Respiratory Care
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pmath_RRT specializes in Respiratory Care.

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  1. Proning patients, face and neck positioning

    Your friendly RT should be taping the tubes as well. Using AnchorFasts cause soo much breakdown due to the hard plastic on them. I normally place a saline bag under their forehead and one on their chest and it seems to help. I don't think the...
  2. RN coworker discouraged me

    Confront her in a professional manner. Just tell her you don't appreciate her condescending comments about your personal life and you feel like she's creating a hostile environment. Majority of the time people like that will back down. Throughout m...
  3. Let's say you were in mgmt and what happened to you was brought to your attention. What would you do to handle this situation?
  4. Oxygen and the rebreather mask question

    Non-rebreather masks should not be set lower than 15L. You run it any lower than that you will cause the patient to rebreathe their CO2. The bag MUST be inflated at least 2/3rds full on peek inspiration. Is the pts SPo2 on the NRM 90%? If yes then ...
  5. Difficulty with respiratory issues as a new grad?

    RT here, A lot of new grads/med/surg nurses tend to always think just because they hear a CHF pt with audible wheezing requires a dose of ALLBETTERol. Not all wheezes are due to bronchospasm. Think about the pathology of the disease state. The pt ...
  6. Uncontrolled asthma.

    RT here, It sounds like this kid needs to be put on maintenance inhalers (LABAS) or maybe just an Inhaled corticosteroid. Also are you checking this kids peak flow? You guys should know what his green/yellow/red zones are. Don't wait to administer...
  7. Intubation turning into a code blue

    Poor seal with mask. Always look for chest rise. Was it difficult to squeeze the bag? Yes I would have put in an oral airway, tongue could have been occluding the airway, if this were the case it would have been difficult to bag. Also i'm afraid ...
  8. Trach with oxygen

    A compressor only delivers RA. No matter what you set that dial on the aerosol bottle you will only get 21%. So it sounds like this pt is not on O2 but is on RA with humidity.
  9. COPD and O2

    Hypoxic Drive...No! Its the Haladane Effet and V/Q mismatch. Remember that its called the hypoxic drive THEORY. It is just a theory, and nothing more. In my years of practicing as an RRT and seeing countless COPD'ers who were retainers I have never s...
  10. COPD and O2 use, am I wrong?

    Hypoxic drive THEORY. Notice I put theory in all caps because it is just a theory and actually more of a myth. Look into the Haldane effect and V/Q mismatch. Also if this pt has never had a PFT done then you can't assume he has COPD just because he ...
  11. Best choice for emergent desaturation in COPD

    Sorry, no BiPAP for someone who is unresponsive. Patient cannot protect their airway with a mask strapped to their faces. Bipap requires patient participation as it is only for spontaneously breathing pts. NRB good choice if pt was able to maintain s...
  12. oxygen delivery with nasal cannula

    Yes there are these complex answers given by everyone in here but there is also a very simple explanation. The bubble humidifier is only meant for 6L. Exceeding this flow will cause the humidifier to build up way to much pressure and then, KABOOM! N...
  13. ABG Results, Explain this to me....

    Redraw. That is an false reading. Possibly air got into the sample or the ABG machine isn't calibrated right. Always "look at your patient". Do those results reflect how the pt looks?
  14. ARDS patient, dialysis

    Thats what we call a combined acidosis. The RT needs to fix those vent settings fast. And the docs need to get on that renal issue too. CRRT would help but we can blow that CO2 off to bring that pH up to make it suitable for life.
  15. Bipap/Cpap

    BiPAP is considered "non-invasive ventilation". Therefore it is a ventilator.