Stories of a Respiratory Therapist

Would you like to see more of these little case studies?

  • Yes

    Votes: 20 95.2%
  • No

    Votes: 1 4.8%

  • Total voters
    21

Dualie Woolie

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#1
Since I am a student going into a Respiratory Care Student, I decided to make a thread talking about what I learn in clinicals over in hospitals I shadow. Right now all I know is a few cases i have done, in which I saw the most interesting case.


It was a case in which this person was in for cardiomyopathy, which was induced by meth and alcohol. they are a meth addict, yet is a stage 3 morbidly obese, and has possible type 1 diabetes. they complained about swelling in his lower appendages which could be from the myopathy, that or they could have a case of pulmonary edema.

Of course, due to HIPPA, I can't disclose anymore information unless it is deemed public if it is a public concern with WHO or CDC. So what I can't disclose their name, age, height, facial features, or gender. their medications included Albuterol, Kipponin, I think there was some Lidocaine, and norcocaine to flush the meth out of his system

I will keep weekly posts, and I mainly made it for people who enjoy the medical career, and want to get into it.
 

Dualie Woolie

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#3
Sure, I would like to see someone’s health life.
If they don’t die, of course.
Note: I am only there for 8 hours, at different hospitals, I would have to ask for their information after I leave to see if they live or die. So I think this is good for now. I go once a week, so that is why it will be weekly posts
 

Sympathetic

Laughs at his own jokes
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#4
I never was into medicine but I always like to hear amusing stories about weird people. Keep going.
 
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Dualie Woolie

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#5
Okay guys, here is another exciting tale of a respiratory student, this one was IN THE ERRRRRRR(Emergency Room)

we had a patient that showed stroke like symptoms, they had a falling accident in a walmart. We had a Neurologist give an opinion and told us it was due to opiate/narco prescribed medicine overdosing, they took lortab(which if you haven't seen that, think of a slightly weaker vicodin-see House MD-. We gave them norcocaine, which stops the drugs and helps us flush them out. they were still disorientated. We were called for a ABG(an Arterial Blood Gas, to see if their pulmonary functions are doing well.) They were skinny, so it was easy to find the artery(if you haven't had an ABG before, imagine giving blood, but the pain is way worse, since it's deep skinned). For some reason, we were cucking up the ABG, so we had a local ER nurse come in and try it, nothing, the non-lucid patient started to weep tears(to them they were basically thinking they were in their friend's house getting needled). We were cucked up because when we tried one last time, to look up. THE FUCKING PEOPLE LEFT THE BLOOD PRESSURE CUFF ON, SKIN TIGHT.

It was so embarassing, but apparently this person was 50 pack smoker per year, and was obviously a falling hazard since they wanted to get up outta bed and go home.(family left to the chapel, so they inadvertently didn't see the patient in pain.)


So that is today's weekly post, if I get more interesting cases in my next clinical, I will post.
 

CocoTM

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#6
how to be sadistic:
rate funny

But seriously, a 50 pack smoker p/year? You would have so much tar in your lungs...
 

bungthebadger

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#7
how to be sadistic:
rate funny

But seriously, a 50 pack smoker p/year? You would have so much tar in your lungs...
Rip lungs:
 
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CocoTM

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#9
Rip lungs:
Not very nice, isn’t it? Some people stil smoke even though they know they will get those lungs by smoking 50 p/year. I understand if the nicotine inside is addictive but they need help. Fast.
 

Dualie Woolie

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#12
a better alternative is that you take nicotine patches. Some insurance companies can pay for it, or even better, you can get into Smoking Cessation and internet help, such as people doing checkups on you, giving you positive vibes over the phone or by texting. It's a positive reinforcement method to fix your lungs.

If you don't know what smoking does. You won't get much damage for smoke alone, it's actually the combination of both, since they slow down the cillia in your lungs that moves mucous around to expel it. If you smoke, it will slow down, and even stop. They re-awaken when you wake up since it was a while since they were depressed. That is why you get smoker's morning cough right before they have their first cig. They might not wake up, it's less of cancer then the smoking can cause you so get cysts by mucus and lung capacity can go down.
 

Dualie Woolie

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#13
I know this isn't a weekly post, but I decided since I was bored, I had another case seen at my 2nd clinical. This was a hospital that was away from the city I lived in for the first time.

