Respiratory Therapy 101 Just Keep BreathingRespiratory Therapy 101 Just Keep BreathingRespiratory Therapy 101 is a blog about my life in the world of medicine. I am a respiratory therapist, and my job is to make sure that people keep breathing. It is an important job because if they are not breathing, they are not doing anything else. Articles
Break:
2008-04-26 20:22:00 Now for a break from the usual madness. By way of Atomic Nerds, I found this image: I am way too amused by this. I’ll be chuckling about this all week. More About: Break
JCAHO strikes again
2008-04-26 04:41:00 We all know that I think the Joint Commission is about as useful as a screen door on a submarine. I’ve found that most people who work in actual clinical jobs share my contempt for the Joint Commission because we can see it for what it is; namely, a useless organization devoted to improving patient ...
From Russia, with love
2008-04-25 21:42:00 I’d like to give a big shout-out and a big thanks to Doc Russia , who has composed this elegant piece entitled The Lie Of Multiculturalism. I normally shy away from anything political, but this is too good not to share. More About: Love , With Love
Inappropriate Diagnostics
2008-04-25 21:18:00 The ER physicians at my hospital are addicted to ABG’s. Our blood gas reports seem to have a crack-like effect on them; they take on hit of the ABG report and suddenly they can’t stop ordering them. It’s not just ABGs, it’s everything: CAT scans, lab tests, and more. Not all of the ER physicians are ... More About: Business , Doctors , Diagnostics
Depressing
2008-04-24 05:05:00 30 years old with terminal cancer of a non-removable deeply essential organ. No family. No friends. No wife. No children. Just a man alone with his tumors, wasting quietly away in the ICU where we can do absolutely nothing beyond meaninglessly prolonging his suffering. That, my friends, just plain sucks. ... More About: Depressing
Not my first choice, but?
2008-04-20 21:05:00 Hypnosis would not be my first choice for anesthesia, but I guess it works for some folks. More About: Choice
Eerie
2008-04-19 18:37:00 There’s been an eerie lack of excitement at the hospital lately. We’ve not had a single code, bad Critical Assessment Team call, or trauma in a few days. We’ve still got all of our longer-term patients, but as for new stuff…well, not so much all of a sudden. As usual, the optimist in me says ...
Quote of the day:
2008-04-16 04:45:00 “Heck no we weren’t using him for medical experiments. His basic problem was that he was a late term HIV patient in an ICU. That’s like being a thirty million Tesla magnet in an iron filing museum.” More About: Quote Of The Day , Quote
A nurse speaks:
2008-04-15 23:07:00 A nurse speaks on the proposed JCAHO regulations. From CountyRat, reader and commentor extraordinaire: This is insane! JCAHO is so removed fom the realities of patient care, and so ignorant of the capabilities of those who provide it, that their recommendations are becoming more absurd and distructive every year. I am a registered nurse, and I ... More About: Nurse
What?
2008-04-15 02:55:00 Has anyone else seen the new ad for Celebrex on TV? The one with a man and his dog made entirely of fine print? The ad that is basically a two-minute warning on how Celebrex or any other NSAID can kill you, but how Celebrex is a more fashionable way to die? What the hell was ...
Thank you, Bill Dubbs
2008-04-14 03:54:00 If you think about it, JCAHO has no incentive to promote quality because if healthcare wasn’t perceived as a problem they’d have no reason to exist. I’ve ranted about my dislike of the joint commission before. Apparently the latest shenanigans from JCAHO include an attempt to make ancillary services such as respiratory care, physical therapy, radiology, ... More About: Bill
Off
2008-04-13 05:01:00 I had a day off today. After pulling so much overtime, it’s refreshing to just sit for a day. Working so much can really burn a person out, especially as hard as they push us here at Sunny Flats–we work damn hard for our meager paychecks, and I’ve been increasingly vocal to management about that ...
Prognostics
2008-04-12 02:31:00 One of my favorite prognostic signs is the equipment-to-patient ratio. If you have a patient who is only mildly ill, the equipment-to-patient ratio might be low…say, two IV pumps and an oxygen cannula for an equipment-to-patient ratio (EPR) of 3:1. With a 3:1 EPR, recovery seems likely. Or you might have a patient with twelve pumps, ...
Strangely compelling
2008-04-12 02:21:00 I was surfing the web and I stumbled across this collection of strangely compelling photos. This is a series called Life Before Death, and it is 22 photos of hospice patients before and after their death. Small vignettes about their lives appear on the right-hand side of the screen. It is strangely compelling. I don’t quite ...
The Joint Commission: A Wretched Hive of Scum and Villainy
2008-04-10 21:01:00 911Doc over at M.D.O.D. has an excellent piece on how JCAHO (the Joint Commission on Accrediting Healthcare Organizations) and their evil companion Press-Ganey are really little more than modern-day protection rackets that prey on hospitals. Back when I was a “newbie,” I used to believe in the mission of organizations like JCAHO and Press-Ganey. I thought ... More About: Scum , Hive
Extubation and BiPAP
2008-04-09 05:03:00 As part of the ongoing reader response to my interesting airway scenario, one reader asked whether BiPAP had been considered as a post-extubation plan. The answer in short is no, but that does bring us to the interesting idea of extubating from the ventilator directly to BiPAP. Recently, Respiratory Care Journal did a meta-analysis of the ...
