Thursday, February 14, 2008

MRI naps

The subject today is MRI. I have a few problems with MRIs.

1. Why does it take so damn long?
I guess I just got used to instant results. I love being able to run my own ABGs. I love seeing the change in peak pressure when I put someone in PRVC. I love the sound a patient makes when I do a sternal rub. I'm a instant results kind of guy. I do not love setting in a wheelchair for over an hour trying to find a dance-able beat to the loud MRI machine. Don't get me wrong. I am glad that Downhill Medical Center has the facilities to give the MD exactly the picture they want, I just wish that I didn't have to set in there while it is happening. My ADHD does not approve of me staying in one place for that long. Hell, my ADHD barely allows me to sleep. TGFB!

2. Why is it so damn loud?
I drive a economy car. It gets 35 mpg. It cost $7,500 slightly used about a year ago. It has a muffler. By contrast, according to Wikipedia (it must be true!) "New 1.5 Tesla scanners often cost between $1,000,000 USD and $1,500,000 USD. New 3.0 Tesla scanners often cost between $2,000,000 and $2,300,000 USD." So what? Can't they put an muffler on it. Come to think of it the tech looked like Vin Diesel. Maybe he put one of those "fast and furious" exhaust systems on it. Which brings us back to # 1. Seriously, my ADHD was screaming.

3. Why do I always lose my pen?
When I empty my pockets some shit-bird always steals my pen. At least they leave my wallet.

On to more important things. I've been trying to come up with interesting ways to squeeze the bag during the MRI. I've tried the right handed and left handed power pump and the amazing two handed human ventilator. After my hands tired I did the funky chicken with the bag under each arm. When my wings gave out I tried the official Suzanne Somers thigh master technique. I was just getting bored enough to start the stomp the ambu bag when the door swung open and Vin told me I didn't have to go to ICU but I couldn't stay there.

It could have been worse. There's nothing like a good MRI nap. One hour where you don't have to do anything but breathe for one patient. Your mind tends to wander and you find yourself coming up with stupid names for your bagging technique.

I take it all back, I love MRIs.


Saturday, January 26, 2008


Who's got them? I know that as a fledgling therapist I have come into the business at a time when the protocols are already written. The old-schoolers have fought for the respect needed to allow us to change Granny's nebs to while awake so we don't have to wake up a sleeping COPDer. They bravely stood up to the docs and said,"We can be trusted not to mess it up too badly!" So what have us kids done?

What I mean is this. I work in a hospital with world class protocols. I can order or change any respiratory med. Unless the doc opts out I can change orders for CPT. If I get called to a patient's room I can can stick them for a ABG, start a neb, order a chest X-ray, interpret the film and blood and call the doc with my recommendations. Many times my recommendations are for lasix, narcan or ativan.

Where is the push to open up our protocols further? Respiratory therapists are able to give these and many other meds. We are able to decompress tension pneumos and insert emergency cricothyrotomies. In fact RTs in my state working in transport can do some pretty amazing things including intraosseous placement and ej placement. They advance the practice of respiratory care.

This is your call to arms. What can you do to advance the practice of respiratory care? How can you prove to the docs that we can't screw it up too bad. If for no other reason do it to piss off that really lazy guy in your department. He'll get called that much more often.

Saturday, January 19, 2008

Back by popular demand person mentioned me briefly. I promise to try for at least a weekly post in the future.

I've been settling into my job at Downhill Medical Center and Resort for the Undead. It's been a transition that I wasn't ready for.

Don't get me wrong, I love the autonomy that we have here. My problem is that we have a large university medical center down the road from us. So while they get all of the stabbings, shootings, MVAs, ecmo babies, blunt force trauma, general trauma, heart transplants and "Hey ya'll, watch this" stunts we get the leftovers. I would say that octogenerians, ODs and belly surgeries gone horribly arwy makes up 80% of our vent business. In fact, it's so bad we have a long-term care facility within our hospital so they don't have to take a long bumpy ambulance ride to the vent farm.

I am by no means complaining. I love my job and wouldn't trade it. However there are times when I would love to see a good trauma roll in the door. You don't know what you will miss until you give it up.

Respiratory Terrorist

People love me here, even though I can be an asshole.