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Monday, April 7, 2008

My response to your websearch queries

Here is my weekly response to Internet search engine questions that lead someone to my blog.

1. side effects of respiratory therapy: I will consider a side effect as something negative that could happen. I think that the #1 side effect is burnout, followed closely behind by frustration at not having more control over who gets respiratory therapies, not having more protocols, etc. In some rare cases there has been seen complete animosity toward this profession, which is probably no different from any other career.

2. can i take only serevent for asthma: It's recommended that if Serevent is indicated, Flovent should be taken with it. Thus, if both are prescribed, the patient should talk to his or her doctor about taking Advair, which is a combination of both drugs and only requires one puff in the morning and one at night. For more information regarding Serevent, click here.

3. mixing mucomyst with albuterol: It is mandatory that if Mucomyst be given that Albuterol be given with it. While Mucomyst is supposed to break up thick mucus, it can also cause bronchospasm.

4. what do people think of respiratory therapists: I think that most people don't even know who RTs are until they see us in the hospital. But, once they get to know us, I think we are highly thought of by most patients. We do our own surveys here at shoreline, and most of the comments are excellent when it comes to "what do you think of your RT services."

5. albuterol steam machine: I think you are thinking of an air compressor and a nebulizer. When the air passes through the nebulizer, it forms a mist not steam. And, breathing in this mist is what causes the medicine to get into the lungs and do what it's supposed to do, which is relax bronchial muscles.

6. what are post-op crackles in the lungs caused by?: Can be caused by a lot of things actually, but the general idea is that they are caused because abdominal or thoracic pain from the surgery is preventing the patient from taking in deep enough breaths and stretching the alveoli in the bases of the lungs, and thus making them more prone to pneumonia. Likewise, some pain medicines and sedatives can also make a person take shallow breaths, and this too can cause crackles. It is for this reason we encourage post op patients to use an incentive spirometer and to do cough and deep breathing exercises, of which I wrote about right here.

7. what to do when you dread going to work: We all have those days. What I do is go to work and hope for the best. It's also a good idea to get a good nights (or in my case days) sleep.

8. respiratory school formulas printout: I actually have a list of the relevent formulas I can post if you want me to.

9. how often should a patient use combivent: Recommended QID or no more than Q4. If you need it more often see your doctor. However, there are exceptions to this guideline.

10. how does ventolin work in the respiratory system: The Ventolin particles are nebulized into a particle size of 0.5 microns and work their way into the bronchioles, where they bind with beta adrenergic receptor cells and cause bronchodilation.

11. does nasal cannula make pneumothorax worse in children : Why would it?

12. advantage of using a mist tent over nasal cannula : A mist tent is good for use with a child with croup in that it provides a cool mist to help reduce swelling in the throat. However, at Shoreline we've decided the mist tent more or less just gets in the way of caring for the child, and we've pretty much scrapped them. If a child need oxygen, we use nasal cannulas. However, the mist tent is still always an option.

13. which is stronger ventolin mdi or ventolin aerosol mask: According to scientific data obtained, an MDI used with a spacer and used correctly should be just as effective as a Ventolin nebulizer treatment. And, a nebulizer taken with a mouth piece is more effective than via a mask, and a mask is more effective than a blowby treatment.

14. does singulair make it easier to cough up flem from lungs? : Not that I know. Singulair blocks the release of leukotreins which cause bronchospasm.

15. which should be given first if both are ordered serevent or flovent: Good question. Check out my answer to #2, and then I'd have to say Serevent because it's a bronchodilator. Considering neither has an immediate effect, I would guess that it doesn't matter. Any one else care to chime in here?

16. best respiratory therapist: Who decides? Is the person who loves button pushing really better than the RT sage? I wouldn't think so.

17. using bipap in place on ippb : I have debated this with some of the older RTs who will defend the IPPB machine to the death, but I think that all the IPPB does is over distend the good alveoli. I can produce some reliable studies that have come to the same conclusion.

18. continuous albuterol with bipap vision: Connect the neb as close to the mask as you can get it and have at it.

19. what does a respiratory therapist wear: Well, I wear scrubs and a white lab coat. Boring hey?

If you have a question I have not addressed here, or if you want an answer right now, feel free to contact us anytime and we'll get you an answer ASAP. You can contact me at

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