Pixie Dust...What can it do for us?

There is a article at CNN.com about some stuff coined "Pixie Dust" which is being experimented with on soldiers who have a amputated body part like fingers, arms, legs or toes but not heads. This is being trialed at Brooke Army Medical Center (BAMC) in San Antonio Texas where I took my Respiratory Training.

You can read the article here: Pixie Dust

This pixie dust is supposed to give the body a salamander effect and trick the body into regenerating the missing body part. The powder forms a microscopic "scaffold" that attracts stem cells and convinces them to grow into the tissue that used to be there.

"If it is next to the skin, it will start making skin. If it's next to a tendon, it will start making a tendon, and so that's the hope, at least in this particular project, that we can grow a finger," Wolf said.

This is pretty interesting, how could this help our profession? Could this "pixie dust" help regenerate lungs destroyed by smoking, improving quality of life for COPD patients? Could it help people exposed to substances cause them to get fibrosis?

Interesting to say the least and I will keep a look out in for how it turns our for humans and for the soldier in the article. Hope it works.

Protocols Do Work.

Today I had to come into work early due to the requirement of the monthly Staff Meeting. Ohh what fun, but I did actually gain some information this time that I thought was pretty interesting.

If you have read one of my earliest posts I talked about a Therapist Driven protocol that we had implemented at my little hospital about 7 months ago. This protocol had to do with us the RT's assessing patient and then being able to adjust nebulizer, MDI and Oxygen therapy's as we deemed needed. Well we are now done with the testing phase of the implementation of our therapist driven protocol and a letter from our director is out to the doctors with surveys to see if we continue with this type of therapy.

There are some statistics that we pretty interesting that were compared from this 6 months of the protocols being in use and the 6 months prior to the protocols being in use. These stats were pretty interesting and pointed in favor of using these protocols and making them law. The only areas of care that were talked about were patients with Pneumonia and COPD issues.

Hospital staylLengths for Pneumonia and COPD decreased by 1 day in both areas. So we were able to adjust treatments for the patients and decrease their length of time in the hospital.

Now here is what I though was pretty amazing in the financial aspect.

In patients with a Pneumonia the cost of Respiratory Therapy given to the patient was DECREASED by 23% with the protocol in use. We saved the hospital 23% per patient on average if they had pneumonia.

And

Patients in with a COPD issue the cost of Respiratory Therapy given to the patient was DECREASED a whopping 36% with the protocol in use. Here we saved the hospital 36% per patient on average if they were in for COPD.

These facts speak strongly for the use of Therapist driven protocols and that we might actually know what we are doing.


During this meeting I did get into a disagreement with the director and supervisor about how we should for the first 24 hours do the treatment exactly how the doctor ordered it due out of respect to the doctor so they don't think we are just saying they don't know what they are doing.

Whats the point of doing the protocol assessments in the first 24 hours if we are not going to change anything? The doctors signed off on the protocols, so we have a right to use them as needed, otherwise you need to change what the protocol says.

I think I stunned the director when I said "So basically you two want us to suck up to the doctor's so they don't feel bad?" They said no it's a teamwork thing.

I don't know I feel as though if we don't use the protocol as written the doctor's might get the impression that we are skeptical on our abilities as therapist to assess our patients and choose the right treatments.

Fortunately I have a couple of other therapist who agreed with me and backed me up in my thoughts. Good to know I wasn't alone in my thoughts. So this was to be a unwritten rule that I'm not so sure people will follow. I for one will keep doing it as I have been and that's by the book on how the protocol was written up. Can't get into trouble for that.

Statistics show that we must be doing something right, and there are no complaint's about how we have done our assessments so far. Hopefully the doctors do really see it that way and the surveys come back in good shape, then we can make this law and continue on.

Drive on RT's

Stop and put you hand on that person.

I'm coming up on my re certification of my CPR card very soon and I was looking around on the guidelines at the American Heart Association to see if there are any new changes, and wow did I see something different:

Hands Only CPR.





