Friday, January 25, 2008

Friends Vs. Military Friends

Ok so this doesn't have much to do with Respiratory or medical in general except it was sent to me from one of my Respiratory friends from the Military so I guess it's kind of Respiratory related.

I thought this was interesting and actually very true as I'm closer with my Military friends than I am with my say High school Buds. Which is OK because really my military buds and I have been through much more together in my 10 years of service, hell we lived together in many different situations and places. So anyways here goes:

Friends Vs. Military Friends

1. FRIENDS: Tell you not to do something stupid when drunk

MILITARY FRIENDS: Will post 360 degree security so you don't get caught

2. FRIENDS: Call your parents Mr. and Mrs

MILITARY FRIENDS: Call your parents drunk as hell and tell them about
The fat chick you tried to pick up

3. FRIENDS: Hope the night out drinking goes smoothly, and hope that no
one Is late for the ride home.

MILITARY FRIENDS: Know some wild shit will happen, and set up rally
Points and an E & E route.

4. FRIENDS: Bail you out of jail and tell you what you did was wrong.

MILITARY FRIENDS: Will be sitting next to you saying, Damn...we fucked
up...but hey, that shit was fun "

5. FRIENDS: Cry with you.

MILITARY FRIENDS: laugh at you and tell you to put some vagasil on your

6. FRIENDS: Borrow your stuff for a few days then give it back.

MILITARY FRIENDS: Steal each other's stuff so often nobody remembers who
bought it in the first place.

7. FRIENDS: Are happy that someone picked up a one night stand and leave
them alone.

MILITARY FRIENDS: Will Low Crawl naked into the room with a camera and
for the tag team.

8. FRIENDS: Know a few things about you.

MILITARY FRIENDS: Could write a book with direct quotes from you.

9. FRIENDS: Will leave you behind if that's what the crowd is doing.

MILITARY FRIENDS: Will kick the whole crowds ass that left you.

10. FRIENDS: Would knock on your door.

MILITARY FRIENDS: Walk right in and say, "I'm home!"

11. FRIENDS: Will try and talk to the bouncer when you get tossed out of
the bar.

MILITARY FRIENDS: Will man up and go after the bouncer for touching you
the way out.

12. FRIENDS: Will wish you had enough money to go out that night, and
are sorry you couldn't come.

MILITARY FRIENDS: Will share their last dollar with you, drag you along,
try to steal free drinks all night

13. FRIENDS: Will take your drink away when they think you've had

MILITARY FRIENDS: Will look at you stumbling all over the place and say,
"Bitch, you better drink the rest of that shit, you know we don't waste.
That's alcohol abuse!!!" HAHAHAHA !!!!

14. FRIENDS: Want the money they loaned you back next week.

MILITARY FRIENDS: Can't begin to remember who owes who money after
care of each other for so long.

15. FRIENDS: Will say "I can't handle Tequila anymore".

MILITARY FRIENDS: Will say "okay, just one more..." and then 2 minutes
"okay, just one more!".

16. FRIENDS: Will talk shit to the person who talks shit about you.

MILITARY FRIENDS: Will knock them the Fuck out!!

17. FRIENDS: Will tell you "They'd take a bullet for you."

MILITARY FRIENDS: Will actually take a bullet for you.

18. FRIENDS: Will ignore this

Just though I would share this with everyone.
Thanks for reading and Please support our troops.

Wednesday, January 23, 2008

Nothing to do but keep busy.

I am back out of a busy time at my place of business. We have gone from 8 patients with treatments through the night, 3 bipaps and 1 ventilator running back to just having one Q6 during the night now, actually only 4 patient with breathing treatments in the whole hospital, wow what a change huh.

This got me wondering what do people do at their hospital when they have nothing to do? What are some things to keep you mind from total boredom?

This list below are some of the things that I know of from different places I have worked at, some current and some not so current. In my current job I am the only night person on in my department at a time so we have to find things to do, if there was 2 of us here we could take turns being on call, but as you see that isn't possible.

