All that wheezes is asthma

It's asthma even if it's heart failure.

So, it was so long ago. It was in 1998. I was called to a room. The patient was extremely short of breath. The patient was winded. She was sitting in the recliner all frogged up. She was blue. Her saturation was 77%.

The nurse said, "She just went to the commode and she got like this." 

I was a new RT. I was stressed. What do I do?

Thankfully, a senior RT came to the rescue. She smoothly investigated the situation. She said, "What are the patients i's and o's." It was the first time I heard that question asked.

The  nurse said, "I don't know?"

The RT bluntly said, "I think we should check."

Later she said to me, "Sadly, RTs are the only people who ever check the i's and o's." Twenty years later, when I found myself the seasoned RT, I found myself saying the same thing to a new RT. Go figure! Twenty years on this job and not much has changed.

So, anyway, this seasoned RT gave the treatment. The patient's sats increased to 98% during the treatment. But, as soon as the treatment ended, and the patient was back on 2lpm nasal cannula (back then you didn't dare increase the flow rate without first asking the doctor's permission), her sat went back down to the mid 80s.

So, the therapist did the only logical thing. She started the treatment back up. Only this time there was no medicine. She later told me she did this to save the life of the patient. She knew the patient needed oxygen. She knew what was wrong with the patient: She needed oxygen. She also needed something other than the albuterol. She needed medicine to treat heart failure.

So, I saw this one time and I knew and I learned. I saw this one time. And, you would be amazed at how often this happens in the hospital setting. The patient uses the commode, gets winded, and RT is called to give a breathing treatment. The patient gets fluid overloaded, RT is called to give a breathing treatment.

I find that respiratory therapist learn. I feel I don't need to educate RTs about this. The people I would like to educate are the doctors and nurses. But, how do you do that without offending people?

So, that's the state of the medical profession today. Actually, it's no different than it ever has been. Medicine is based on myths, and myths prevail to this day. And one myth is that all shortness of breath is cured with asthma medicine. The myth is all that wheezes is asthma. And this may never change in an ever-present dogmatic medical world we live in.