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Friday, August 6, 2010

your rt queries

Occasionally 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:

What happens if oxygen is given to non hypoxic patients? Nothing. However, at high concentrations, such as higher than 60%, oxygen has been shown to cause lung damage. Also, high concentrations of oxygen have also been associated with the possibility of cancer later on.

bilevel positive airway pressure in neonates: This is something I'm not familiar with. I do not work with neonates other than to package them up and transfer them. I have not heard about BiPaP being use for neonates, although if I learn anything I'll be sure to let you know.

weaning off ventilator 60% on and 40% off is that a good sign: You mean 60% while on the ventilator and 40% while off the ventilator. Actually, it would seem highly unlikely someone would be ready to wean on 60% Fio2, however I suppose there are times when you might try it. Where I work it's not done though. However, if someone requires 40% off the vent and 60% on, I imagine that would be a good sign.

what happens if doc cant diagnose asthma? If the doctor can't diagnose asthma he should rule out asthma and start looking at other possibilities, such as cystic fibrosis, heart failure, COPD, etc.

strongest drive to breathe: The strongest drive to breath is CO2. The central chemo receptors recognize increases and decreases in CO2 and adjust breathing accordingly.

copd and tremors: Tremors, or shakes, are common with diseases such as COPD. It's not necessarily the disease itself that causes shakes, yet the medicine used to treat it. Ventolin, Xopenex and corticosteroids have all been known to cause shakes.

when was the bipap invented? Check out this link. It must have been before 1976, because in may of that year the FDA recognized both CPAP and BiPAP. In 1989 Medicare and Medicaid started to recognize and reimburse for usage of these devices. By the late 1990s BiPAP devices were more commonly used for COPD and CHF and now appear to be used to prevent these patients from needing a ventilator.

is the hypoxic drive a myth? Yes. I've actually been pondering writing an update article on this topic. So stay tuned.

could a patient be hypoxic on a BiPAP: Yes.

fine and wet crackles + lung: Can be indicative of lots of things, such as chf, pulmonary edema, pulmonary embolus, pneumonia (especially if isolated) and etc.

What is C02 retainer? We consider a CO2 retainer anyone who has COPD and has a elevated CO2 and a compensated pH (7.35 to 7.45). Since it's compensated, Bicarbonate (HC03) will likewise be elevated. Usually the pH is 7.40, CO2 50 or so, and HCO3 in the 30s.

I hate respiratory therapists: Always get one of you goons.

do breathing treatments stunt growth: If they did they wouldn't be abused by doctors.

can you go in the sun when taking advair and spiriva: Yes.

i hate being a respiratory therapist: So get a new job.

can bipap be used for hyperventilation: I suppose you could try it, but I don't see what good it would do.

Any further questions send me an email.

1 comment:

Lung Lover said...

I think BiPap in neonates is known as SiPap. I am not sure if that is a brand name - we only touched on it briefly in school.

Here's a link I found http://www.viasyshealthcare.com/prod_serv/prodDetail.aspx?config=ps_prodDtl&prodID=197