Things to do when you patient load is down:
  • Catch up on some reading, personal or work related. A library card is nice to have for this.
  • If you have internet access take a online college class. Great time to do homework
  • Bring in your laptop and rent some movies or T.V. series. I now have seen all 3 seasons of Lost, which I now am hooked on, all of Entourage which I fully recommend, and in the 3rd Season of Soprano's. I have been watching these at home also on days off. We had a lot of downtime this summer. This is a good reason to use Netflix.
  • Learn to program different languages on your laptop.
  • Learn to speak a different language.
  • Enter Photoshop contest's on
  • Play games on the laptop.
  • Work on your skills with paper football.
  • Blog
  • Write articles or edit articles on Wikipedia.
  • Terrorize the nurses by going into a empty and pushing the call light and hide.
  • Explore the hospital. I have noticed in the different hospitals I have worked at that there are some interesting areas and to find. Little nooks and crannies.
  • If you hospital has a Physical Therapy gym you can use, life some weights or get on a the treadmill or bike.
  • Play hackey sack.
  • Do some checkbook balancing and pay some bills.
  • Play online poker, never done this at work but would be nice if it wasn't blocked.
    Old school ETT tubes used to come in a Long hard plastic tube. Well in the military we figured out how to make a blow dart gun out of it and I.V. needles. Then we would use a dartboard and have contests. Lots of fun.
  • Tackle you colleague, wrap him up in ace bandages and Kerlex like a mummy, carry him up the elevator to a medical floor, toss him out and yell help. Umm I might of seen that happen one time.
  • One Military hospital I worked at we would bring in a Playstation and have Madden Football tournaments.
  • Hook up a ekg training module to a beside monitor in the ICU of a patient who has a brand new nurse and have it run different rythm's on the monitor and watch the new nurse freak out. Sorry nope never seen that happen.
  • Actually learn something new, or refresh something you know about your job.
  • Work on something you can improve in your department.
  • Find a place, take a catnap.
  • Go out to the floors and socialize with the nurses and tech's. This is a good thing to do because they get board also and it makes a stronger relationship between RT and RN's and other support staff like Xray and Lab. I recommend doing this once a shift. Funny thing I actually had a night where I was just tired and didn't feel much like talking with people and a Nurse from the ICU paged me just to see if I was ok and what I was doing. Kind of nice.

That's about all I can think of right now but would like to hear any other RT's ideas of what they do when there is nothing to do.

When you bored you can either make the time productive or just have fun with it and relax, I guess it's up to you and how you department its.

Take care.

Saturday, January 19, 2008

What a Difference 3 days makes!

I don't really have a lot of time to write much here today but I thought I would put a little something up on the Ol' Blog.

I was off for 3 days and when I get back it's crazy busy here. This is the classic "Feast or Famine" in my little hospital and we are definitely feasting over here.

When I last worked I had a whole two Q4's to do through the night, now 3 days later there are 7 Q4's and a ventilator to keep me busy. Much to my surprise though all of these Q4 treatments are actually really sick. Forgot to mention the 2 bipap's we have running also which are not for sleep apnea but for respiratory distress, so yes they happen to be pretty sick to.

A common theme I noticed with these sick patients and with some of the QID patients also was that there is a Mucomyst craze right now that just seem to have started. Not only is it Mucomyst there is this large concotion of Mucomyst, Albuterol or Xoponex, and Atrovent together ... but wait there is more, not only do we throw in those 3 meds we add it all to a Ezpap. This takes FOREVER! There are also the bonus patients who twice a day get to add in Pulmicort, WOW what treatment that becomes.

Sounds like the last 3 days there have been an extra RT per shift which is good but very unusual at my hospital. My night tonight I had someone here til 2am then again at 4am so I only had to brave it alone for only 2 hours, really wasn't that bad but most of the other RT's have never worked in a Large hospital and are not used to a heavy patient load...I am so I was fine.

Well gotta run just ran a ABG with a CO2 of 91 and a PH of 7.20, time to go save someone.

After that my next task is to get off work and hope my car starts since it is -20 degrees Fahrenheit right now and I will be wearing the nice and thin scrub pants...brrrrr

Keep em breathing.

Tuesday, January 15, 2008

Herbal Asthma Tea?

Was surfing around and came across this posting for:

Herbal Asthma Tea

This blogger states that this tea concoction helps with her asthma.

Some of the ingredients are:
Lemon Verbena: known for stopping wheezing.
Skull cap: is good for respiratory health.
Chamomile: It’s a relaxant, anti-allergenic, antispasmodic and anti-inflammatory.
Caffeine: Suposedly has a effect on asthma.

Here is the Recipe on the site

Asthma Tea
1 part of each in dried herb form - Chamomile flowers, Passionflower, and Echinacea Root
1/2 part each in dried herb form - Licorice root, Elecampane root, and lemon verbena leaves.

