The other night at Shoreline Medical, I again got called to ER to give a nebulizer tx to a "diff breather". When I arrived I found a sweet little old lady with what sounded like a good case of bronchitis. While talking to her I discovered that she had been in the ER two nights previous and was discharged with home nebs, antibiotics, and just in case, a jolt codiene for her cough. The patient's caregiver told me that she must not have done "it" right as the "sweet little thing" has not gotten any better. " The discharge instructions directed me to give the nebs if she coughed. Well, she didn't cough so I didn't give her any nebs and now she is worse and coughing real bad! "
Now I ask you, when did we start sending every Tom, Dick and Mary home from the ER with home nebs to treat their cough? Do bronchodilators treat a cough? Are the doctors reading something I've missed? The sweet little old lady had coarse rhonchi, no wheezes, and no crackles. And, if you give someone codiene for their cough and then tell the caregiver to give nebs for the cough, just when exactly do you think the patient is going to get around to coughing I ask you? And, where the H--- is the indication for the patient to have nebs at all, let alone home nebs?