I occasionally check my statcounter to see what Google inquiries or searches lead someone to the RT Cave. If I think the landing page did not answer the question, I humbly try to provide the answer in this post.
So, here are Your RT Queries:
1. Should children use a face mask for a a breathing treatment? I think most studies recommend a mask is the best method to get the most medicine into a child's lungs. A mouthpiece is the best method, yet many children can't use a mouthpiece. Check out this link and this link for more detail.
2. Do I need a respiratory therapist for a Cpap? If you are in a hospital and need a CPAP you will inevitably have to deal with the CPAP experts. However, outside the hospital you can obtain a CPAP from your home care establishment, or may run into a CPAP machine if you have a sleep study. I guess the answer to your question is yes and no but not necessarily so.
3. How do you write prvc settings? Where I work PRVC is the default mode per our ventilator protocol, where if there is no order we automatically use PRVC. In fact, if PRVC is available, I see no reason to use any other mode unless you have a greater objective.
4. Respiratory therapist dying field: I do not believe RT is a dying field. In fact, there is no evidence of such. Respiratory therapists are an essential part of the patient care team. They are the lung experts, and rather than being utilized less in the future, I think they will be utilized more.
5. Why elevate hob for patient with COPD? Because it helps them to expand their lungs so they can get more air in. It helps relieve the feeling of dyspnea, or air hunger. Try slouching forward in your chair. Now try to take in a deep breath. Now sit straight up as you can, and try to take in a deep breath. It is much easier when you are in a high position. When you're not short-of-breath you don't think of things like this, yet when your short-of-breath you quickly learn it's easier to breath sitting high, or even standing.
6. I can't find a job in respiratory therapy, so what should I do? I know there is a squeeze on hiring at most hospitals. Your best bet might be to spread your application around and be willing to move if necessary. Chances are the jobs available will be pool positions. Another thing you might want to try is another job in the hospital, such as a nurses assistant or a tech. Sure these might not be the ideal jobs, but at least it would help pay the bills while helping you get your foot in the door. Good luck.
7. Are crackles found at the base of the lungs in chf patients? While the CHF patient is having an episode of acute heart failure, yes there will be crackles. This is the sound of fluid in the lungs. Between acute episodes, there ideally should not be crackles. However, this will also depend on the overall health of the patient too. End stage COPD patients have a tendency to CHF, yet many COPD patients have crackles all the time in the bases. This isn't so much fluid, but the air sacs opening and closing with inspiration. Yet, during acute CHF episodes, the crackles will be more prominent, may fill the lungs about half way up, and sound like water in the lungs. Stay tuned, because on 9-1-2010 I will publish a post everything you need to know about CHF.
8. Wet lung sounds: See #7 above. Also see the lung sound lexicon.
9. DNR full code definition: This refers to do not resuscitate. According to Wikipedia: "document is a binding legal document that states resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. Abbreviated DNR, such an order may be instituted on the basis of an advance directive from a person, or from someone entitled to make decisions on their behalf, such as a health care proxy." I believe (as I wrote here) that DNR orders can be a good thing, especially if you have a patient who is chronically ill or at an elevated age. I believe there comes a point where it's better to let nature take its course. Not only is this better on the patient, but on the family. So, it's a good idea to plan ahead.
10. Why don't we give 100% oxygen to patients on ventilators?: Because oxygen is a drug, it should be utilized as a drug. New studies (like this one) show that even being on oxygen greater than 60% for as little as three hours can do damage to the lungs. So it is essential that if a patient require oxygen at greater than 60%, that he is weaned off as soon as possible. Stay tuned, because I have more research coming up in an upcoming post.