S - Status
B - Background
A - Assessment
R - Recommendations/plans
Examples:
S - Patient is intubated with a 3.0 @ 7(lip) ventilated in PC-IMV, 15/5 +5 f40
B - 27+2 week 2 month old neonate, apgars were 0,1,1. Last gas was 7.33/44/80/24 with a Lactate of 1.1. We also have tracheal stenosis, PPHN, sp VA-ECMO.
A - CTAB, frequent suction is required and the secretions are white+frothy
R - Ventilation status is going to remain because we're going to OR on Monday and then we're just waiting on weight-gain.
A blog about Respiratory Care by a Respiratory Therapist
A Day in the Life of a NICU RRT
18:33 - Arrived in parking garage and begin walking briskly toward the hospital.
18:42 - Clocked in at first available time-clock.
18:46 - Walked into the 5 minute team-meeting announcing new practices and mistakes to avoid.
18:55 - Arrived in the NICU respiratory office, dropped off backpack and begin taking SBAR report on all 70 patients.
19:15 - Signoff/report is interrupted several times for various reasons.
19:30 - Report is finished and the 70 patient assignment is split between two respiratory therapists using ventilators as major acuity guides.
19:30 - I am called stat to initiate a high frequency oscillator and inhaled nitric oxide on a patient.
19:45 - I am notified of 2 patients going to MRI on ventilators
19:47 - I call house supervisor to have coverage for the transport.
20:00 - I am called stat to patients room to change ventilator from high-frequency oscillator (HFV-A) to high-frequency jet (HFV-P).
20:10 - Transfer complete to HFV-P.
22:20 - I am called stat to bedside. Upon arrival discover patient arresting, code called entire medical team works to revive patient.
23:10 - Code is stopped.
23:20 - I am called to patient bedside for loose endo-tracheal tube. Retaped tube without incident.
00:00 - Called stat to OR-2 for twin c-section
01:25 - Called stat to Labor and Delivery 9 for meconium
02:00 - Lab machine goes into self-calibration setup, so all gases are tubed to another unit to be run.
03:00 - Still waiting on machine to come into service, been cleaning up the lab with no calls.
04:00 - Lab machines are still down, check all ventilators with no discrepancies, no issues.
05:00 - Lab machines come back up, just in time for 5am gases. Draw and subsequently run 35 capillary gases.
06:00 - Prepare signoff report to oncoming Respiratory Therapists
06:50 - 4 Relieving RRTs arrive to take SBAR report.
07:36 - Clock out and head out to the parking garage.
18:42 - Clocked in at first available time-clock.
18:46 - Walked into the 5 minute team-meeting announcing new practices and mistakes to avoid.
18:55 - Arrived in the NICU respiratory office, dropped off backpack and begin taking SBAR report on all 70 patients.
19:15 - Signoff/report is interrupted several times for various reasons.
19:30 - Report is finished and the 70 patient assignment is split between two respiratory therapists using ventilators as major acuity guides.
19:30 - I am called stat to initiate a high frequency oscillator and inhaled nitric oxide on a patient.
19:45 - I am notified of 2 patients going to MRI on ventilators
19:47 - I call house supervisor to have coverage for the transport.
20:00 - I am called stat to patients room to change ventilator from high-frequency oscillator (HFV-A) to high-frequency jet (HFV-P).
20:10 - Transfer complete to HFV-P.
22:20 - I am called stat to bedside. Upon arrival discover patient arresting, code called entire medical team works to revive patient.
23:10 - Code is stopped.
23:20 - I am called to patient bedside for loose endo-tracheal tube. Retaped tube without incident.
00:00 - Called stat to OR-2 for twin c-section
01:25 - Called stat to Labor and Delivery 9 for meconium
02:00 - Lab machine goes into self-calibration setup, so all gases are tubed to another unit to be run.
03:00 - Still waiting on machine to come into service, been cleaning up the lab with no calls.
04:00 - Lab machines are still down, check all ventilators with no discrepancies, no issues.
05:00 - Lab machines come back up, just in time for 5am gases. Draw and subsequently run 35 capillary gases.
06:00 - Prepare signoff report to oncoming Respiratory Therapists
06:50 - 4 Relieving RRTs arrive to take SBAR report.
07:36 - Clock out and head out to the parking garage.
Aimee Fortney's spicy Caribbean fish sandwiches
Youcan make these as spicy as you desire with 1 or 2 habanero peppers! So easy and so very yummy!
Place the following ingredients in food processor:
1 large clove of garlic
1 habanero pepper, stem removed (if you like things really hot, use 2 habanero peppers)
1 small carrot, quartered
1 bunch cilantro
1 small sweet onion, quartered
Remove mixture from food processor and place in a large bowl.
Add 1 pound Tilapia, to food processor and pulse to very small pieces.
Remove Tilapia that has been pulsed and add to vegetable mixture. Next add:
1 teaspoon ground black pepper
1/4 teaspoon cayenne pepper
dash of ground cumin
1 beaten egg
1 cup bread crumbs
Stir to mix well.
Heat your griddle, skillet or cast iron skillet to medium heat and spray with cooking spray. Use an ice cream scoop to form sandwich, then cook on griddle or cast iron skillet for a 3 to 5 minutes on each side until cooked. (The vegetables being chopped so small in the food processor help them to cook faster). The cilantro lime cream sauce really helps "tone down" the heat.
Buns of your choice
Serve with Cilantro Lime Cream Sauce:
1 cup sour cream (or Greek Yogurt)
1 large lime
1 bunch cilantro
pinch of salt and pepper
Pulse sour cream (or yogurt), lime juice, zest of lime and cilantro in blender. Add pinch of salt and pepper to taste.
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