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

I enjoy medical field
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#21
So, I got to do some cool shit this week my dudes.

I got to do AIRBORNE PRECAUTIONS for a potential TB patient, in which I wasn't fit tested for a N-95 respiratory mask( that completely blocks any foreign body droplets, since TB is small enough in particles to go through regular masks. So I got to wear like one of those CDC helmets with a face shield and a oxygen pump that blew filtered air into my mask, so basically I looked like this


So it was cool. I felt like I was in a 1960's sci-fi movie with it on. I proceeded to go through the day, almost had a code(in which I would have to do compressions in hopes to save their lives) in the ER, but, the ambulance called it because it was a 37 yr old that was found cold and lifeless, no one say them a day before, so rigor mortis was kicking in. It was too late.

We had a suicidal 21 year old that we assessed for all of 10 seconds, he apparently tried to overdose on tylenol(aka don't do this, if it doesn't work, you are basically going to live with a damaged liver for the rest of your life, suicide isn't the solution and a suicide this stupid isn't good either, you are in pain, and won't be able to process chemicals.) He was handcuffed after the 10 second assessment, I feel bad for saying this but he looked like one of the columbine kids, like edgy clothes, wearing timberlands, and shit.

So I am basically wanting to pass out, but I got classes, yesterday I woke up at 3 am and went to bed at midnight, to almost a 24 hour shift(even though the midnight time was because I was working on homework).
 

Dualie Woolie

I enjoy medical field
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#22
this is my last week at this particular hospital, next I will be going to another hospital. This visit made me feel terrible, like a piece of shit. I didn't do anything but it just particularly made me feel like a piece of shit.

We had a 62 year old male, he kind of looked like Michael Rooker a bit of Michael Rooker had two sleeves of tattoos. This man had Streptococcal Pneumonia, and Monday he had a Chest X-Ray, it looked kind of bad, you can see the dry septum that needs to get out, we give him the breathing treatments accordingly. 2 days later(IE Wednesday) he has another, his entire chest is cloudy and white. This man has no wife or friends visiting him because his wife died due to Chronic COPD(they were both smokers.)

His friends mainly died due to lung cancer, and at the start of the day, doing his flutter valve treatment(5 breaths of him trying to force a ball bearing, which makes your lungs work and gets them to move the secretions). At the peak of the day, it turned into 5 words dropped him from 95 percent(on 12 Ls of oxygen, IE it's pure O2 and he isn't even 99). 5 words makes him drop to 82, which is terrible.

Also, a man from like a town 5 hours away, we talk to him, and we tell him we were students working clinicals to become licensed, so basically free labor. This guy decides to take it upon himself, as my bae(aka a girl I am seeing that I plan to make my girlfriend, and bam, he pays for our meals.) All together was gonna be 30 bucks. it was the nicest thing a stranger has done for me, not someone who knows me, a family member, or a friend. This guy was a stranger and did it. It changed my entire worldview. I plan to repay it sometime in the near future.

Also, I learned about Adrenergic and Anticholinergic aerosolized medicine. Which is cool
 

bungthebadger

Fuck off bung
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#24
I feel like you are Doc. Since you are becoming a Pulmonologist. You can be the Doc who always shoots at my lungs with your stim pistol to stop me from dying. (As long as Fuze doesn't kill you with those hockey pucks.)
 

Dualie Woolie

I enjoy medical field
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#25
There won't be a post this week from a hospital, but, I will post about me going to a conference, it's in the big boi city, basically a city that goes from 50k(my city) to 580k. We get to be big boi status. Will post certificate of attendance too(might edit out my information)
 

Dualie Woolie

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#26
So, I went to a hospital that was in a larger city, that had a bigger room for stuff to happen, naturally. We went throughout our day, I fucked up an ABG on a ER patient, she had a weak fast pulse and the attending RT got it in two tries. I come back after eating lunch with my instructors to come back to a empty RT department, to be picked up 2 hours later by a senior student in my class that works there for some extra cash. She said they were in the ER.

She walks me down there, and told me her top two stats.

for reference, I have stated before 7.35-7.45 on the ph scale is average human beings, and 7.21 is usual rating to be intubated.

This lady's was 7.09. Your body has a homeostatic balance that keeps it at this range for a reason. This level could be lethal and kill them within hours. Also, her PaCO2 was 125(basically triple of the normal)

So she was set up on a ventilator, but the settings to get her stabilized for transport was too high for us to even keep her. For the levels, you are legally required to have a pulmonologist on site. Which we don't have one. We got her to 7.26, and a PaCO2 of 46.

Sidenote: This woman was 500 pounds....just stating it

I got to move her to the ambulance and learn how to switch from the hospital's ventilator, to the Ambulance's ventilator.

that is how my day went.


As these days go by, I get kind of sad, my partner on the clinical site keeps me preoccupied and happy. It's a lonely life inside a hospital for 12 hours at a time, but I try to make the most of it, by being friendly with patients and the attending. Also, I met someone I knew from high school, they used to call her a slut, face might be like a 6-7/10 but how well she keeps with her health, her body is a 10/10 healthy.
 