Not sure if this all works but check the site to see what you think.


Lab results we might be interested in.

I started wondering today about what lab results might be of interest to the friendly neighborhood RT so I did some researching and tried to narrow down different tests that could come in handy for information in our area of work. One test that I will not include here is the Arterial Blood Gas (ABG) because if you are a RT this is a common test and you should know this one my now. I will be looking at test that normally nursing and doctors will look at more than us but maybe could give us some insight on the patient.

Lab Results of Interest to Respiratory Therapists

Alpha-1 Antitrypsin: Lungs
An alpha-1 antitrypsin concentration is ordered to help diagnose the cause of early onset emphysema, especially when a person does not have obvious risk factors such as smoking or exposure to lung irritants such as dust and fumes.

Alpha-1 antitrypsin (AAT) is a protein that is produced in the liver and released into the bloodstream. AAT helps to inactivate several enzymes but primarily works to protect the lungs from elastase. Elastase is an enzyme produced by neutrophils and it is part of the body’s normal response to injury and inflammation. Elastase breaks down proteins so that they can be removed and recycled by the body but, if its action is not regulated by AAT, elastase will also begin to break down and damage lung tissue.

Lower levels if AAT indicate onset of Emphysema

AFB Smear and Culture: Lungs
AFB smears and cultures are used to determine whether you have an active Mycobacterium tuberculosis infection, an infection due to another member of the Mycobacterium family, or TB like symptoms due to another cause. They are used to help determine whether the TB is confined to the lungs (pulmonary) or has spread to organs outside the lungs (extrapulmonary).

3 Sputum samples are collected. Positive AFB smears indicate a probable mycobacterial infection. Positive AFB cultures identify the particular mycobacterium causing your symptoms and give your doctor information about how resistant it may be to treatment.

BNP and NT-proBNP: Heart
Either BNP or NT-proBNP may be ordered to help diagnose heart failure and to grade the severity of that heart failure. Heart failure is still often confused with other conditions. BNP and NT-proBNP levels can help doctors differentiate between heart failure and other problems, such as lung disease.

Higher-than-normal results suggest that a person is in heart failure, and the level of BNP or NT-proBNP in the blood is related to the amount or severity of heart failure. Higher levels of BNP or NT-proBNP also may be associated with a worse outlook for the patient.

CK or CPK: Heart
Blood levels of CK rise when muscle or heart cells are injured. The doctor may test for CK if the patient is having chest pain or other signs and symptoms of a heart attack. In the first 4 to 6 hours after a heart attack, the concentration of CK in blood begins to rise. It reaches its highest level in 18 to 24 hours and returns to normal within 2 to 3 days. The amount of CK in blood also rises when skeletal muscles are damaged.

A high CK, or one that goes up from the first to the second or later samples, generally indicates that there has been some damage to the heart or other muscles. It can also indicate that your muscles have experienced heavy use.

CK-MB: heart
CK–MB levels, along with total CK, are tested in people who have chest pain to diagnose whether they have had a heart attack. Since a high total CK could indicate damage to either the heart or other muscles, CK–MB helps to distinguish between these two sources. If the doctor thinks that the patient may have had a heart attack and gives a “clot-dissolving” drug, CK–MB can help the doctor tell if the drug worked. When the clot dissolves, CK–MB tends to rise and fall faster. By measuring CK–MB in blood several times, the doctor can usually tell whether the drug has been effective.

If the value of CK-MB is elevated and the ratio of CK–MB to total CK (relative index) is more than 2.5–3, it is likely that the heart was damaged. A high CK with a relative index below this value suggests that skeletal muscles were damaged.

Sometimes persons who are having trouble breathing have to use their chest muscles. Chest muscles have more CK–MB than other muscles, which would raise the amount of CK–MB in the blood.

Electrolytes: fluid retention
Electrolytes are electrically charged minerals that are found in body tissues and blood in the form of dissolved salts. They help move nutrients into and wastes out of the body’s cells, maintain a healthy water balance, and help stabilize the body’s pH level. The electrolyte panel measures the main electrolytes in the body: sodium (Na+), potassium (K+), chloride (Cl-), and carbon dioxide (total CO2).

The doctor will look at the overall balance but is especially concerned with your sodium and potassium levels. People whose kidneys are not functioning properly, for example, may retain excess fluid in the body, diluting the sodium and chloride so that they fall below normal concentrations. Those who experience severe fluid loss may show an increase in potassium, sodium, and chloride. Some forms of heart disease, muscle and nerve problems, and diabetes may also have one or more abnormal electrolytes.

