Chris and I decided tonight that our "bright idea" for the year would be to cut to the chase and just start nebbing albuterol through the air ducts over the entire hospital. Wouldn't that be grand? Think of the community benefit. Why, every patient would be cured of every wheeze, rhonchi, pneumonia, fever, fluid overload, and cancer. What a wonderful fountain of youth and health it would be if we could but shower everyone who enters the hospital with a mist of albuterol wafting from the air ducts.
Because we certainly all know that albuterol cures every ill. Right?
We're thinking about making Carrianne a t-shirt that says "I wouldn't have broken my foot if only I had used my inhaler before I took that run."
And like a present from the sky, I got a call in the wee hours from an RN saying that she had a patient who'd just started wheezing, that "no" the patient didn't have any kind of respiratory regimin but she did currently have a fever. So I rushed right up and gave her an albuterol via neb treatment. Yeah, right. Not gonna happen.
What I did do was go examine the patient and listen to those wheezes along with her complaints of not being able to take her wedding ring off since last night and about how her name band had become so tight overnight that it was cutting into her skin. Hmmmm...I don't know. Let me think really really hard about this one.
I went to the computer and pulled up her records. No respiratory history. No surprise there. Then I clicked the magic tab "I and O". Again, no surprise, holding on to every drop being running into her. I called the nurse over, someone I really like by the way so I really wasn't trying to embarrass her. I showed her the report and said "Are these numbers correct, because if they are, I bet you a Wild Cherry Pepsi this has nothing to do with reactive airways." She said "Oh" when she saw what I was pointing out. She and the charge nurse went in and assessed the patient. I cheerily said "Call me if you need me" and went back to setting up home meds.
Hey, I wish albuterol could cure fluid overload but it simply can't. I could have dipped that lady in albuterol and she still would have been wheezing. What impressed me, though, was that once they saw what I saw, they got it and they didn't say that one sentence that makes every RT's skin crawl like nails on a chalkboard: "Yes, I agree this is fluid. So you're going to give them a treatment, right?" I respected that they didn't say that at all but immediately started working on the actual problem.