RDP: Bronchiolitis

Respiratory Driven Protocols are something that should be really pushed. I honestly don't see ventilator settings being a RDP type thing, since Respiratory Practitioners are quite capable of completely managing a patient on a ventilator. Doctors being able to modify the settings, sure, but only by order. It should be a very unified standard of care that an RP is completely responsible for the safety and outcomes related to ventilator care. However, there are some things, like Asthma or Bronchiolitis that I will not argue should be under a protocol guidance.

Bronchiolitis
"Respiratory eval & treat"
Evaluate for a complex Respiratory Distress Score tailored to Bronchiolitis.
Automatic: Respiratory eval for Bronchiolitis RDS Q4H
Automatic: Suction at bedside PRN
Automatic: 3% NaCl Q4H with suctioning 20 minutes after NaCl delivery
Automatic: Corticosteroid of preference Q6H

During assessments:
If wheeze of any kind: Nebulized epinephrine (racemic is okay) Q4H PRN

This bronchiolitis protocol requires a ton of clinical judgment on the behalf of the respiratory practitioner. That is fine, respiratory practitioners are fully capable of managing this kind of thing. To help maintain competence: in-services about bronchiolitis are definitely recommended too.

What do you think? Do you have a Bronchiolitis RDP?

15 Famous people with HIV

Magic Johnson

Most people over the age of 30 won't soon forget the emotional public disclosure on Nov. 7, 1991 from one of basketball's all-time greats. Magic's HIV diagnosis essentially ended a phenomenal NBA career, though he did make a few brief comebacks.

His disclosure spurred a re-evaluation of safety in sports and was a watershed moment in HIV awareness. He has thrived since, leading some to believe he was somehow cured. To combat this type of misinformation, Magic has dedicated himself to HIV education and helping those living with HIV through theMagic Johnson Foundation and several other efforts.

Rock Hudson

One of the most beloved movie stars of the '50s and '60s, Rock Hudson's AIDS-related death in late 1985 was a shock to the world. In a move that is truly emblematic of the unparalleled stigma of HIV, his publicity team had covered up his illness by saying he had liver cancer.

Hudson's HIV disclosure just prior to his death brought forth the fact that this matinee idol, a leading man in numerous romantic comedies, was gay. For better or for worse, his death sparked a landslide of conversation in mainstream media about homosexuality and HIV.

Freddie Mercury

As the lead singer of Queen, one of the top-selling rock bands of all time, Freddie Mercury was among the most recognizable faces of the '70s. He tested positive in 1987 and died of AIDS-related pneumonia four years later, one day after publicly acknowledging for the first time that he had AIDS.

Had Mercury lived in a different era, perhaps people would be thinking about eradicating HIV every time they heard "We Will Rock You" or "We Are the Champions" booming over the stadium loudspeaker. Instead, it simply became a footnote on his life.

Keith Haring

Keith Haring was an iconic artist who rose to prominence during the '80s. He was best known for his street murals and cartoonish figures. He was diagnosed with AIDS in 1988 and died just two years later.

Unlike many public figures, Haring did not shy away from his AIDS diagnosis. During those last few years of his life, he dedicated himself to raising HIV awareness through his artwork and afoundation he established that still benefits HIV causes to this day.

Eric "Eazy-E" Wright

Eazy-E was a rap legend and co-founder of the influential group N.W.A., along with Dr. Dre and Ice Cube. Their album, Straight Outta Compton, went double platinum in 1988 and cemented Eazy-E's legacy in gangsta rap history.

His lyrics jolted many, but nothing shocked people more than when he fell ill in 1995 and publicly acknowledged that he had AIDS. He died just one month after his diagnosis at the age of 31. His death was another key moment in public awareness of HIV/AIDS, particularly within the African-American

Elizabeth Glaser

Though she was not a celebrity in the traditional sense, Elizabeth Glaser gained fame and notoriety through her tremendous efforts to fight this disease. She contracted HIV in 1981 but did not find out until 1985. As a result, she unwittingly passed on the virus to both of her children. Her daughter Ariel lost her life in 1988, but her son, Jake, is alive and well today.

Following Ariel's death, Glazer co-founded what is now known as the Elizabeth Glaser Pediatric AIDS Foundation, one of the leading AIDS charities in the world. The Foundation is dedicated to preventing and eliminating HIV/AIDS in children. Elizabeth died in 1994, but her legacy lives on through her foundation. community.

Isaac Asimov

Isaac Asimov was one of the most prolific authors of all time, best known for his science fiction novels and short stories. He died of AIDS-related complications in 1992, but his HIV status was only revealed by his widow 10 years after his death.

Because of the tremendous stigma associated with HIV, particularly prevalent in the early '80s, Asimov's family had been advised to keep his true cause of death a secret.

Arthur Ashe

As the first African-American man to win a Grand Slam title, Arthur Ashe broke down the color barrier in tennis. An accomplished champion and Hall of Famer, he is perhaps best known for his humanitarian and civil right efforts.

He was diagnosed with HIV in 1988, but didn't go public until 1992. He died a year later from AIDS-related pneumonia. During his final year of life, he was instrumental in raising HIV awareness through various efforts, including a speech at the U.N. on World AIDS Day and the creation of an AIDS foundation.

Liberace

Liberace was a pianist and entertainer who became a worldwide icon in the '50s. He appeared in films and television shows, and released numerous albums. He was the highest paid entertainer in the world for over a decade and was known for his opulent lifestyle.