Hemoglobin: Lungs
This test measures the amount of hemoglobin, a protein that is found in red blood cells, and is a good indication of your blood’s ability to carry oxygen throughout your body. Hemoglobin carries oxygen to cells from the lungs.

Normal values in an adult are 12 to 18 grams per deciliter (100 milliliters) of blood. Above-normal hemoglobin levels may be the result of dehydration, excess production of red blood cells in the bone marrow, severe lung disease, or several other conditions.

Heavy smokers have higher hemoglobin levels than nonsmokers and living in high altitudes increases hemoglobin values due to an increase in the number of red blood cells. Your body produces more red blood cells in response to the decreased oxygen available at these heights.

Troponin: Heart
This test measures the concentration of cardiac-specific troponin in your blood. Troponin is a family of proteins found in skeletal and heart muscle fibers; it helps muscles contract. There are three forms of troponin: C, I, and T. Cardiac troponin I and T are different enough from the troponin I and T found in skeletal muscle that they can be specifically tested for. These types of troponin are normally present in very small quantities in the blood. When there is damage to heart muscle cells, cardiac troponin I and T are released into circulation. The more damage there is, the greater the concentration of troponin I and T.

When a patient has a heart attack, levels of troponin can become elevated in the blood within 3 or 4 hours after injury and may remain elevated for 10 to 14 days.

Normally, troponin levels are very low; even slight elevations can indicate some degree of damage to the heart. When the patient has significantly elevated troponin concentrations and other clinical signs, such as an abnormal ECG then it is likely the patient has had a heart attack. If CK and CK-MB, and myoglobin concentrations are normal but troponin levels are increased, then it is likely that either a lesser degree of heart injury is present or that the injury took place more than 24 hours in the past. If the first troponin performed is normal but subsequent (6 hour and 12 hour samples) troponin tests are increased, then the heart injury likely occurred within a couple of hours prior to the first test and had not had time to increase. When a CK test is elevated but a CK-MB (which is more heart-specific than CK) and troponin test are normal, then it is likely that whatever symptoms are present are due to another cause, such as skeletal muscle injury. When a patient with chest pain and/or known stable angina has normal troponin, CK, and CK-MB concentrations, then it is likely that their heart has not been injured.

Well there you have it some different lab test that could give you more insight on your patients condition. If anyone happens to know of any other tests that could be of help feel free to post a comment and I will at it in here.

Most information was found at Lab Tests Online, along with some information from other sites.

Take care and keep em breathing.

Monday, January 14, 2008

Quick Request for Information.

We use the Voldyne Incentive Spirometer and it has the predicted volumes for patients with the age over 20.

But how do you calculate the predicted volume's for patients under the age of 20? We currently have a 13 year old patient who had surgery and the Doc wants I.S. done and we have a protocol on doing these but we cannot find a proper predicted volume.

If anyone has a chart or calculation for this could you do me a favor and leave a message with this information..

Thanks for any help.

My Mirror RT.

Back again for episode ... Umm something or another.

OK so I live in a small RT cave at a small hospital in a small town on night shift. I also happen to be the only RT on at night, besides my mirror RT who works the nights I don't work. Which if you think about it is kind of funny in the way of social interaction type thing. You see here we only have a total of 9 people here in my RT department and the other night shift person is the only person I really don't know all that well. Why you ask? It's because there are only 2 of us night shifters here and if I'm working he is off and if he is working I'm off so with this little interesting arrangement we never really see each other, we will never really attend the same function together, we will never meet out with coworkers to have a drink together, nothing. The only real interaction we have together is over the phone if one of us wants to make a switch of shifts. I hear stories and anecdotes of him, some good, some bad, some interesting and there is a day shift RT who is dating him so I'm assuming she knows him well.

There is a shelf of our coffee cups here were we store our personnel cups, mine is up there right next to his and sometimes we play jokes on each others cup because he happens to have a Minnesota Vikings cub and I have a Chicago Bears cup. Yep 2 teams in the same NFL division so they play each other in the season and if the Bears lose I get a little note or something done to my cup and visa versa. Kinda makes for some fun.

