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Monday, May 26, 2008

RRT saves another; new use for Ventolin

Here's an interesting situation. A patient who was admitted several days earlier suddenly has an SpO2 of 72%.

Thus, the rapid response team (RRT) is called. Upon entering the room the RT finds the patient in no respiratory distress and he adamantly denies any trouble breathing. The rest of the RRT has now arrived.

By RRT protocol, the RT opted to do an EKG and found that there were changes: elevated ST in various leads. Per RRT protocol, the nursing supervisor orders cardiac enzymes, and the patient's RN rushes to call the doctor.

Hold the phone. After a quick ABG draw the patient was placed on a 75% non-rebreather. The doctor was called, and the patient was promptly transferred to the critical care.

Upon the arrival of the doctor, a breathing treatment was ordered. The RT grumbled about this because he couldn't see a purpose for doing this. What is Ventolin going to do for an MI?" the RT thought. But like a good boy he did his job.

Then a second treatment was ordered. He grumbled to himself, but did the treatment again like a good boy. Then, as both the RT and doctor were standing beside the bed, the doctor says, "Let's get a second EKG."

That's fine. An EKG I can understand.

Lo and behold, this EKG was back to normal. While the underlying cause was still undetermined, it appeared to this humble RT that the EKG changes were due to hypoxia, and the oxygen boost helped the patient.

After examining the EKG, the doctor said, "We better do a another breathing treatment."

What are you thinking, Dr. Mast? What in the world are you thinking? You can't possibly think your frivolous breathing treatment actually...??? NO!. Couldn't be.

Nonetheless, we now have discovered another use for Ventolin:

By some magic power, Albuterol now is capable of dissolving a clot in the coronary arteries and fixing an MI. If Ventolin is not the greatest drug of all time, I don't know what is.

Coronoryolin? MI-olin?

Now, on a side note and being serious again for a moment, the RRT came to the rescue and saved another life. I love it when we RNs and RTs are allowed to use our skills to help someone.

On a similar note, if I had access to a scanner I'd put those EKGs up here for you guys to look at. It was pretty neat seeing the changes on the EKG and then the change back to normal after the heart was oxygenated.

1 comment:

Djanvk said...

I love this medication, I really they would get a over the counter version so when I get a Headache I can just go and buy some.