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Thursday, September 24, 2009

your rt queries: COPD, Asthma & Ventilators

Every week 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:

do you think respiratory therapists make good money?: Quite frankly, I think the answer to that depends on location. I think the highest paid RTs are in Arizona and Hawaii, but then again the cost of living in those areas are the highest too. In Grand Rapids, MI, the wage for RTs is about $5 more an hour than here in Shoreline, but you must also consider the cost of living is greater there too. So, in general, I think the wage of RTs is acceptable, but -- to be honest -- I really don't make enough money so I can tell my wife she doesn't need to work. The RT wage is okay, but nothing to gloat about. The answer, I would suspect, also depends on what your goals are in life. If you want to live in a condo and have three boats and six cars, then this isn't the career for you. Yet, if your goal is to live a modest life and be happy raising your family, or if you're strapped for money and need a guaranteed job that is recession proof, then the profession of RT is right for you.

ABG neonate values:

flovent strengthens lungs: Yes it does. It makes your lungs stronger, it helps control inflammation, and it creates more beta 2 receptor sites for beta adrenergic medicines like Albuterol to land on and ultimately helps them work better too.

what causes restrictive airway: That's a great question that has many scientists perplexed. I discussed one theory in my post: The Hygiene Hypothesis: Does Cleanliness Cause Asthma?

low hospital census: Is this true or what? Where I work the census is so low half the hospital is closed and layoffs are abounding. We RTs have been safe so far, although many of us have been forced to take many no work days (except for us night shift RTs). I think the reason for the low census here anyway is because few are electing to have elective procedures.

pulmonary toilet chf: Pulmonary toilet is a term to describe all the techniques used to help COPD, Cistic Fibrosis, pneumonia or other patients with thick secretions loosen, bring up, and expectorate those secretions. It is not a procedure that will benefit CHF patients. In fact, I believe it is contraindicated for CHF patients, especially if they are in pulmonary edema.

spiriva and symbicort combination therapy for copd: That's a good combination. The symbicort treats the chronic inflammation and prevents bronchospasm, and the spiriva also prevents bronchospasm but via a different route. Symbicort is proven to improve lung function, and Spiriva is also proven to improve lung function. Both are highly recommended, and they also work well when taken together. Likewise, they are both proven safe so long as you rinse after each use.

too much heat bad for asthma?: Heat does not trigger asthma, but humidity does.

Symbicort versus Advair: They are both the same type of medicine. Both have a long acting bronchodilator and inhaled steroid. Both are highly recommended as great ways to control and prevent asthma. The only real difference is the bronchodilator in Symbicort works a bit faster, and Advair is a dry powdered discus and Symbicort is an inhaler. Which one is best for you is basically a personal preference of yours and your doctors.

what happens when you stop the ventilator?: That's kind of a vague question, because the answer depends on the patient. If a patient who is not breathing is taken off the vent, he will most likely die. However, most patients are placed on a ventilator short term while their lungs (or heart) heal, or during surgery. Once a patient's lungs are healed, or wakes up from surgery and starts to breath on his own, the ventilator can be removed without complications.

what should a respiratory therapist do in a case where a patient tells you she wants you to turn off the ventilator and let her die: Talk to the nurse and the doctor. An RT must never discontinue a ventilator without a doctor's order.

respiratory therapy basics for the layman: Check out the link to the left, or click here.

how do dr.s listen to the lungs: Hopefully they use a stethescope.

can patients with copd and chf expect higher co2 levels when given morphine: Morphine is a medicine used to relax patient's in respiratory distress, and it is also a mild bronchodilator. It can slow the respiratory rate down, but it should not have an effect on CO2 if the dose is appropriate for the patient. It can also help lower blood pressure, especially if it is caused by anxiety due to respiratory distress.

how to give ippb via trach tube: In this case, the IPPB treatments works similar to a ventilator or BiPAP. You use an adaptor to hook up the machine to the patient, and then you adjust the settings and instruct the patient as appropriate. Note: This RT does not endorse the BiPAP. It is a worn out machine that works only to overinflate good alveoli. Cough and deep breathing, incentive spirometry, and PEP or Flutter valves are much more effective ways to recruit alveoli and promote airway clearance.

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.

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