There it is My Mirror RT, possibly me in a alternate universe, like I'm Spiderman and he is Venom or I'm Superman and he is Bizarro Superman. OK maybe not, I don't think we are complete opposites of each other but I just find it interesting that I have a opposite RT from when I work with whom during my time working here I may never really get to know as a coworker or a friend, just as that person on the other side of my RT mirror.

Just another tired night when the mind gets to wandering...

Wednesday, January 9, 2008

Military Occupational Speciality: 91V10.

Life in the Respiratory Therapy school where I went was and entirely different experience than the standard college Respiratory course I think I am safe to say. I only say this because I did my schooling in the U.S. Army and with this post I am going to try and explain what my school was like. Now keep in mind that I didn't go through the college course for Respiratory Therapy at all so I really cannot compare the two with personnel experience but my comparison comes from other RT's who went the standard route of college. So here is my story of sorts on how I did it.

This all started when I was over in Mogadishu Somalia and my first 4 years of enlistment was coming to a end and I had some choices to make: Stay in as a Medic, change MOS (Job), or get out and be a civilian. I wasn't ready to get out(ETS is acronym for basically get out) yet and I figured that I should go for more schooling if I wanted to become more marketable if I ever decided that I wanted to ETS in the future. At this point I started to look in the books to see what other Job (MOS) choices there were available and I found 91W or Nuclear Med Tech which sounded interesting plus it was a year school in Baltimore Maryland at a Naval base which would be a nice change of scenery, so I was able to get the necessary reference letters and applied for the class. Didn't get it, and actually a guy in my Unit got the last slot for the fiscal year for that year. Back I go to the retention officer (Recruiter for active soldiers) and look to see whats available and he comes to me with the MOS 91V a Respiratory Therapist. Now at this time I had NO CLUE what one was but what swayed my mind toward was what was called a 3 Alpha Bonus for completing the school and low promotion points.

I will explain ... 3 Alpha bonus is equal to 3 times your base pay times the years your reenlist for which came out to a $12,000 bonus, SWEET. Promotion points are points you have to get for the next NCO Sergeant rank, and the least amount you have to get the faster you get promoted which also means more money.

So what do you think I did .... Signed right back up for this Respiratory School and for another 4 year hitch in the Army and decided I needed to do some research to see exactly what I've got myself in to and it really didn't look to bad except for the 80% attrition rate with school in the military had which is as high as Special Forces schools.

August of 1995 my bud from my unit and I packed up our stuff, kissed the wives goodbye and left from Fort Carson Colorado and headed to the U.S. Army Academy of Health Sciences at Fort Sam Houston, San Antonio Texas. Now I had been here already with my Combat Medic course so I was looking forward to getting back, but this time my cohort and I were able to rent a Apartment to live in instead of the barracks, this would be nice.

Now my schooling was broke down into 2 sessions of 4 months each, with the first being basically schoolwork and the second being on the job training at Brooke Army Medical Center, which I was a lucky one to get to be the first class in the new version of this hospital, the old one was scary. Our class actually took a day and helped move patients over to the new one when it opened, that was interesting and good training I'd assume.

So this first session of 4 months started with a math test on day 1 and if you didn't pass you had another chance the next day to pass it, but if you didn't you were out of the course just like that. The second say of school we lost like 5-10 soldiers that day to the math test, mind you we are starting with 80 soldiers in this class. That was a stunner, not the rest of the tests went a lot like that: if you fail you can retake it, if you fail again you are out. If you fail more than than 2 tests during the session you are gone also, but if your overall grades are good you can be what was called a recycle...hold over til the next class comes in.

My days in this session would go something like this: 3 days a week(Mon, Wed, Fri) would have to be information at 05:30 for Physical Training (PT), you know running, sit ups, push ups etc and this lasted for a hour then had to be ready for class by 08:00. So after PT you would run home and shower, get something to eat and maybe cram the books a bit. The other 2 days (Tues, Thurs) you had to be in class by 07:30. These class days would last until 17:00 with a hour break for lunch and a 15 min "smoke break" every 2 hours where we seemed to always get a good game of Hackey Sack going, hey we actually got pretty good at this, hell we did it a couple times a day for 4 months, also someone always seemed to bring a football out to. In this session we were not issued any books at all, we received handouts for each section and then given a lecture on the topic and we had to fill in the missing areas with the information given during the lectures, well we did have one book A Eagan's Guide to Respiratory Therapy. During these weeks we would also have 2-3 tests a week along with some hands on testing with some of the equipment which was mainly different ventilators. Yep we were constantly studying, but the tests soon became a competition between everyone, soldiers have a tendency to compete. This all went on for 4 months, PT, classwork, tests, hackey sack, studying, competing on tests. Everyone inevitably got to know each other pretty well. Along with all this you also had a kind of Drill Sergeant. I say kind of because they were not really around except for the morning and night formation, other than that we were really on our own. It really wasn't to bad. At the end of this time we were down a lot of Soldier to about 50 now, so we lost about 30 from the classroom session, the testing got em, but I made it.