He died of AIDS-related complications in 1987, but the cause of his illness during his final years was kept secret from the public until after his death.

Anthony Perkins

Anthony Perkins was a film and stage actor who will always be remembered for his unforgettable turn as Norman Bates in Alfred Hitchcock's Psycho. He had a productive career that spanned nearly 40 years.

Oddly, Perkins only discovered he was HIV positive in 1990 after a National Enquirer article exposed that he had AIDS, leading him to get tested. He had suspected that he might be HIV positive, but chose to ignore it for fear of what it might do to his career. He died two years later from AIDS-related complications.

Robert Reed

Robert Reed portrayed perhaps the most beloved father in the history of U.S. television. As Mike Brady on The Brady Bunch, he was the head of a highly traditional household. It was hard for some to believe that the man who played this almost puritanical character was in fact a gay man who tested HIV positive before his death in 1992. Like a number of others on this list, the word about his HIV status only spread after he died.

Greg Louganis

Greg Louganis is an Olympic diver who won multiple gold medals in the '80s. He was one of the most recognizable faces in American sports during that decade. He tested positive in 1988, the same year he won two gold medals at the Seoul Olympics.

Louganis went public with his HIV status seven years later in his autobiography, Breaking the Surface. Having now lived with HIV for more than 20 years, he has been a champion for numerous HIV causes.

Alvin Ailey

Alvin Ailey was a renowned choreographer and a major force in modern dance beginning in the 1950s. He formed the Alvin Ailey American Dance Theater in 1958, a groundbreaking dance company still popular today. Though based in New York City, the group has performed all over the world.

Ailey died of AIDS-related causes in 1989 at the age of 58. Like a number of others on this list, Ailey had his doctor hide his true cause of death to protect his family from the stigma of the disease.

Gia Carangi

Gia was a world-famous fashion model in the '70s and '80s. She was among the most sought-after models of her time and graced the cover of such magazines as Vogue andCosmopolitan. Her career was cut short in the early '80s after she developed a debilitating heroin addiction.

She was later diagnosed with AIDS and died of a related illness in 1986 at the age of 26. Her death was largely kept quiet; few in the fashion industry even knew of her passing, and her funeral service (which was held in a small funeral home) was modest.

Her story was eventually told in Gia, the aptly titled HBO biographical film starring Angelina Jolie.

Pedro Zamora

Pedro Zamora gained fame as a cast member on the third season of MTV's The Real World in 1994. Having worked as an AIDS educator following his diagnosis in 1989, he viewed The Real World as a unique opportunity to educate on a mass scale. His appearance on the show had a major impact in raising social consciousness about AIDS, particularly among young people.

Zamora grew ill as the season as wore on and was hospitalized with progressive multifocal leukoencephalopathy (PML) just a few months after shooting wrapped. He died at the age of 22 in November 1994, one day after the final episode aired. His impact has lived on through numerous charities formed in his name.

This list only covers 15 of the most notable HIV-positive celebrities. There are many more famous people with HIV -- some are out, but many are not, while there are others who might have HIV (or even died from HIV), but have never been tested.


Pulmozyme (rhDNase) in neonates.

Pulmozyme is being used off-label increasingly across institution neonatal intensive care units.

It purges free-floating (extracellular) DNA by ripping it apart and cleaning it out.  Which in refractory atelectasis appears to be one of the contributions to its refractory-ness.

Some limited research[1] suggests it might be beneficial.  Respiratory Therapists may be using this more and more frequently in non-cystic-fibrosis neonates.

Previous research produced positive outcomes.[2]
  1. Mackinnon R, Wheeler KI, Sokol J. Endotracheal DNase for atelectasis in ventilated neonates. J Perinatol. 2011;31(12):799-801.
  2. Hendriks T, De hoog M, Lequin MH, Devos AS, Merkus PJ. DNase and atelectasis in non-cystic fibrosis pediatric patients. Crit Care. 2005;9(4):R351-6.

Spanish Phrases for Respiratory Therapists

Spanish Phrases for Respiratory Therapists
Quick and dirty spanish thats easy to remember

Are you in pain?
Tiene algún dolor (or just "Tiene dolor?")
Pronounced: Tee-in-ae Al-goon Doh-lor

Take a deep breath
Respira profundo
Pronounced: Res-pida pro-foondo

Take a deep breath and cough
Respira profundo y la tos
Pronounced: Res-pida pro-foondo ee la tos-ae

This medicine helps make breathing easier.
Esta medicina ayuda a respirar menos trabajo.
Pronounced: Es-tah med-icin-a ae-you-dah a res-pidar (or just say res-pida) men-ohs tra-bah-ho

Do you need anything?
Necesitas algo?
Pronounced: Ness-a-seetas al-go
If yes, and you can't understand what they want, it might be something complex, so call for a translator.

Do you have any questions? If yes, call for a translator.
Tiene preguntas?
Pronounced: Tee-in-ae pre-goon-tas

For help press this red button for help. (while pointing at the nurse call button)
Por ayuda pulsar el botón rojo.
Poor ae-you-dah pul-sar boo-tun roe-hoe

My name is _____________
Mi nombre es ____________, or mi llamo es ____________

I am a respiratory therapist
Yo soy terapeutas respiratorio.
Yo soy tera-peu-tas respir-a-torio