at, some current and some not so current. In my current job I am the only night person on in my department at a time so we have to find things to do, if there was 2 of us here we could take turns being on call, but as you see that isn't possible.Things to do when you patient load is down:Catch up on some reading, personal or work related. A library card is nice to have for this.If you have internet access take a online college class. Great time to do homeworkBr...
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What a Difference 3 days makes!
2008-01-19 12:32:00
I don't really have a lot of time to write much here today but I thought I would put a little something up on the Ol' Blog.I was off for 3 days and when I get back it's crazy busy here. This is the classic "Feast or Famine" in my little hospital and we are definitely feasting over here.When I last worked I had a whole two Q4's to do through the night, now 3 days later there are 7 Q4's and a ventilator to keep me busy. Much to my surprise though all of these Q4 treatments are actually really sick. Forgot to mention the 2 bipap's we have running also which are not for sleep apnea but for respiratory distress, so yes they happen to be pretty sick to.A common theme I noticed with these sick patients and with some of the QID patients also was that there is a Mucomyst craze right now that just seem to have started. Not only is it Mucomyst there is this large concotion of Mucomyst, Albuterol or Xoponex, and Atrovent together ... but wait there is more, not only do we throw in those 3...
More About: Days , Difference

Herbal Asthma Tea?
2008-01-15 13:02:00
Was surfing around and came across this posting for:Herbal Asthma TeaThis blogger states that this tea concoction helps with her asthma.Some of the ingredients are:Lemon Verbena: known for stopping wheezing.Skull cap: is good for respiratory health.Chamomile: It’s a relaxant, anti-allergenic, antispasmodic and anti-inflammatory.Caffeine: Suposedly has a effect on asthma.Here is the Recipe on the siteAsthma Tea1 part of each in dried herb form - Chamomile flowers, Passionflower, and Echinacea Root1/2 part each in dried herb form - Licorice root, Elecampane root, and lemon verbena leaves.Not sure if this all works but check the site to see what you think.Enjoy.

Lab results we might be interested in.
2008-01-15 09:09:00
I started wondering today about what lab results might be of interest to the friendly neighborhood RT so I did some researching and tried to narrow down different tests that could come in handy for information in our area of work. One test that I will not include here is the Arterial Blood Gas (ABG) because if you are a RT this is a common test and you should know this one my now. I will be looking at test that normally nursing and doctors will look at more than us but maybe could give us some insight on the patient.Lab Results of Interest to Respiratory TherapistsAlpha-1 Antitrypsin: LungsAn alpha-1 antitrypsin concentration is ordered to help diagnose the cause of early onset emphysema, especially when a person does not have obvious risk factors such as smoking or exposure to lung irritants such as dust and fumes.Alpha-1 antitrypsin (AAT) is a protein that is produced in the liver and released into the bloodstream. AAT helps to inactivate several enzymes but primarily works to pro...

Quick Request for Information.
2008-01-15 01:50:00
We use the Voldyne Incentive Spirometer and it has the predicted volumes for patients with the age over 20. But how do you calculate the predicted volume's for patients under the age of 20? We currently have a 13 year old patient who had surgery and the Doc wants I.S. done and we have a protocol on doing these but we cannot find a proper predicted volume.If anyone has a chart or calculation for this could you do me a favor and leave a message with this information..Thanks for any help.
More About: Information , Quick , Request

My Mirror RT.
2008-01-14 11:09:00
Back again for episode ... Umm something or another.OK so I live in a small RT cave at a small hospital in a small town on night shift. I also happen to be the only RT on at night, besides my mirror RT who works the nights I don't work. Which if you think about it is kind of funny in the way of social interaction type thing. You see here we only have a total of 9 people here in my RT department and the other night shift person is the only person I really don't know all that well. Why you ask? It's because there are only 2 of us night shifters here and if I'm working he is off and if he is working I'm off so with this little interesting arrangement we never really see each other, we will never really attend the same function together, we will never meet out with coworkers to have a drink together, nothing. The only real interaction we have together is over the phone if one of us wants to make a switch of shifts. I hear stories and anecdotes of him, some good, some bad, some inte...
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Military Occupational Speciality: 91V10.
2008-01-09 12:53:00
Life in the Respiratory Therapy school where I went was and entirely different experience than the standard college Respiratory course I think I am safe to say. I only say this because I did my schooling in the U.S. Army and with this post I am going to try and explain what my school was like. Now keep in mind that I didn't go through the college course for Respiratory Therapy at all so I really cannot compare the two with personnel experience but my comparison comes from other RT's who went the standard route of college. So here is my story of sorts on how I did it.This all started when I was over in Mogadishu Somalia and my first 4 years of enlistment was coming to a end and I had some choices to make: Stay in as a Medic, change MOS (Job), or get out and be a civilian. I wasn't ready to get out(ETS is acronym for basically get out) yet and I figured that I should go for more schooling if I wanted to become more marketable if I ever decided that I wanted to ETS in the future. At...
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We have a Drought!!!
2008-01-09 12:26:00
This is just a FYI and a call for anymore information.So my little department here is down to just 2 Nasal Cannula Humidifiers (AKA Bubblers) here in my hospital. Where have they all gone?OK word around here has it that the FDA has decided to put stronger rules or whatever on the Sterile water for Inhalation and how it's made and packaged, so they have not stopped the companies from making anymore at this time. What more do they want? Extra sterilization, better packaging, fruity flavors? Hell I don' t know.What I do know is that is what we are told here at my Cave and that there is a nationwide shortage now of Bubble humidifiers for nasal cannulas. Has anyone else head of anything about this, or can anyone find any articles on this topic that is current ... I have found some from 2003 but am looking for something more current.Oh well just thought this was interesting and would like to know if anyone else out there in Respiratory land has been told anything.Drive on and keep ...
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30 Minutes past tired.
2008-01-06 11:37:00
First off Happy New Years everyone and I hope it's a great one for you all.So anyways this is my weekend to work and we consider our working weekend to be Friday and Saturday for us 2 night shifters here at my small Hospital and this is why I'm 3o Minutes past tired which in my opinion why I'm so awake right now, I'm past tired but it makes work easier so I'm not falling asleep here.Friday started early trying to find someone to cover my first 4 hours of my 12 hour shift. Why would I do that, well my daughters (9 and 10) are on a private swim team here in my town and they have a meet this weekend out of town which would of been Saturday and Sunday, BUT the coach put them in to do their first Mile (1650 yards) race. Now as swimmer in High School myself and a proud Dad there is no way I'm missing this. Of course they have to be at the pool at 15:45 and school gets out at 15:35 so of course we have to pull them out early with no complaint from my girls and drive 45 min's away to...
More About: Past , Tired , Tire

Chips Anyone?
2008-01-01 06:00:00
Well I found this kind of interesting, the first of this medical device that I've had a patient actually using. OK let me explain this one.I was doing a ECG on a patient in the ER tonight and the ECG machine was picking up a lot of artifacts on the tracing so I readjusted all my leads and checked my wires and disconnected the lead to the ER monitor and still the same with the artifacts but the ECG machine was saying it was detecting muscle tremors. Now here is the part the that I though was quite interesting the patient said to me "Could it be the chip a doctor had implanted in her when she had heart surgery last year?" so now I'm curious and I ask her what chip is she talking about and she continues to tell me that it was told to her after the surgery that the doctor implanted a microchip in her with information of her surgery for future knowledge.Now I start thinking maybe this is one of the RFID chips that I have heard about which can carry your medical information. I'm thinki...
More About: Chips

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