There are only 2 Steps to save a person's life:

1) Call 911
2) Push hard and fast in the center of the chest.

So I started looking around a little bit and from what I understand is that this simplifies the process for the standard layperson. Just make a phone call and press that chest.

This is just for a adult who was witnessed collapsing not someone who possibly has been down for awhile or a drowning victim. So basically if you see someone collapse just start pressing that chest. Easy right.

One of the big things I see this helping is the though of most people that they don't want to put their mouth on a strangers mouth for fear of disease, this is understandable and this technique removes that problem. Also this is a very simple process so the person who is going to do CPR doesn't have to worry about not remembering the proper steps to do CPR. These 2 factors could possibly help a person faster than before because now maybe people will be quicker to react and not hesitate because fear of doing this wrong or getting their mouth on a strangers mouth, unless of course it is some Hot person you would want to put your mouth on.

Back to the topic at hand. Of course is this is the full standard now there would really be no need for a CPR class because it would take like 2 minutes to teach, so no this isn't all there is anymore you still need to learn the regular way for if you find someone down and not sure how long they were down. This also isn't for the pediatric population only for Adults witnessed collapsing.

Hopefully this isn't old news to everyone but I found it interesting, now to sign up for my CPR class and get this over with.

Drive on RT's.

Here's you card....Duhh

Ring Ring (RT Department Phone ringing)

Me: Respiratory Therapy, can I help you?

Nurse: I have a patient who wants to take his MDI, he has 2 in his med cabinet but only had orders for one of them but he wants the other, can I give it to him?

Me: What is the order for?

Nurse: Albuterol 2 puff, may take on own.

Me: What is the name of the other mdi medication he has?

Nurse: Ventolin.

Me: (Laughing to self) Ok Ventolin is albuterol, it's the a commercial name of albuterol.

Nurse: Really, I've never heard of it.

Me: Yea it's like how acetaminophen is the same a Tylenol, or ibuprofen is the same as Motrin only cheaper.

Nurse: Ok I got it, so which one can I give him?

Me: (Duh look no face) Which ever one he wants.


Someday people will understand.

Miracle, sure it is, but something is missing.

I ran across this new article here from Newsnet 5 talking about a woman who was clinically dead but miraculously came back to life and all was well.

Here is the article, for you RT's out there you might find something out of the ordinary, or which I have given a hint by making the area's bold. This will also all into line a bit with my previous article about respiratory mishaps in movies and TV shows.

Woman Wakes Up After Family Says Goodbye, Tubes Pulled

CLEVELAND, Ohio -- A West Virginia woman was being transferred to the Cleveland Clinic after walking the line between life and death. Doctors are calling Val Thomas a medical miracle. They said they can't explain how she is alive. They said Thomas suffered two heart attacks and had no brain waves for more than 17 hours. At about 1:30 a.m. Saturday, her heart stopped and she had no pulse. A respiratory machine kept her breathing and rigor mortis had set in, doctors said. "Her skin had already started to harden and her fingers curled. Death had set in," said son Jim Thomas. They rushed her to a West Virginia hospital. Doctors put Thomas on a special machine which induces hypothermia. The treatment involves lowering the body temperature for up to 24 hours before warming a patient up.After that procedure, her heart stopped again.

"She had no neurological function," said Dr. Kevin Eggleston. Her family said goodbye and doctors removed all the tubes.

However, Thomas was kept on a ventilator a little while longer as an organ donor issue was discussed.

Ten minutes later the woman woke up and started talking.
"She (nurse) said, 'I'm so sorry Mrs. Thomas.'
And mom said, 'That's OK honey. That's OK," Jim Thomas said.
Val Thomas and her family strongly believe that the Lord granted them their miracle and they want everyone to know."I know God has something in store for me, another purpose. I don't know what it is but I'm sure he'll tell me," she said. She was taken to the Cleveland Clinic for specialist to check her out. Doctors said amazingly she has no blockage and will be fine.