Interesting airway sequel
2008-04-08 02:01:00 Thank you, dear readers, for your responses to the previous post. Most of you guessed that the patient would end up being reintubated. One of you mentioned having seen this unusual technique used before as a temporary measure, which makes sense to me, but using this technique over several hours is a recipe for certain ... More About: Interesting , Sequel , Airway
An interesting airway situation:
2008-04-06 02:23:00 Today at work there was an interesting airway situation. We had a patient who had had a lengthy and complex course on the ventilator. The time had come to attempt an extubation. However, because of the patient’s borderline respiratory status the attending physician was concerned that reintubation would occur. Reintubation would not normally be a terrible ... More About: Interesting , Doctors , Airway , Situation
TV medicine is not real medicine
2008-04-05 02:52:00 We have had a rash of people lately in the ICU who have been expressing frustration at the perceived slowness of their loves ones’ recoveries. I have been glared at when patients fail Spontaneous Breathing Trials and accosted by angry family members who are upset because their loved ones have been on the trache for ... More About: Medicine , Real
A success and a failure
2008-04-03 03:36:00 A success: The patient presented approximately one month ago after a severe motor vehicle collision in which he was mostly paralyzed. He went into ARDS and had a prolonged and difficult ventilator wean. The patients care was complicated by his paralysis, but through intensive prophylactic respiratory care including EZ-PAP therapy and inspiratory muscle training, he pulled ... More About: Success , Failure
Trouble
2008-04-02 01:06:00 You know it’s trouble when you hand the anesthesiologist a blood gas with a pH of 6.90 and she says, “That’s a heckuva lot better than her gases during surgery.” Not a good sign. Not a good sign at all.
A little knowledge is a dangerous thing
2008-03-30 05:34:00 I’d just like to take a moment to remind my readers that this blog is intended mainly to be a source of entertainment, not a source of education or reliable medical information. I am a certified and licensed respiratory therapist, but I am not a physician and I do not know you or your circumstances. ... More About: Knowledge , Thing , Dangerous
Rule Number Four: The Patient is the One with the Disease
2008-03-28 06:09:00 It’s time for installment number four in my long-neglected series on The Rule s of the House of God. Today’s rule: The Patient is the One with the Disease . At first, rule four seems obvious. Many of you are saying, “Of course the patient is the one with the disease. That’s why they’re the patient, you ... More About: Number
Bad Things to See
2008-03-28 02:48:00 When you’re looking down a laryngoscope, and you pop the epiglottis out of the way and you see the vocal cords, you feel good. “Look, here I am!” says the trachea. “I’m right here! Put a big plastic tube in me!” That is a happy feeling, and when the big plastic tube goes through the ... More About: Things
Huh
2008-03-27 02:30:00 Out of perhaps a dozen old stab wounds, at least one gunshot wound to the head, several months in rehab, and a lifetime of IV drug abuse, the final push for one of my patients was… …a fall from bed leading to a subarachnoid bleed. Go figure.
Complementary and Alternative Medicine
2008-03-23 18:42:00 Ah, Complementary and Alternative Medicine ! Such a controversial topic, full of intrigue and shady evidence and passionate arguments from many different people. Speaking personally, I don’t have an issue with CAM; indeed, I know and am related to many people who swear by things like acupuncture and herbal remedies. When I was but a wee ... More About: Alternative Medicine
For the Children
2008-03-22 19:12:00 There are two things that have really gotten out of hand lately. One is those little bracelets that come in a variety of colors that are supposed to show how much you support a cause. You know the kind I mean, the little bracelets with things like LIVE STRONG or FIGHT FOR A CURE or ... More About: Children
More Linkage
2008-03-20 18:37:00 By way of Emergency Emily, I found the blog of Aaron Buzzard, an physician with the U.S. Army who is working in an ER in Iraq. There’s some mighty interesting reading in there, so if you’re up for something nifty go on over and check it out. More About: Linkage
Kidneys For Sale
2008-03-20 17:59:00 Marko over at The Munchkin Wrangler has written an interesting piece about paid organ donation. I always have been the sort to make light of organ donation. Indeed, a friend of mine and I had a long-running joke about starting a kidney smuggling ring for fun and profit. But all jesting aside, organ donation is ... More About: For Sale , Sale
Time off
More articles from this author:2008-03-19 03:57:00 After a couple of epic weeks of almost nonstop work I finally have some time off. I need it badly. In this last two-week pay period I slammed 164 hours out at the hospital. That’s only four hours less than the number of hours in a week. I’m amazed that the hospital let me do ... More About: Time 1, 2, 3, 4, 5, 6, 7 |
|
 |
|
 |
