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.