Lately...

I apologize for the lack of posts lately.

Life has been kinda hectic for me. A lot of it I can't go into for one reason or another, but just know that I've been stressed to the max most days.

Yep, that's right. To quote my best friend, "I'm fried." Crispy, even. It's a feeling I never really understood until I experienced it myself.

School is kicking my butt. As we're nearing the end of the semester, it's a little less challenging, but finals are coming up soon, and I fully intend on rocking them. It's just going to take a little work.

So what's been going on this semester? Well, as I posted a while back, it's the start of my second year of RT school. It's been pretty busy. We're building on concepts we learned first year, and learning a lot of interesting things.

Here are the classes that have been occupying my time:

1. Pulmonary Diagnostics
More than you could ever want to know about sleep studies, capnography, flow-volume loops, pulmonary function studies, bronchoscopies, lung/chest imaging techniques, and the like. Interesting stuff, folks. I'm slowly finding out that next to good assessment skils, diagnostic skills are key.

2. Advanced Respiratory Care Patient Assessment
By far, my favorite class. I may or may not have talked before about how much I enjoy using my assessment skills to troubleshoot and treat my patients. Without these skills, there wouldn't really be a need for respiratory therapists. It's this particular class that helps me realize that we truly are specialists in the health care field and that we have a lot of good knowledge we should put to use. EKG interpretation, analysis of serum and urine chemistry, auscultation of heart sounds, and so on and so forth. Fun times.

3. Mechanical Ventilation
VC/AC, PC/AC, SIMV, PRVC, bilevel, APRV, VC+...say whaaaa? That's right. Homeboy knows his way around a vent now. This was, without a doubt, the most difficult class I have ever taken in my entire college experience. And believe me, coming from the guy who didn't know what he wanted to do with his life and has all the pre-requisites finished for four different degrees, that speaks volumes (Volumes? Yeah, I guess I still have ventilators on my brain). I remember when we first started working with vented patients and I was so intimidated, but now I have the confidence I need to be able to perform my job well.

As far as reading material goes?

Waugh, et al. Rapid Interpretation of Ventilator Waveforms, 2^nd Ed.


Ruppel, Manual of Pulmonary Function Testing, 9^th Ed.


Cairo and Pillbeam, Mosby's Respiratory Care Equipment, 7^th Ed.


Wilkins, et al. Egan's Fundamentals of Respiratory Care, 9^th Ed.


Chang, Clinical Applications of Mechanical Ventilation, 3^rd Ed.

So, there you have it. Add a precious three-year-old into the mix and such has been my life for the past 4-5 months.

I promise I'm working on a few posts that I have saved in my drafts folder. Bare with me as I get through this (I *can* get through this, right?), and I promise great things will be coming soon.

How's your life been lately?

One Last Breath.

As RT students, we are always taught how important it is to maintain a patent airway. We are taught from the beginning of school how to treat shortness of breath, airway obstructions, hypoxemia, and respiratory failure. This is our job. It's what we do for a living.

Many of us pride ourselves on being in a profession where we help people breathe better. I can't imagine anything better than treating an asthmatic who comes in with a full-blown attack and seeing her get discharged from the ER with a respiratory rate of 12-20, non-labored. Or weaning a vent patient to nasal cannula successfully. As they say, if you aren't breathing, you aren't doing much else.

At the same time, sometimes we have to go against what we have learned, based on the patient's decision. And that can be both emotionally trying and somewhat difficult to do. But it's important to keep in mind that we're in this for the patients and for no other reason.

Yes, I did it. I finally had a time where I had to withdraw care from my ventilator patient. I was the one who had to go into the room full of crying family members and turn off the patient's vent, knowing there was basically no chance of him being able to breathe on his own. And let me tell you, that...was the most difficult thing I've ever done, next to coding a pre-schooler.

For the first time, instead of helping a patient breathe, I had to take their breath away.

Instead of using everything I've learned to make adjustments to the vent to help this patient breathe on their own, I had to put it all aside and D/C the ET tube.

It was no longer my job to notify the nurse when her patient started bradying down (50s, 40s, 30s, 20s).

I did not treat his shortness of breath. I watched as he went into respiratory arrest, followed by cardiac arrest.

But...

I held his hand and told him it would be okay.

I comforted his family members and reminded them we were carrying out his wishes.

I prayed with them when they asked if we could pray.

I did not become startled as he gasped for his last few breaths. I squeezed his hand tighter and told him it would be over soon.

And, as my patient took his last breath before my eyes, I didn't reach for the ambu bag. Not this time.


He's in a better place. There was no chance of recovery from his condition. I wondered how I would sleep that night, feeling like I was the one that caused him to die...

But then I realized something. We all love saving lives-- there isn't a better feeling in the entire world. And sometimes "saving a life" doesn't mean bringing a patient back after CPR. Sometimes, saving their life, involves putting them totally at ease. He can now breathe better. And, in a sense, so can I.