One day during the first session that stands out is At 10 a.m. on October 3rd, 1995 we were all out in our cars listening to the radio waiting as the Verdict of the O.J. Simpson case came out. As you remember he was innocent and wow was everyone surprised. Kind of funny class was actually put on hold to hear that even the instructors were out there. It was a nice sunny day to.

After we had a 2 week break for the Christmas holidays where everyone went home we go ready for the second session. WOoooHHHoooo Halfway done.

This second session consisted of 4 months of OJT at the hospital broken down into 8 different rotations that lasted for 2 weeks. These consisted of PTF, SICU, MICU, NICU, Burn, and Floor Rotations. If you noticed there were only 6, we did 2 rotations with the ICU and Floor's. When a new rotation started you were give a big packet which you had to fill out with information you gathered from you rotation and your test would be over these packets at the end of the 2 weeks. Of course a resourceful as soldiers are after the first rotation after you received the packets for the next rotation we would exchange the already finished packets with people who are just starting that rotation for the one you needed and fill out the new ones. The whole 2 week rotation then consisted of just studying the packet you just filled out, no searching for answers, made for longer time to study and better test scores.

The average day consisted of regular 8 hour shifts, 07:00 to 15:00 then you were off on your own. One of my classmates and I would bring clothes to change into when we got off then went straight to the post golf course almost daily and play a round of golf while quizzing each other on the packets. This was a fun session. Unlike the first session there were no Drill Sergeants, no Physical training but you had to keep up on it because there was a PT test at the end where you did a 2 mile run, 2 mins of Push ups and Sit ups you had to pass or you failed.

Most of the rotations were pretty fun except for PFT rotation which was VERY boring after 2 days and the NICU rotation. The NICU rotation was interesting BUT we were unable to touch anything, all we could to was observe but I did get to see ECMO being used on a baby...very interesting. The Burn unit was pretty cool, you had to actually get orders to work there, and you were only assigned there. In that unit the heat and humidity were turned up so high you would be drenched by the time you came out of a room because you were also gowned, gloved, masked, hair was crazy but very interesting also.

Funny but one of the big things you needed to do to pass this session was to be able to change a ventilator circuit out on a patient with a PB7200 ventilator in under 2 minutes. Yes you were actually timed to do this, you had to complete 3 of these to pass the course. We also had to pass ACLS in this session, and of course the 8 different tests.

In the end I graduated in May of 1996 with 19 other soldier who made it. Yes you read that right only 20 of the original 80 made it to graduation day and we were all close friends who did a lot of partying and traveling on weekends and studying on the weekdays. One weekend we road tripped to Corpus Christie to go deep sea fishing and one bud of mine caught a Shark so we had it filleted and brought it back and had a beer and BBQ shark night, good stuff. That was also the night I walked through the sliding glass door, cut my knee and owed $220 for it. There were also poker parties the first weekend after payday and I lost some and won some but it was a good time.

Would I do it again oh yeah I would, we became a really close nit class due to everyone being away from home we were all we had, I learned a lot and had fun and became one of the 300 of the RT's in the military at that time and was sent off to William Beaumont Army Medical Center in El Paso, Tx just 8 hours down the road and that's where my career as a RT began.

Yep I know long posting, but hope you enjoyed my insight on how I became a RT, any question's or stories about this or your schooling please ask.

Thanks for reading.

We have a Drought!!!

This is just a FYI and a call for anymore information.

So my little department here is down to just 2 Nasal Cannula Humidifiers (AKA Bubblers) here in my hospital. Where have they all gone?

OK word around here has it that the FDA has decided to put stronger rules or whatever on the Sterile water for Inhalation and how it's made and packaged, so they have not stopped the companies from making anymore at this time. What more do they want? Extra sterilization, better packaging, fruity flavors? Hell I don' t know.