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Dualie Woolie

I enjoy medical field
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#27
I decided to try to reawaken this thread because now im no longer a student and I work full time at a inner city hospital. I will try to think about situations that I had that I found interesting.


First one: I had a patient that was medicated with morphine sulfate to ease him since he was aggressive. I go in to assess the patient, in which he was refusing treatment, then realized I saw a big gash on his bandaged foot. This is concerning to me because I have never had this patient since, last time I saw this person was when they were breathing through a trach tube, and heavily more medicated than this. I had a mention from a nurse that said they would flop around alot and be restless. I grab the other nurse that was on the floor, we walk in, and I see streaks of blood on the floor as I turn on the lights(I work nights). Then I saw the weirdest sight... leeches on the floor engorged by blood. and I saw the pt's foot, and it looked almost like jello blood. pretty jarring but pretty standard so Im used to it. They mentioned they like to use alternative medicine and mentioned later this is like a last ditch effort usually to return circulation to the body part(which in the jello there was a big embolism)((blood clot)) So pt might be facing losing a foot, which sucks.

I have another trauma story Im gonna post after this one.
Post automatically merged:

Another trauma I got to see, but not have much interaction with:


Pt comes into ER with a knife embedded in his skull, barely scrapping by their nose, and goes in about 6-8 inches deep. The pt is so drunk, that they dont even know it's in there, they said they were asking questions like "why are you all staring at me like that?" So they put them under and intubated them, took them to surgery.

Surprisingly before surgery they did a CT Scan(which is like MRI, except not magnetic and it's not for soft tissue really) and surgery proved to be easier than excepted. I was assuming that the embedded knife(and was correct) was below the pituitary, which sits in a saddle ridge in your skull, and controls most of your endocrine balances in your body(besides adrenals and thryoid) and was on the brain stem. Another problem going forward was the bleeding that would occur after pulling a knife. This is the reason why if you are stabbed, and it's still in you, dont pull it out until you find medical attention.

So what they did was deep cauterization of the wound to prevent bleeding and surprisingly the knife extraction didn't need much easy handling. Besides hypoxia, he would probably be good with no/minimal brain damage/deterioration.
Pic Related below: not pt's image to circumvent HIPPA violations. Except angle is slightly different and it was way deeper than that.

 
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Dualie Woolie

I enjoy medical field
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#29
Alright, making another one.

Had this patient for about two nights, very overweight pt with no brain activity, all they would do is stare at you, mouth agape, not being able to respond or react to anything. The doctors assumed that it is brain damage, and she would most likely either live like this or die from the injury itself. Last time I had the pt I went in, I was told by the day RT that they had to suction the pt's mouth because it would be filled with secretions, and washed with saline because air drying. I decided to take a swab and try wetting the mouth, which I noticed some secretions. The dried secretions wasnt what bothered me though, I open her mouth slightly wider, and notice something in the corner of the pt's mouth. I decided to go at it with a suction catheter. As an RRT, this is the first time I physically cringed at sputum before, in which had the consistency of melted cheese on a grilled cheese sandwich, and looked like a spider web in the pt's mouth. After the tx(which was the last of the night) i decided to just leave it be.


Next night, I didn't have them, one of the new employees had them. I was told by the nurse while attending one of our long time, worst pts ever that somehow they just "woke up". Sudden recollection of brain activity, asking for water, while we all thought they were going to die(guess the MRI didn't show anything if you ask me, but still, no activity to suddenly speaking normal is quite a feat only what I would state is nothing short of a miracle.)


I'll post some later but I been sitting on this one for quite some time.
 

Dualie Woolie

I enjoy medical field
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#31
Passed my National Registry for Respiratory therapy, IE as long as I get my continuing education hours(12 every 2 years, 30 every 5.) I will have a free pass to work anywhere in the country that requires patients that need tending to.

I get paid almost 25 dollars an hour, life is good. Im going to go for my bachelors degree later next year. Also since my bachelors requires a 2nd degree. I might try to learn german, french, or russian.


let's put it to a poll for people who check forums:
confirm/check for french
late for german
and funny for russian
 

Dualie Woolie

I enjoy medical field
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#32
Lets try how to deal with a patient that is fully aware of where they are sensorium. Pt has a "larry tube" which is a laryngeal tube that is placed at the stoma site to help facilitate long term ventilation(also easier to suction since it looks like a nasal trumpet, but they always look disgusting though. They are almost always sutured in, which if I had the supplies and or recording equipment I would demonstrate on how to make a stitch/suture)

Anyhow patient was nice, I setup a cool humidity trach collar(which helps with tracheotomies((which is different from a stoma, stoma is closer to the clavicle and at the carina of the lungs, tracheotomies are at the circoid, which is where your adam's apple is at/vocal cords)) to provide humidity to move secretions, since oxygenation cools/stagnates sputum.)

later I come back and they told me that he has a hard time breathing, despite saturation and respirations not changing whatsoever, he has no secretions, his site is still swollen, and sutured in place. So there isn't really a problem of positioning, just post surgery inflammation. I said "I will be right back." pt got up and slammed the door right behind me very loudly in anger. it was 5:30 am, i decided not to go there and told day shift about it. The End for that day.