Arrrgh! Some times I really HATE RTs'
I have never worked in acute peds. I do peds homecare. Every one of our kids has some sort of respiratory problem. The stories some of the parents come back from an admit with burn me. The 2 latest are:
3 yo profoundly retarded/blind/deaf/CP sitting up in bed clutching rails, a few scattered wheezes I/E, wants the O2 mask ON, sats are 90% on 3 liters. RT walks in, says the sats are fine (Um...baseline sats are 99-100 on RA, I think his brain cells would like a little more please) and he doesn't need a neb tx, tries to do the MDI, kid can't understand/communicate/cooperate. RT charts refusal and leaves.
A&O X4 8 yo SMA, trach & vent since 11 months. Suctioning Q 5 min (thank God for skilled parents @ bedside), high pressuring almost constantly , no wheeze, CPT/PD done, sats 96% (baseline) and good movement with sxn...RT says she doesn't need a tx.
Heres the kicker: BOTH
admitted by their PCP with orders that state: Albuterol 0.083% ud via HHN Q 10 min PRN SOB,respiratory distress, increased sectetions, O2 requirements > 2 lpm.
So even having 'good orders' doesn't matter sometimes.
And the Doctors sometimes wonder why we work so hard to manage these kids at home first.