Women who quit smoking before 30 cut risk of tobacco-related death by 97% according the a new study from the Lancet of more than 1 million women. This is good news for those female teenagers who started in High School and then decide to quit early.

Why is that when someone is coughing outside of the hospital they will go get cough medicine or a decongestant? But when there is a patient coughing in the hospital the first treatment of choice is the great a powerful nebulizer. This always amazes me because I see quite a few patients where just a nice cough medicine would probably do the trick to get rid to the dry throat or the tickle in their upper airway. Now I do know that some coughs are caused by a bronchospasm, but ERs are notorious for calling for a nebulizer treatment on any patient with a cough even though they have not actual respiratory history. Im pretty sure that cough medicine is much cheaper than calling us RTs for a nebulizer tx. In another aspect of common sense I see quite a bit in my 16 years as a therapist is the classic, "The patient got up to use the bathroom and now is back in bed and winded." Yes a COPD patient or a morbidly obese patient will get winded by walking to the bathroom and back when they are sick. Lets compare this walk with a 5 mile run in a healthy person. When I go for a run and I stop yes I am winded but I do not have bronchospasms going on. Now lets think what works for relieving my windedness (not sure if thats a word), well I just rest and can re-cooperate back to my normal breathing. Back to the sick COPD or morbidly obese patient, or even a pneumonia patient, moving that short distance in their present condition can cause them to be winded or short of breathe, not really due to a bronchospasm but because their body is out of shape due to their current condition, so it is my thought that if your allow these people to sit and re-cooperate they will recover. Again as I said previously there are situations where one of these patients could definitely be having a legitimate bronchospasm, but Ive seen it multiple times where Im called for a breathing treatment on these patients when Im with another patient and by the time I get to this patient they have recovered. The recovery can also be sped up by increasing their oxygen flow if they are on for a little while. These are all just observations I have noticed, but they seem to fall under the use of common sense and just thinking things through, even though most of the time the nurse and patient really dont want to hear this they just want immediate solutions and in their mind medicine is the best treatment.

Study Exposes Grave Health Risks of Silica A study conducted in China has recently unearthed some new findings that could be very important to the prevention of future respiratory problems. The study, which was conducted by Chinese scientists over many years, followed and examined a large group of Chinese mine workers that were exposed to a compound called silica. Silica is a substance that is present in both sand and rock, and can be extremely harmful if inhaled. It is perfectly harmless if contained within the rock or the sand, but when rocks and sand are drilled or broken, fine silica dust particles then escape. These are easily inhaled and then lodge themselves deep within the lungs. This leads to all kinds of problems, such as scarring and respiratory issues and even death. The problems experienced by the Chinese workers - who were working in places such as mines, pottery factories and gem stone factories - had a sinister outlook. The study found that the workers were not only experiencing problems with breathing, but as a result were also at a greater risk of contracting very serious heart problems, infectious diseases and even cancer. Significant findings The study is of particular significance due to its sheer size. The scientists monitored the health of 74,040 mine and pottery workers in China, and over a period of 33 years. They then compared the health of these workers to that of people who were not exposed to silica. One of the leading researchers on the study, Professor Weihong Chen at the School of Public Health, Huazhong University of Science and Technology in Wuhan, Hubei province, acknowledged the new significance of the findings: "In addition to a higher risk of respiratory disease, we see a heightened risk of cardiovascular disease in exposed workers," she said. "This is a new discovery." The findings of the study are likely to change the focus of health concerns for those conducting jobs with a high exposure to silica and other harmful dust particles; not only for those in mining jobs but also those conducting regular activities such as joinery, glass engraving or sanding. "Before we were mostly concerned about respiratory diseases," Professor Weihong Chen explained. "As to whether it raises the risk of cancer, we can give a definite answer: We see a heightened risk of lung cancer in workers exposed to silica." Large scale The results of the Chinese study are not only significant in terms of focus and direction of health care issues for these workers, but also in terms of the scale of the risk being posed. The study found that workers exposed to silica were a massive seven times more likely to develop harmful infectious diseases, five times more likely to develop serious respiratory tuberculosis, and around twice as likely to develop some form of cardiovascular illness than those people that worked in clean environments with little exposure to silica. Also among the findings of the study was that those working in environments such as pottery factories or mining wells were almost twice as likely to develop nose or throat cancers. This study should set off warning bells for industries such as mining, pottery and stone farming, not just in China, but throughout the rest of the world. China is one of the many countries that has a strong industrial dependency, with around 23 million workers exposed to silica through their jobs. Although the United States has nowhere near this number (we currently have around 1.7 million people in these trades), we still have a huge number of people to think about. Silicosis One form of harmful respiratory disease is a condition called silicosis that, as its name suggests, is caused by silica. In China, around 24,000 workers die from this disease every year as a result of silica getting into their lungs and staying there. The silica causes so much inflammation, scarring and pain that people with the disease die young - commonly in their forties. This is a huge proportion and a grave cause for concern. It is hoped that the publication of this study and its findings will lead to increased awareness of the dangers of exposure to silica and will prompt companies to do all they can to decrease the risk of harm to their workers. Professor Chen has made the following recommendations for organisations. "We recommend that worksites control levels of such pollutants; its a public health problem. Through changes in the work environment, we can reduce the risk of disease and (early) death. Factories can use stronger ventilators, and more effective masks for workers will reduce silica exposure." Members of the general public should also take this study as a warning of the dangers of dust compounds such as silica. It is always dangerous to expose your lungs to overly dusty environments. Wearing masks in these circumstances will go some way to protecting your lungs against harmful long term damage. The ground-breaking study was published this week in the Public Library of Science journal PLoS Medicine.

