a month in acute care

I recently completed a month rotation through general care / acute care.  In pediatric respiratory therapy this means I spent every day working with Cystic Fibrosis patients.  Respiratory Therapy with a Cystic Fibrosis (CF) patient is a big workload.  While admitted to a hospital, a CF patient receives respiratory therapy 4 times (QID) a day.  Each segment of therapy requires around 60 minutes of constant therapy and atention to the patient.  Meaning if therapy is given appropriately, a single therapist can not take more than three CF patients during a 12 hour shift.

Treatments are just like I learned in school, except we have some additional rules that I probably just forgot.  Typically a regimen goes like this: Albuterol MDI or nebulized,  wait 10 minutes for proper peak onset, administer hypertonic saline (percentage is different per patient, but 7% is standard for most kids) and then administer 30 minutes of chest percussion.  Vest therapy can be substituted for manual percussion and in both every 5 or 10 minutes stop the treatment to get good strong huff coughs to help mobilize the secretions even more.  After percussion, Pulmozyme (Dornase Alfa) is given and then any add-on steroid treatments.

Other than CF kids, I had a series of nasotracheal suctioning and a lot of PRN treatments.  Acute Care in pediatrics is incredibly busy, though even being so busy - I don't have any remarkable stories, other than I made friends with my CF kids and their families, it would be hard not to.  I spend at minimum 3 hours with them every day and if the kid is a handful even more.

I started the Neonatal Intensive Care Unit last week, I hope to include some cool stories about that soon!