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Saturday, October 26, 2013

I've decided it's okay to cry during a treatment

No, I'm not talking about the respiratory therapist crying during a treatment, although that's okay, I guess, too.  What I'm referring to is a baby crying during a breathing treatment.

The fallacy among nurses and doctors, or many of them, is that if a patient is crying during a treatment he is taking deep breaths and will get the medicine deeper into the lungs.  Yet the truth is the opposite occurs.  During rapid inhalation, most of the medicine impacts in the upper airway, and hardly any medicine gets to the air passages.

Plus during crying most of the time is spent during exhalation.  So, if you're giving said treatment as a blowby, you can guess that about 0.99234234234234234234234234234 percent of the medicine is getting to the airway.  The treatment is useless.

So you have a kid who is crying vehemently, and the patient is also in respiratory distress.  The doctor and nurse are all panicked and insisting you give the blowby treatment.  So you do to no effect.

Finally you tell the nurse and doctor the treatment has no effect, so they order you to give ten more.  And you are pissed because you know this isn't doing any good anyway.  You know the patient does not have bronchospasm, because that audible stridor is not a sign of bronchospasm.

So, this irritation has made me a lazy RT.  I find that it is easier just to do the blowby treatment on the crying kid and go back to the RT Cave and blog.


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