We came into the room and the patient looked like the portrayal of a blind man in hollywood movies


like this patient, except old. We came in for their breathing treatment, and they was a bit loopy. Like way too loopy for an average old man. We did some stuff that I never did yet, which was oscillating therapy, or broncho-vest therapy. This procedure is done for people with Cystic Fibrosis or COPDers(Chronic Obstructive Pulmonary Disease). It shakes up all the loose cillia and mucus in your lungs, and gladly helps you cough it up. Before this technology, they just had nurses go around doing this. The procedure only takes 10 minutes. It has greatly improved Quality of Life for Cystic Fibrosis instead of about 18-28 years of age, they reach about 50. I feel bad since my partner has a kid that has the same disease. NOTE: this was like 6:30 in the morning, we been there for like 2 hours already.

We put it on and started it up, the patient instantly starts laughing loudly. WE HAD TO SHUT THE DOOR BECAUSE THIS CUCK WAS LAUGHING SO HARD THAT IT WOULD'VE WOKEN UP THE ENTIRE WARD. I calmly ask the attending RT if he "normally acts like this" She thought it was a joke and told her friends later, thinking it was the funniest shit. the reason why he was so loopy is because he was getting pure oxygen for his low O2 Saturation, which was 82. usually a good oxygen saturation for a healthy person is about 97-100 percent, and okay O2 is like 89-100. So this person was in their own little world. btw, they were just in for hospital acquired pneumonia, which is slightly serious.
 

Dualie Woolie

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#14
There might not be a story for this week since the hospital I am going to is so meager, like other people that went there they have told me "we saw a total of 2 patients within a span of 8 hours, just bring something to work on or bring your phone" so essentially, nothing to write home about disease wise.
 

Dualie Woolie

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#15
Oh, I have a story btw, but it's a shit one.

This hospital is essentially a 3x smaller version of a hospital in the city I live in, aka it's a "Pavillion". The RT there was nice, but we clock in at 5:30, but we don't even get our first treatment until 11:00 am. The patient had COPD, the first checkup clocked their HR at 62 beats per minute, and their Respiratory Rate at 26 breaths per minute(if you wanna learn how to time it, you get a pulse oximeter to see oxygen saturation, and pulse, if you don't have that, count the pulses while you watch the clock for 30 seconds and multiply by 2.)(for Respiratory Rate, do it for 15 if you desire, just learn to look at chest rise and multiply by 4.)

Later, we came back at 1 to check them. Their HR went down to 52 and RR was 36(tachypnea, aka the usual rate is about 22).

They had clubbed fingers, aka when I say that, thin fingers, but their joints in their fingers are bloated and distained.

I am pretty sure they were going to kick the bucket soon, considering they were around 82 years of age.


The RT spent most of her time watching wheel of fortune in the waiting room. Our instructor visited and told us a rumor that they might shut down the hospital, FeelsBadMan.
 

Dualie Woolie

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#16
Got confirmed, our schedule is now different, they are seriously considering shutting down that hospital, and it has been taken off our schedules because of our 2nd classmate that got kicked out of the program for not showing a professional appearance (IE cursing in sentences explaining stuff, and using their phones while in the hospital halls and patient rooms)

I am frankly glad she is gone because she is a bad influence, she has to learn this isn't just EMT school all over again, where you are stuck in a truck waiting for critical care situations,this is patient care and you have to be a complete professional about it(you can joke around with them, just no crude humor like cursing)

tl;dr hospital and student BITES THE DUST
 

Dualie Woolie

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#17
probably next week(IE the thursday after this one) I will be going back to clinicals, so that means there will be more I can teach to our community, Happy new years everyone.
 

Dualie Woolie

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#18
Alright, not a clinical, but I decided to share information. For those that don't follow my snapchat, I had a painful experience with a wrongly placed needle in my brachial veins, getting my blood and cycling it through a machine, to give back. It takes me platelets(IE Thrombocytes; parts of your bloodstream that help clot blood in say a cut or stagnated blood)(both good and bad)(if you need to know what can reduce the risk of heart clots and such, take say a baby asprin a day, or ibuprofen. Anything like that, or if you want a more clinical one, Heparin.) So while this 2 hours of agony I was occuring, I was telling people that this experience for first timers, you will experience(alot worser cases than giving whole blood 1 pint, since this is all of your blood being processed) dizziness, trembling, pallor(aka white complexion), numbness, and during the start your olfactory regions of your nasal cavity and your brain(your frontal lobe to be exact) will trigger weird smells, usually something smelling like iron or a metallic smell. This is normal.

If you do volunteer, in most places they have online rewards and platelets give you 3x the points than whole blood. for 1.1k or something like that, it will be say a 25 dollar giftcard to walmart. So if you are bit crunching your money so you can survive, you can still have money that you don't need to use while the giftcard can buy you steam cards or other shit.
 

