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Friday, June 6, 2008

Coming up on the RT Cave

We haven't really written about anything educational in a while here at the RT Cave, and that is because Shoreline has been so busy lately. Now that things have settled down a bit (fingers crossed) we hope to learn a little and share some RT wisdom.

I wrote a while ago that I was going write more about COPD, and then I mentioned briefly that I was going to write about the hypoxic drive theory and how it's been disproven.

In fact, I had an RT student the other day tell me that her teacher told her that he was considering no longer teaching about the hypoxic drive theory.

Ah, but I will keep you in suspense. The great writers keep their readers in suspense mode so they keep reading. Kind of like the tabloid TV shows that hint about what's coming up, "Right after these messages," only to get to it 3 or 4 commercials later.

So, that in mind, I thought I'd give you a list of things I have on the edge of my brain that I'd like to blog about some day soon here on the RT Cave. If I had time I'd do it in a timely fashion, but being the family comes first, and patients come second, the RT Cave has to come somewhere down the priority line.

That in mind, these are some of the things I've been thinking about writing about when the opportunity presents itself. Things to look out for.

  1. The nurse wants you to stand there looking at that sat. When should you quit this and actually call the doctor.

  2. What the heck is ARDS anyway. Us small down RTs don't deal with it often enough to stay up to date.

  3. I get asked this all the time: what oxygen device should be used and when. After explaining why nasal cannulas don't belong in the mouth, this is the most common thing I find myself educating RNs about.

  4. I don't do PFTs, so I thought I'd do a little review for myself.

  5. Why is it that doctors want to ventilate obese patients based on their weight? That in mind, how do we ventilate obese patients.

  6. The hypoxic drive theory is the gold standard with doctors, but is proven folly time and again. Is it a fallacy or truth?

  7. Why the heck do people breathe anyway?

  8. Do we really need to learn the A-a gradient?

  9. There's a lot of talk around here about PE precautions. So, who is at risk for PE, and how do you know if someone has it?

  10. Many RTs stress out about the prospect of a baby going bad. That in mind, at what point do we intubate neonates, and how do we ventilate them? Since we don't get many bad babies here, this is something we constantly review.

  11. You know normal adult ABGs, so what are normal neo ABGs?

  12. The doctor tells you to select an ETT for a 4 YO girl. What size ETT do you select? Are you stressed yet, or are you prepared?

  13. Remember bubble CPAP? It was outdated when I was in RT school, and now it's back.

  14. Do you know your Ventilator graphics, or do you simply ignore them?

  15. What about Capnography?

  16. You do look at lab results, don't you? So do you know by looking at the labs if a patient has failing kidneys? liver? lungs?

  17. We RTs are educated not to over oxygenate neonates. So why do RNs in OB still do it? Why is it still taught to keep that baby pink in STABLE classes?

We will get to these, right after these messages...


1 comment:

Djanvk said...

All bubble cpap, the last hospital was a testing ground for Bubble Cpap and we used it all the time in the NICU.