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Your Question : Why aren't there more RT blogs like yours. My Answer: There are a few, as you can see by the "Links" tab above. However, many of those blogs have not been updated in so long that I might as well delete them from my list. This is unfortunate, but I think fear has a lot to do with it. In fact, I know of one blogger who was told to quit blogging or he would lose his job. He had the best RT blog ever. Okay? And now he's done because he didn't want to lose his job. I don't know if you have ever noticed this or not, but sometimes I publish posts on this blog and then think better of it and hit the delete button.  I don't do this very often, but sometimes I have to act as editor and protect the real me from the writer me. I have a tendency to be non-politically correct and truthful, and, Lord knows, the truth can get you into trouble sometimes. Of course, you might be thinking, "What about freedom of speech?" I think that freedom of spe...

How they present when you are in their rooms. A diagnosis sometimes observed in the clinical setting is an exaggeration of asthma ( staticus wheezicus ). These patients often have a diagnosis of asthma/ COPD, although often learn to play it to their advantage. Clinical Presentation : You can observe them from the doorway, such as while they are sleeping, and they are fine. But as soon as you wake them up, they have a forced, expiratory, almost stridorous wheeze. It is often audible. They may appear fine as you enter their rooms, although as soon as you pull out your stethoscope they start forcibly exhaling. Heart rate may be elevated slightly. Oxygen saturation is usually within normal range. (This section was submitted to me by a reader here at the RT Cave, and published with permission. ) Differential diagnosis .  The RT Cave sponsored a committee of 20 respiratory therapists and five doctors. During a meeting on January 27, 2017, they came up with three mechanisms for establishi...

One of my coworkers introduced me to this Youtube video where three critical care nurses describe how important it is to respect your respiratory therapists. This is pretty good.

A new version of Ventolin, aptly termed "Keep-me-alive-olin," has been shown to prolong life. This is according to analysis of studies conducted by the Real Doctor's Creed Committee. Keepmealivolin was listed as the #61 most popular version of Ventolin prescribed by doctors by our own experts here at the RT Cave. This version of Ventolin was first recognized by Dr. Happy Lackluster in 1985. He t he ordered a respiratory therapist to give a Ventolin breathing treatment by mask to a patient who was terminally ill, who had an ejection fraction of 20%, and who was in otherwise poor health with terminal bone cancer, diabetes, and kidney failure. Dr. Lackluster sadly passed away in 1998. However, the RT Cave was able to get ahold of Dr. Will Chambers, a longtime coworker of the beloved Dr. Lackluster. "He was a fine fellow," said Dr. Chambers. "We were all so impressed with his discovery. I remember Happy  telling the story. He about keeled over laughing becaus...

The following is a guest post. By Wanda Bunch I'd like to voice my frustrations as a Respiratory Therapist today. I'd like some ideas or suggestions on how we can make changes on a state level for Respiratory Therapist. I want my ideas/opinions/ and my voice to be heard. I LOVE being a therapist (5 years) in Oklahoma. The respect and understanding of what we truly are capable of doing needs to be recognized. Our career (notice I didn't put job) is in jeopardy due to health care changes and we need to grow with the changes; so our career path we choose can continue to exist. It sadness me to hear therapist of under 10 years talk about being burnt out due to being disappointed (due to department leadership and policies ). I feel the field has become stagnant with old policies/ goals/ and career ladder. YES we have them available to us. I feel strongly about my career choice and want to continue to Excel at it and make improvements. So all therapist around the US should be ask...

Your question : How high can you set CPAP? What are the disadvantages of CPAP that is too high? My answer . This is a good question. According to Egans, CPAP is a continuous flow of pressure on inspiration and expiration.If there are alveoli that are collapsed due to atelectasis, CPAP acts to recruit them, and open them up. It thereby acts as a splint to keep them open to improve oxygenation. If CPAP levels are set too high, alveoli will be over-distended, and this may result in air trapping. (1, page 1066) Another thing to keep in mind here is that CPAP acts to reduce venous return to the heart so the heart doesn't have to work so hard to pump blood through the body. This is the advantage of using CPAP to treat heart failure. If CPAP is set too high, this pressure may ultimately reduce venous return enough as to cause a reduction in cardiac output, which can be measured by a drop in blood pressure. Over-distended alveoli and air trapping can also result in a drop in oxygen levels,...

PEEP is an abbreviation for Positive End Expiratory Pressure. It's a small amount of pressure above what is in room air that remains at the end of expiration. The benefits of PEEP are. Increased Residual Capacity.  This essentially means that it increases the amount of air that stays in the lungs. This works to... Recruit collapsed (atelectic) alveoli . This makes it so they participate in gas exchange. It also works to... Keep alveoli from collapsing . It keeps alveoli open so the effects of fluid or atelectasis do not cause shunting. This also helps to reduce V/Q mismatching . This also makes it so you have an... Increased PaO2 for a given FiO2 . It's a good way of improving oxygenation.  Decreases Cardiac preload and afterload . It reduces the amount of blood returning to the heart, and thereby reduces the amount of blood leaving the heart. In this way, it can help patients who are in heart failure (pulmonary edema) by reducing the amount of work their heart has to do ...