I just find this funny as we all know what you cannot talk while on a ventilator especially with a endotracheal tube in. I'm sure she wasn't trached with a Passey Muir valve on or a capped trach with fenestration since this seemed to only happen in about 24 hours. As bad off as she was I'm thinking a trach was the last thing they were thinking about. I just found that interesting how the media can get things wrong.

So what to do, well I'm going to drop a email off to this news channel just to see if I get a response. I'm thinking this was maybe make to be a little over dramatic as most of the public has not clue with some of this medical stuff. But us RT's will catch the little respiratory inconsistencies that people will make when it comes to our profession right.

If I get a response, it will be posted here for all to see at a later time, but I'm not really expecting anything to much, you never know though.

Drive on RT's.

Google Health.

Just a quick post here about the recently released:

Google Health

I've been playing around with it a bit and it does seem like it could some in pretty handy and informative for someone who uses medications and has multiple medical problems.

You can put in your medications here and it will show indications, contraindications and possible problems if you have incompatible medications, which is good so you don't become like Heath Ledger.

One thing I'm not to sure of on this site is the ability to upload your medical records to the site. I'm thinking some kind of privacy issues here, but on the other hand it's Google and if they do share your information you can definitely win a large sum of money from a lawsuit.

Overall it looks very promising as all Google products seem to be, I do like the idea of all my information, calendar's, email and other information in one place. Google is a well respected name and is probably trustworthy. It's probably something that could help people keep their medical information organized, plus there is a nice print function that will print all your information out so you can go to the doctor with your medication listing and prior procedures and hospitalizations. That is good because I see a lot of people come in with written lists of their own information and with the computer age and Internet being so big now this can be a easy way to pull up your information from anywhere really.

I'm liking Google's response to Microsoft ’s HealthVault (which launched last October), Revolution Health, and Aetna’s SmartSource, because is uses Google clean interface with nothing really distracting on the screen.

I'm not Pro Google or Microsoft or anything but I just really enjoy technology and of course the way it can interact with health care.

Keep it real RT's.

High off Inhalers?

I ran across a article in Science Daily that is talking about teens misusing inhalers (MDI's) to get a buzz or get high off of them.

"Asthma inhaler misuse is prevalent in the adolescent population, particularly among antisocial teens, US study findings indicate."

I find this interesting because I'm wondering how many puffs off of a MDI do they have to do before the feel any effects of being high?

There was a study conducted to get an idea of how prevalent this actually is and the results were kind of surprising:

"Brian Perron (University of Michigan, Ann Arbor) and Matthew Howard (University of North Carolina at Chapel Hill) conducted a cross-sectional survey with face-to-face interviews assessing substance use, psychiatric symptoms, and antisocial behaviors among 723 adolescents in residential care. Over 26% (193) of adolescents were diagnosed with asthma, 91.2% of whom had received a prescription for an inhaler. Almost a quarter of the 373 adolescents who had used a prescribed or nonprescribed inhaler reported using an inhaler to get high."

Is this like any other inhalant that kids use to get high, is it like huffing gasoline, inhaling paint thinner? You would think that there would be a cheaper way to get this type of high, but I guess if insurances is paying for it or you are from a lesser well off family and you have a medical card, it probably is pretty low cost for the kids who do this.

Reading later in the article is shows what effects misuse of the inhaler can cause:

"Inhaler misusers were significantly more likely than asthma inhaler users to report euphoria, memory problems, slurred speech, blurred vision, confusion, dizziness, and a variety of other acute reactions to asthma inhaler use."

Pretty interesting to see how people will look to anywhere to find a way to get high, and with inhalers I'm sure these kids are thinking that this is a lot safer to use like this instead of other inhalants like gas and paint thinner. Wow what is this world coming to, are we now going to start have MDI seekers coming into the ER as well as the regular drug seekers? I'm doubt that would happen as this I couldn't see becoming very popular, but on the other hand you can never fully tell what is going to happen.

As you giving that MDI and spacer instruct to a person who you didn't think really needed that neb you just did on them, they might just be a one of those MDI get High people.