Dualie Woolie

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#19
Okay

C R A C K S F I N G E R S

This is what happened on January 19th, aka Thursday of 2017. We went to our clinicals, we had a few breathing treatments(IE my partner got to do alot of cool stuff, and I had to take his preceptor's workload). Some interesting ones like a 3 year old with RSV (Respiratory Synovial Virus) and had contact precautions with masks(not to be confused with droplets, which we would have different masks on, but anyhow, getting off-track.)

We had to go to the ICU about 11:00 for a Intubation(aka shove a Endotracheal Tube down a unconscious man's throat)(and as I am typing this, I have realized google doesn't know jack shit about medical terminology) So we basically sat there like ducks watching this weird procedure, handing them equipment. Next is that my partner's preceptor and him go to the cath lab(catherization lab) for some artery blockage. THE APEX OF THE HEART STOPS MID CATHETER PROCEDURE and so they have to code him and get him back to life, meanwhile this happens, I am basically walked a total of 5 miles in this hospital doing their work load, then the guy ended up dying after they revived him. We find out with my preceptor that the person we Intubated was in fact DNR(aka "do not resuscitate" which means don't try to bring them back to life if it means pain.) so he coded while I was gone for 20 minutes for a quick lunch, I was pissed.

The main reason I was pissed because A. I need it for my class so I can graduate and B. I love helping people, and being in a stress environment will condition me for it.

So, my partner extubated the patient(IE take his tube out, while he is dead) so he gets that checked off. The worst thing I got to see that day was a lady that was nauseous from the medicine and threw up so much her vomit was bloodlike, and had extreme heartburn. Yet it was just breathing treatments for her.


So RT's can have interesting days, but it is essentially some people can see the cool and interesting stuff in the world, meanwhile others get diddly jack shit. My partner wants to do PFTs, which is basically quiet work environment. I had some people from a big hospital saying "don't be a med jockey" telling us to get respect by specializing and shit, frankly I wanna do it all, I wanna save people from the brink, but I also want to talk to old ladies and stuff and get to know them. It is the way I am essentially.
 

Dualie Woolie

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#20
Okay
S U H D U D E S

I went to my clinicals, which is going to be the last one for a long time due having rotations, now my hospital is going to be an hour away, and it's even smaller, so means less patients. I decided to get a mobile battery bank that I can charge, so I can have even longer battery life on my phone because 12 hour shifts fucking suck.

I mainly had alot of breathing treatments, duo-nebulizers, which contained bronchodilators(if you don't know what that means, bronchus/bronchi-oles are in your lungs, they are the passageways to your aveoli.) the broncho dilators names are Albuterol(which is basically mist form adrenaline in it's purest form) and Pulmoncort. They after the 80's-90's have been treated for longer term pulmonary care, and the newest one in the field is called Brovana. That is a way smaller dosage and is more powerful, and I actually learned about it in August in a conference and hospitals started using it.

Stuff I saw; a full code(IE no DNR/DNI)((Don't Resuscitate or Intubate) on a 102 year old woman, if you don't get what I am saying, this lady is basically at death's door with heart failure, atrial fib, respiratory failure, alkaline(which in terms of pH scale is basic IE leaning more towards bleach) and she was transported to the ICU.(Isolated Containment Unit)(either where you are kept if you intubated, or you are in bad conditions like bipap is essentially the only thing keeping you breathing.)

a man with dementia and I guess so bad of oxygen saturation, that I tried to gently shake him to wake up, to do his breathing treatment, didn't even get up, IE we had oxygen/aerosol going(which is high pitched, which your brain reacts to during sleep mode)AND DIDN'T EVEN WAKE UP.

and I think I must've caught something at the hospital, or since I left my jacket at home, it could've been the 23 degree weather. I have some sort of Bronchitis considering the coughing fits and soreness. I got fever reducers, Day/Nyquil, and this pill for breaking Bronchitis called Azithromycin(I know it's a long name, but this is medical pharmacy stuff, not walmart store bought.) It's strong enough that it's a 5 day treatment, and you take a pill a day, that is how strong it is.


Footnotes: the base normal range for pH in your blood is usually 7.35-7.45, 7.25 is where you need to be ventilated, and stuff like 7.7, you basically instantly die, there is no coming back from it.

PaCO2(carbon dioxide in your lungs/bloodstream) normal range is 35-45, lower means alkaline, higher means acidosis

HCO3(or Bicarb, regulated by your kidneys) is usually 22-26 area, higher means alkaline, lower means acidosis.

there is a PaO2 but normal is basically like 40-50 range.

This is an ABG(Arterial Blood Gas) reading format.


Always make sure you are clean/sterile, never cross contaminate patients.


I think I deserve the title rating of "Doc" from Rainbow Six Siege, am I right guys????
 
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