I just made an observation in the emergency room that made me chuckle to myself. Now no one had a clue what I found so amusing, nor did I say anything, but I just couldn't help myself but to find humor in the moment.
One of my favorite all time patients came into the emergency room in dying agony because her legs were cramping. She was so restless I could barely get her to hold still 20 seconds so I could get a good EKG reading. The doctor, however, decided that she was probably having cramps due to a low potassium, and opted to give the patient an awful tasting drink of patassium.
What I found so amusing was that I was giving a breathing treatment to this lady, and just last week this same doctor had me give a treatment because a patient had a high potassium. So, if Albuterol is supposed to lower potassium, why the hell would a doctor give it to a patient with low potassium level.
I mean, this patient was obviously not short-of breath if you know what I mean. When I asked the patient if she was short-of-breath she said, "No. but I'm wheezing."
The nurse interjected, and said, "She has CHF."
"Well, that's no indication for a breathing treatment," I said ruefully.
"She also has treatments at home." Then she definitely needs one now. That should cure her cardiac wheeze. Not. I held my tounge like a good politically correct RT.
Ah, but that's the power of Ventolin. Now, not only does Ventolin lower potassium, but it somehow, miraculously, causes potassium to increase. We'll have to call this new brand of Albuterol Hyper-K-uterol.
Now, for all you non RTs out there, potassium levels can drop if you give a very high amount of Albuterol to a person in a short period of time, such as when we are giving a continuous breathing treatment, or treatments every hour round the clock, or something like that. But one treatment will NOT lower potassium enough to make a difference.
And Ventolin does not increase potassium. I'm being facesious here when I say it does. But still, I find humor in this. I will, if I ever get access to the bottom of my blog again, have to add this to my list of 'olins: Hyper-K-uterol.
Oh, and one more thing. I finally have access to the bottom of my blog, so I will update my 'olin list Sunday night. I have at least 75 more to add, but I'll put up ten or so for you to enjoy by Monday morning.
2 comments:
You know, the whole CHF breathing tx thing drives me nuts and I know I'm not alone on that. I'm kind of skipping the potassium part to rale on the cardiac wheeze thing. Just when I think I have the nurses trained that we don't give albuterol for CHF (No resp hx) then I have a pt walk through the door whose primary care doc has given them an inhaler to "help that wheezing". How do you tell a pt their beloved doc is giving them an inhaler either in ignorance or as a pacifier?
I'd be thrilled if our doctors just ordered an inhaler, at least then all I'd have to do is an instruct and be done with it.
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