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Tuesday, November 18, 2008

My answers to your RT queries

Every week I check my statcounter to see who's typing things into Google or Yahoo and being linked to my RT Cave blog. Assuming the queries were not answered, I provide in this spot each week my humble responses.

And, hey, if the query is comical, it deserves a comical response. If it's serious, I treat it as serious. That in mind, here are this weeks queries:

1. career change respiratory therapist to rn : While I think that RT is a noble profession just like RN, we RTs are still working on developing the same kind of respect RNs have in the medical profession. We have made major strides just in the 10 years I've been an RT. But we have much farther to go. That in mind, there are some struggles in the RT community. Likewise, pay is not as great as for RNs. Fair? Well, if you don't think so, you can always become an RN yourself. Still, can you go from a mucus sucker, frivolous Scrubblin-Bubblin giver, roamer of the entire hospital to a poop scooper person who has to take care of the same patient all night. For the advantages and disadvantages of being an RT, click here.

2. how to break up wet lungs: Despite the myth that aerosolized sulfate will bind to the fluid particles in the lungs forcing the body to "exhale" the fluid, this IS -- my friends -- just a myth. Actually, if you have a patient with wet lungs, a diuretic is the best method of getting fluid from the lungs to the Kidneys and out of the body through the urinary tract. For more information about diuretics, click here. If by "break up" you are referring to pneumonia, the only thing that will "break up" pneumonia is the human body's defense system, and sometimes with a little assistance of an antibiotic.

3. what is the indication for albuterol with atrovent? It's basically the preference of the doctor. Some studies do indicate slight improvements when Atrovent is used in conjunction with Albuterol in emergency rooms. Others show that it works well for COPD to improve lung function long term (click here for more). Most studies show Atrovent is not beneficial for asthma patients. Whether they want to believe every study that's out there is up to the discretion of each individual doctor. Out of the hospital Atrovent is no longer used as a rescue bronchodilator. It is used as a "preventative" asthma medication. For more information about Atrovent as a bronchodilator click here and here.

4. coarse lung sounds: There is no such thing as coarse lung sounds. If you are hearing coarse, then what you are really hearing is rhonchi. Click here for more information.

5. dont give incentive spirometer to copd patietns: This is a fallacy. There is no reason a COPD patient couldn't benefit from good old fashioned deep breath with a breath hold followed by a cough. In fact, I would recommend it.

6. will unprescribed ventolin hurt children? Not any more than prescribed Ventolin, unless it was obtained by some illegal source; or unless it is outdated. Still, if you decide to use some other person's prescription, you should at the very least call your or your child's doctor.

7. baby's chest caves in while crying: This could be a sign of respiratory distress. Click here and check the other signs of respiratory distress.

8. atrovent pulmonary oedema: I have not seen any studies that show Atrovent does anything for pulmonary edema. If you find any studies to the contrary I would love to read about it.

9. when to stop singulair for asthmatics: Of course I'm no doctor, but I think the general consensus is you do not ever stop taking medications that are preventative in nature unless some better and safer med comes along, OR if you experience side effects that effect your quality of life. Singulair is a medication that works to prevent you from responding to your allergens, and there fore if you stop taking it you could have trouble with allergies and asthma. Asthma medicine should never be stopped without the explicit direction of a physician.

10. dummies guide to respiratory care: Sometimes that's how I think of this blog. However, none of my readers are dummies. You are all brilliant.


Amy said...

Do you know if any of the studies on Singulair side effects differentiated b/t allergic and non-allergic asthma patients?

I've often wondered about this. My kid can't tolerate it and she's maintained well on Flovent, anyway, but she also has no allergy triggers except for dust mites.

In my completely anecdotal, very non-scientific observations, I've noticed that people who do best on Singulair DO tend to have allergy triggers. And it was originally developed as an allergy drug, not an asthma one.

So I wonder if the patients who do worst on Singulair are the ones like my daughter, who aren't allergic ones. Do you know?

Freadom said...

I'm not familiar with such a study, but I'll keep my eyes open. I don't really see why anyone would be on Singulair unless they had allergies. If doctors prescribe it just because someone has asthma, I'd like to know the justification. Great question. If I find out more I will let you know.

Amy said...

Yeah, once I learned more about Singulair and AFTER she stopped using it, I was pretty irritated that he prescribed it in the first place, esp. since she had NO allergy symptoms (and never has) and, at that point, had never even had skin testing done.

But I could write pages and pages about THAT doctor, who we left shortly afterwards!

Freadom said...

There might be more to singulair than I'm aware of. But I still think some doctors jump to prescribe meds they do not understand. I think Singulair is commonly prescribed for asthma patients mainly because 80% of asthmatics have an underlying allergy component. But, as you say, it's not an "asthma" medicine per se.

Freadom said...

I think it is used as an alternative to Clariton in asthmatics because it blocks leukotrines. It is leukotrines that cause bronchospasm. If you do't have an underlying asthma component to go with your allergies, I think you would do just as well with Clariton or other allergy meds.