What I do know is that is what we are told here at my Cave and that there is a nationwide shortage now of Bubble humidifiers for nasal cannulas. Has anyone else head of anything about this, or can anyone find any articles on this topic that is current ... I have found some from 2003 but am looking for something more current.

Oh well just thought this was interesting and would like to know if anyone else out there in Respiratory land has been told anything.

Drive on and keep em breathing.

Sunday, January 6, 2008

30 Minutes past tired.

First off Happy New Years everyone and I hope it's a great one for you all.

So anyways this is my weekend to work and we consider our working weekend to be Friday and Saturday for us 2 night shifters here at my small Hospital and this is why I'm 3o Minutes past tired which in my opinion why I'm so awake right now, I'm past tired but it makes work easier so I'm not falling asleep here.

Friday started early trying to find someone to cover my first 4 hours of my 12 hour shift. Why would I do that, well my daughters (9 and 10) are on a private swim team here in my town and they have a meet this weekend out of town which would of been Saturday and Sunday, BUT the coach put them in to do their first Mile (1650 yards) race. Now as swimmer in High School myself and a proud Dad there is no way I'm missing this. Of course they have to be at the pool at 15:45 and school gets out at 15:35 so of course we have to pull them out early with no complaint from my girls and drive 45 min's away to get to the meet which will officially start at 17:00. All goes well we make it there and they really impress me and Mom with they way they swam their miles. I was amazed, 9 and 10 years old and swimming 66 lengths of a 25 yard pools. Now if you remember one of my earlier posts about athletes who have asthma I now have to put my 9 year old in that categorie also. She has a mild case of it but takes advair and uses her Albuterol MDI before meets and practices and it seems to do the trick and she has only had one issue during practice in 3 years. My 10 year old is fine just has ADD.

Well the first day of the meet is over and its after 18:00 so we go get something to eat and head back home so I can get into my scrubs and head off to work, so now I've been up since 08:00 and am off to work all night, not to big a deal done it before.

Now I'm at work and I start feeling like crap, itchy eyes, running nose, sneezing and head all stuffed up with sinus pain. Crap this is gonna be a horrible night. I go to our med vending machine (Great prices here, Children's Tylenol for $0.75 in here, yep I stock up, along with other types of meds) and I get a cold anithistamine med out of there for only $1.25 and hey look $0.75 in change I will get some more children's Tylenol for home (I have 4 kids). Anyways I take the med and notice it does say it may cause drowsiness....Ahhh Crap. So I'm like in and out of different stages of tiredness during the night and it's a busy night of little crap like the pulse ox machine isn't picking up, I need more supplies on our floor, EKG this and that just the little things. I think because of the med I took I was also forgetting to sign off my MAR on some patients, leaving my papers around, this hit me good but I feel better.

So finally the night is over BUT there is still day 2 of the swim meet so I rush home and get like a 1 1/2 hour nap and my wife wakes me up to get ready, quick shower and off we go. Warm ups at 10:30 and meet starts at 11:30. OK well it was supposed to, the older kids swimming earlier in the day was running late meet now doesn't start until 12:30 and I still have to get some good sleep and work yet Saturday night. So finally it finishes at 15:30 and I feel fine but I'm sure it's from adrenaline from cheering my girls on because they had a great meet. We finally get home about 16:45 and I get to sleep about 17:00 but I have to get back up at 20:30 to take some things to my in laws who are watching my kids (wife is at work) and be on my way to work no later than 21:50. Yep it will be a long night after 3 1/2 hours of sleep, NOT GOOD.

So this brings me to now, I do feel Half past tired. I'm wide away for some odd reason, the night has been relatively uneventful and nothing to exciting, but the day is not over yet I still have Day 3 of the swim meet!! Wonder if I will make it or pass out over the railing into the pool today.

I love my family and will not miss a event of my kids if I can help it at all and my wife is the same way and we want to be there for them. I guess this just shows how night shift can really put a hardship on thing sometimes but due to being used to not sleeping more than 5-6 hours on my work days it can be done, it's just hard and sooner or later something will have to give but for now I'm going to do my best to make it work. One of my goals this year it the classic get into better shape, it's not that I'm in bad shape I do lift weights pretty consistently but I need to add more cardio and watch my eating a bit more, hopefully 20 pounds later things will be good. I guess looking at it being in better shape will help with the harshness of night shift on the human body, namely mine.

That's my story and I'm sticking to it, at least until I pass out from sleep deprivation. I hope you can understand why I might be 30 Minutes past Tired.