Protocols Are Nice

Having protocols in place is beneficial. 

For instance, consider a patient without pre-existing lung disease or regular use of respiratory medications at home. They are currently prescribed Pulmicort and Perforomist twice daily, with Duoneb every 4 hours. These protocols empower you to modify their treatment plan.

Alternatively, imagine a patient presenting with a congested cough. Their current regimen includes 3% hypertonic saline solution and Mucomyst. These protocols provide the framework to address and optimize their care.

A patient was short of breath, and so he gets Q4 Albuterol. But the diagnosis later comes back heart failure. Yet we have to give breathing treatments for the next 5 days the patient is admitted. If you have protocols, you can fix this. 

It's almost as thought doctors don't learn the physiology of what Albuterol does. And this is sad, because that means they don't even know what the medicine does that they are ordering. That the medical community submits to allowing us to use protocols, is a humble act. It's acknowledging that those people with two year degrees called respiratory therapists know what they are doing.

We can also get into a discussion about doctor's ordering Q4 Duoneb while the patient is also getting BID pulmicort and performist. There is no reason to give both Duoneb and Performist at the same time, as they are both fast acting bronchodilators. And don't get me started on patient's who are ordered on Spiriva while also getting Duoneb. Protocols allow us to fix this. 

I would not want to work at a hospital without protocols. I did that my first 20 years, and it was hard. That's where memes I created came from, such as "A little of our fluid might make yours go away," and "Q4ever."