The Harry Potter Office
Respiratory Therapy Cave
by John Bottrell
9h ago
The RT Cave has transitioned to a new location, now situated in the front lobby, nestled within a closet. Upon our initial entry into this space last June, our first task was to clear out the broom and vacuum cleaner that blocked our entrance. This chore was swiftly followed by the inevitable sniffles and sneezes as we diligently wiped away the dust that had settled on the two desks within the room. This moment marked the inception of a new era for the RT Cave. Navigating to our office involves passing through the waiting room, amidst patients, where there was originally a chair and space d ..read more
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The Sat is 87%. Oh shit! What do I do?
Respiratory Therapy Cave
by John Bottrell
1w ago
My phone dinged. The message flashed urgently: "CCU2's sat is 87. Can he get a breathing treatment?"  I swiftly replied to the nurse, my fingers flying across the screen: "He just had a breathing treatment." Her response came back quickly, tinged with concern: "But his sat is still low." I felt a surge of alarm. This patient's directive was clear-cut: maintain an SpO2 of 88-92. A saturation level of 87 was not just below par—it was critically low. Without hesitation, I dashed from the RT Cave. Up flights of stairs, down long, echoing halls, through bustling corridors that seemed to stret ..read more
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The Confusion Around AVAPs: BiPAP Machines in Disguise?
Respiratory Therapy Cave
by John Bottrell
1w ago
In the world of respiratory therapy and home healthcare, the distinction between BiPAP machines and ventilators has significant implications for patient care and logistics. One particular type of BiPAP machine, known as AVAPs, has sparked controversy due to how it's classified and billed. AVAPs, a variation of BiPAP, stands out because it guarantees a specific tidal volume for patients. This feature sets it apart from traditional BiPAP machines, which provide varying levels of pressure support but do not guarantee tidal volume. Despite this distinction, home healthcare companies often refer t ..read more
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Have You Ever Poked Yourself?
Respiratory Therapy Cave
by John Bottrell
2w ago
I've been drawing ABGs for nearly 30 years now, and I take pride in never having accidentally poked myself after a draw. I'm grateful for that because I'm not the type to willingly report such incidents—I'd rather avoid the testing they'd require. If it ever did happen, I'd probably keep it quiet and carry on with my day. Fortunately, it's not something I've had to deal with because I've never accidentally poked myself. I have poked myself with the needle, however, Thankfully, each time I have done this it was prior to the poke, not after. I have poked my finger, usually my left pointer finge ..read more
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The Art Of Drawing ABGs: A Skill That Persists
Respiratory Therapy Cave
by John Bottrell
2w ago
I'm 54 years old and still do not wear glasses. Although, I do require reading glasses, unless i'm reading off one of my electronics gadgets. And, technically speaking, I cannot see the bevel at the tip of the syringe. Surely, reading glasses help. Unfortunately, I often forget to bring them to work. Nevertheless, I am still recognized as one of the best at drawing ABGs. Until recently, I dealt with a constant hand tremor. It's not noticeable during my daily routines, but when I'm crouched before a stranger, holding a sharp needle under their watchful eyes, the tremors become apparent. Despi ..read more
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Lidocaine for cough
Respiratory Therapy Cave
by John Bottrell
2w ago
Lidocaine is a versatile medication used in various medical applications. As respiratory therapists (RTs), we occasionally administer Lidocaine breathing treatments to patients. Previously, these treatments were given before bronchoscopies to numb the patient's throat, thereby preventing the scope from irritating the cough reflex and reducing pain during the procedure. (1) However, their necessity has been questioned by doctors in recent years, and Lidocaine breathing treatments have been used less often for this procedure—at least where I work. Nonetheless, Lidocaine nebulizers are still pre ..read more
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Biblical Dates Do Not Disprove The Bible
Respiratory Therapy Cave
by John Bottrell
2w ago
Many critics argue biblical dates as proof that the Bible is a fictional work. For instance, some claim it suggests the world is only 6,028 years old, which contradicts scientific evidence indicating a much older age. The Bible also mentions figures like Noah, said to have lived for 950 years, a lifespan vastly exceeding today's average of 82 years, even with modern medicine in 2024. Critics argue this impossibility as evidence against the Bible's authenticity. According to biblical chronology based on genealogies and historical events, estimates such as the Ussher chronology place the creat ..read more
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Protocols Are Nice
Respiratory Therapy Cave
by John Bottrell
3w ago
Having protocols in place is beneficial.  For instance, consider a patient without pre-existing lung disease or regular use of respiratory medications at home. They are currently prescribed Pulmicort and Perforomist twice daily, with Duoneb every 4 hours. These protocols empower you to modify their treatment plan. Alternatively, imagine a patient presenting with a congested cough. Their current regimen includes 3% hypertonic saline solution and Mucomyst. These protocols provide the framework to address and optimize their care. A patient was short of breath, and so he gets Q4 Albuterol ..read more
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So, you're still nervous?
Respiratory Therapy Cave
by John Bottrell
2M ago
Feeling nervous, especially as a newcomer, is entirely normal. However, my advice is to refrain from showing your nerves to others. Despite appearing competent and confident, everyone present has experienced similar feelings during their early stages. Those who claim otherwise might be overconfident, or possibly dishonest about their own experiences. This is precisely what we've trained for, what we've dedicated years to studying. Trust in your experiences, rely on the knowledge you've diligently acquired, and stay steady. You've got this! Here are some common events that may cause nerves ..read more
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The best part of the job
Respiratory Therapy Cave
by John Bottrell
3M ago
As I stroll through the lobby, a warm smile greets me. "Are you respiratory?" a kind lady asks. "Yes," I reply. With gratitude in her voice, she shares a touching memory from 2015. Her husband, once in a coma for seven days, was breathing on his own thanks to our intervention. She recalls how I explained the significance of the purple marker on the ventilator and encouraged deep breaths. Her appreciation fills the air, reminding me of the profound impact our work has on people's lives. Such moments are the heartwarming highlights of this job. We dedicate ourselves to our work, striving for ..read more
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