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Friday, February 12, 2010

Real Dr's Creed: Indications for bronchodilators

Many of the following might seem like nonsense to thinkers like you and me, but the Real Physician's Creed teaches doctors that bronchodilators are indicated for more than asthma, COPD, CF, etc. Heed, what follows is suruptitious wisdom previously shared only with physicians. This should explain why every patient admitted with any respiratory ailments is prescribed a breathing treatment.


Section B5

The following are the real indications for bronchodilators. There is no scientific proof of the following, but if it sounds good it has to be a valid reason.
  • Dr. ordered it
  • Don't know what else to do
  • Nurse wanted it
  • Pt wanted it
  • Inflammation of throat
  • Inflammation of bronchioles
  • Inflammation of alveoli
  • Suspected inflammation of throat
  • Croup
  • Nasal gastric tube (NG)
  • Suspected inflammation of bronchioles
  • bronchiolitis
  • RSV
  • sinusitis
  • pneumonia
  • nasal drainage
  • Stridor
  • Sinusitis
  • Mesothelioma
  • Lupus
  • M.S.
  • Homeless
  • Depression
  • Pt has home nebs
  • Pt likes tx
  • Pt likes company
  • Bed ridden
  • Patient wearing a mask
  • History of smoking
  • Irritating lung sounds
  • Low SpO2
  • Trach
  • Intubated
  • Post operative
  • Atelectasis
  • Fever
  • Trach
  • Intubation (Ventolatorolin)
  • Respiratory distress of any sort
  • Failure to thrive
  • To prevent failure (Preventolatorolin)
  • To prevent re-failure (Postventilatorolin)
  • CHF
  • Pulmonary edema
  • patient wearing a mask
  • Rhonchi
  • Any wheeze regardless of source or cause
  • Any annoying lung sounds
  • Crackles (any kind)
  • Pleural effusion
  • Pneumo
  • Tuberculosis
  • Sleep apnea
  • Rickits
  • RSV
  • ARDS
  • RDS
  • P.E.
  • Acute asthma
  • Chronic asthma
  • COPD
  • Emphysema
  • Chronic Bronchitis
  • Acute Bronchitis
  • Allergic reaction
  • Bronchiectasis
  • Cystic Fibrosis
  • Cough
  • Not coughing enough
  • Sputum induction
  • Detox tremors
  • Dehydration
  • Hypokalemia
  • Hyperkalemia
  • Priapism
  • Cickle Cell Anemia
  • Anemia
  • Blood transfusion
  • Patient irritated
  • Doctor irritated by patient
  • Doctor irritated by RT or RN
  • RT needs procedure count to stay at work
  • To meet criteria for admission
  • To meet intensity of service
  • All wheezes (all that wheezes is bronchospasm)
  • All SOB (SOB is always caused by bronchospasm)


Anonymous said...

It's kind of annoying that every 4th post of yours is harping on people for using albuterol or taking treatments. Sometimes it's funny, but it's all the time, and here you mention cystic fibrosis. I have CF and yes, we do albuterol nebs along with many others a day, it's not a crime and we aren't stupid, it's got its purposes, maybe YOU should read up more.

Rick Frea said...

You are correct, tx's are scientifically proven and indicated for CF, asthma, COPD, etc. Yet in the real world, bronchodilators are ordered for more than just bronchospasm, as you see by this post. As an asthmatic myself, I can't help but to find humor in this. Yes, I probably write about it ad nauseum, but until doctors stop abusing this great medicine, I don't think I can stop myself.

Rick Frea said...

Actually, thanks for keeping me honest. If you ever want to write anything from your perspective just let me know.

Anonymous said...

Thanks Rick, I didn't mean to be snarky, looking back, I was! I do really enjoy your blog, it keeps things real. Keep on keeping on, man!


CajunGal said...

I know most in the medical profession will use a bronchodilator even for a hangnail, but I never thought that policy was productive. I had been suffering from asthma earlier this year, didn't know I had it and every doctor I saw told me I was a hypochondriac or anxious. They did, however, give me a breathing treatment as protocol. It was probably the ONLY thing that saved my life for the 3 months until I got an official diagnosis.

I guess even a bad policy can sometimes save a life! :-)