bmxRRT

bmxRRT has 6 years experience.

Latest Activity

1. Bipap question

   bmxRRT replied to Dacatster's topic in Pediatric

   I understand where you are coming from. There was a reason why I said case-by-case basis.... not every patient needs bipap and not everyone can tolerate it either. Frankly it is difficult to tolerate. FWIW, heated HFNC can be billed as a different ch...

2. Bipap question

   bmxRRT replied to Dacatster's topic in Pediatric

   There is no "maximum limit" per say. Every patient is different, it is not a device you set and forget. The IPAP needs to be titrated to ensure the measured tidal volumes are in normal ranges for the child's IBW, generally we look for Vt's at least 5...

3. Hypercapnia

   bmxRRT replied to SBURNSTEVEN's topic in Pulmonary

   Careful, not all COPD'ers are chronically hypercapneic! Many of them have normal range PCo2, it has a lot to do with the severity of their disease and the amount of time they've been at that level of severity. If a patient has a chronically high PCo2...

4. oxygen concentration fluctuation

   bmxRRT replied to SBURNSTEVEN's topic in Pulmonary

   It's all about the ratio of air to oxygen. If you set the nasal cannula to 2Lpm, it stays at 2Lpm, it's constant. If the patient increases the amount of air they inhale, that means more of the 21% fio2 room air will be mixed in with the constant 2Lpm...

5. Pulmonary Fibrosis

   bmxRRT replied to moonovermiami's topic in Pulmonary

   Unfortunately with pulmonary fibrosis there is a limited amount of adjunct therapies, seeing as their alveolar tissue is essentially scar tissue now with maybe a hint of underlying inflammation. Even in the ICU, oxygenation is the primary problem wit...

6. Low sat on vent fine off

   bmxRRT replied to moonovermiami's topic in Pulmonary

   Hello, I'm sorry you can't get an RT there to troubleshoot, it sounds like the home care company is slacking or simply short staffed. This question is open-ended, there can be many reasons why a patient may desat while back on the vent, including inc...

7. Don't touch that!

   bmxRRT replied to nursecass's topic in CCU

   Documentation is the name of the game, even if it's standing order.

8. Don't touch that!

   bmxRRT replied to nursecass's topic in CCU

   I'm an RRT at BWH in Boston and residents will occasionally perform mechanics and/or compl/Raw/Ppl on the vents without us being there. Infact its illegal for them to even touch a setting on the vent. Last week I walked in on a Frozen waveform with a...

9. Scary Story

   bmxRRT replied to BlueEyedRN's topic in MICU

   Newer masks have a safety valve now, thank god. Also, that is why many hospitals require anyone using bipap(whether for severe OSA or for ventilation) to be on an alarmed ventilator.

10. O2 is 81, what shoud you do?

    bmxRRT replied to victorsunshine's topic in Neuro

    To the original poster: assess the patient for distress, correlate sp02 rate with palpable heart rate to ensure good quality sp02 signal. Check oxygen delivery device and flow, is it enough for this patient? If not on oxygen, put them on a cannula to...

11. Stabilisation of head posture- Need tips!

    bmxRRT replied to kfmh311's topic in Pulmonary

    Well it sounds like it's orthopnea. Usually chronic respiratory patients like to sleep sitting up(with pillows behind their back) because the leaning forward position provides their AP chest to expand easier than being supine, and they generally fee...

12. A touchy subject perhaps, but...(long)

    bmxRRT replied to AntFlip7395's topic in Pulmonary

    Sorry, I was using the vent patient scenario. Either way, it takes proper patient assessment by both the nurse and the RT. Classic signs of resp distress, assessment findings and initiating proper treatments (IE suctioning, bronchodilators, BIPAP etc...

13. A touchy subject perhaps, but...(long)

    bmxRRT replied to AntFlip7395's topic in Pulmonary

    Well, there's the classical patient assessment failure by the RT. I'm an RRT and have been faced with the same EXACT situation you mention. Plugging off vs. anxiety and agitation, can be tricky. My advice is to suggest to the RT to remove the pt fro...

14. resp therapy vs RN

    bmxRRT replied to obeyacts2's topic in Pulmonary

    I graduated with an AS in RC in May and took my CRT and RRT within 2 weeks of graduation, I'm now working at Brigham and Women's Hospital in Boston. I love my career choice, I thought for a couple seconds if I wanted to be an RN and realized that I'd...