Every so often 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. is chf an indication for albuterol: The only indicatin for albuterol is bronchospasm. CHF is fluid in the lungs, and it causes an upper airway wheeze that is audible, and often presents as bronchospasm. The wheeze is caused because the increased pressure and fluid in the lungs are squeezing the bronchioles. Albuterol will not help CHF patients. Plus, if you read the insert for Albuterol you will see that it says for use for COPD and asthma patients only. However, according to a lot of doctors and nurses, chf is an indication for albuterol. Go figure.
2. how to set up a ventilator: If you can tie your shoe you can set up a ventilator. The only reason we put all those buttons and all those graphics up there is to scare nurses and doctors away.
3. can copd affect a patient post-op: Yes iti can. If you have compromised lungs, you have an increased risk of respiratory complications following surgery. Likewise, many COPD patients have cor pulmonale which means the heart is working extra hard already. It may sometimes take these patients longer to recover from anesthetics, and they often will need to be on a ventilator 24-48 hours.
4. carbon dioxide retainers do not give 100% oxygen: If you have someone who needs oxygen you must provide them oxygen. You will want to maintain an SpO2 over 88% on every patient regardless of disease. If the patient stops breathing due to the increased oxygen, then you should intubate and ventilate those patients. If you allow a patient to go without oxygen, that patient is at grave risk for cardiac complications and death. Do not withold oxygen due to the hypoxic drive fallacy. However, you should also discus this with the physician and do what he says.
5. beer asthma: Beer causes you rlungs to dry out. Plus there are posible asthma triggers in beer. It is recommended if you drink you do so in moderation.
6. tremors and copd: Many COPD patients have tremors. It's not necessarily due to the disease but a result of the treatments used to treat COPD. Both corticosteroids and bronchodilators have tremors as a side effect.
7. ventolin for smokers: If you are to the point you smoke and need ventolin, then please stop smoking. While you cannot undo the damage already caused from smoking, you can slow down the progression of your lung disease.
8. how to fake pneumonia: You cannot fake pneumonia. However, to justify a stay in the hospital, I have seen doctors write pneumonia as the diagnosis for the stay. That way the insurance will pay. I've never had a doctor admit this, but I have seen pneumonia as the diagnosis many times with normal x-ray, normal labs, etc.
9. indications of albuterol with pneumonia: Albuterol is only indicated for bronchospasm. If the pneumonia is causing bronchospasm (as in COPD and asthma) then it is indicated, otherwise it is of no use for pneumonia. I will write a post about this soon, so stay tuned.
10. how would you like to die drowning: Quite frankly I wouldn't. Yet, I do know I can't breathe under water.
If you disagree or agree with my opinion feel free to leave a comment below, as we are all entitled to an opinion. If you have further comments or questions, feel free to write it below or email me.