Obese children need more corticosteroids then these children do according to this study. Obese children with asthma require more steroids. This goes well with I do you said to people lost more weight would spend less time because our country is at an all time high score obesity.

So I happened upon this Wikipedia article about Ondines Curse, also called congenital central hypoventilation syndrome (CCHS) which is a respiratory disorder that is fatal if untreated due to the person with he curse having a respiratory arrest while sleeping. This is a central sleep apnea which is congenital by nature but can occur from a head injury, this can occur in 1 in 200,000 people born so it is quite rare, according the information in 2006 there were only 200 known cases at the time in the USA. What I overall understand about OnDines Curse is that basically you body loses the involuntary ability to breathe so you only can breathe when conscious and most people to survive get a tracheotomy and use a ventilator at night to breathe. Here is a article about a girl who has this issue, its interesting. As respiratory therapist I figured this would be something interesting to find out about and just have a background knowledge of to make us better in our jobs even though the odds are against us at dealing with a patient with Odines Curse, but its always better to learn something new.

Here is a interesting on the effect of caffeine and people with asthma. Its actually a positive effect as caffeine is found in this study to have a bronchodialation affect on people with bronchoconstriction. My conclusion, if you have respiratory issues drink tea or coffee on a consistent basis for maintenance it could work. Wonder though if your having an attack if you could down a Mountain Dew quick to get some relief? Here is the link to the study: Caffeine helps Asthmatics.

New article showing a correlation of Post Traumatic Stress Disorder (PTSD) and respiratory illnesses. The information found in this article was mainly a result of studying people who were around the World Trade Center when 9/11 happened. WTC Responders PTSD Linked To Respiratory Illness Interesting how is shows Psychological issued can cause physical issues.

Where I currently work we are looking to implement a better Oxygen protocol where the RTs are more involved/informed about major changes to a patients oxygen use, for example a patient is on 2L nasal cannula and is increased to a non re-breather mask we want to be informed. So what Im looking for is if anyone reading this could send me a basic idea of what your O2 protocols are your respective hospital or any ideas you could send my way. I have used protocols at prior workplaces and some I like but just want to see what else is out there for use to improve our care and possibly decrease the length of time a patient might be on oxygen.

Stuffed bear lightly smacks you in the face if your snoring to get you to turn your head along with a smaller bear to monitor your Spo2 levels. Not sure if this will take away CPAP machines but a novel idea. This does look much more comfortable for people with very mild sleep apnea.

Just a quick post here, my department is looking for some type of handheld computer we can use for charting and scanning of medications, if anyone has any recommendations I would love to hear them and possible a website where I could get the company information about them also.

This is a promising article about a new treatment for asthmatics to reduce attacks as much as 75% as claimed in trials. Check it out, its good to see that there are still people working on new asthma treatments.

Not the most practical way to decrease the effects of asthma but... A pair of Dutch researchers discovered that the symptoms of asthma can be treated with a roller coaster ride where among the recipients of this years lg Nobel awards, the annual tribute to scientific research that seems wacky but actually could have some real world applications. This study here has more to do with how asthmatics perceive dyspnea during times of either positive or negative stress. It seems in this study that dyspnea seemed less after the ride on a roller coaster was over. To me it just seems like it cant breathe good because Im scared versus the scary stuff is over and I feel better, but I thought is was a bit of interesting asthma research whether practical or not. Take a look at this article on the lg Nobel Awards. Something fun, drive on RTs

Well I havent wrote anything in awhile here but I have a reason for this lapse in time. I was on vacation in the Rocky Mountains and surprise I can relate this to something respiratory.

A new study is showing that a poor diet and being inactive can increase the chances of kids to develop asthma, which is coined "Metabolism induced asthma". The article can be read here: Poor Diet, Inactivity May Lead to Metabolism-Induced Asthma This Ive always had a sneaking suspicion of when we see people in the hospital who are obese and are taking inhalers and told they have asthma but with no actually family history of asthma. I do understand that obese people have shortness of breath due to increase body mass causing them to have a harder time taking a breath or just getting short of breath with exertion. Now Im not sure I believe its acutally "asthma" in those already obese people but as we all know if you lead a unheatlhy lifestyle you chances of having medical problems do increase a lot, so why should it not be possible for kids to develop asthma if they grow up with poor dietary habits and a inactive lifestyle? Its up to us parents to create a healthy lifestyle for our kids and be examples. Now dont get me wrong I have not problem with partaking in the good foods like pizza, cheeseburgers but moderation works well along with getting kids involved in active things like sports or just getting outside. I was watching "The Biggest Loser" last night and there was some scary facts about our county and cities in general. I wish I had the direct quotes but I dont and cannot find a transcript online anywhere but here is just basics of what Jillian, Bob and Ali were saying that stuck out -Our country is at the highest obesity rate in our history -The 5 cities they went obesity was costing the city over $1 billion per year due to hospital costs and other issues. -Our countries hospital admissions have increased over the years due to a increase obesity. All this in turn comes back around to us as hospital workers, we deal with the issues of people who are obese and in my opinion if doctors help patients lose weight versus just treating the symptom which present themselves these patients will have less hospital admissions, less medications to take and just be healthier in general. This in turn will save hospitals money in the long run along with helping keep insurance premiums down. Now this is all just my personal opinion and Im not some health nut who only weights 170lbs. I am 510" 230, but I hit the gym 4 days a week, lift heavy weights and try to eat decent except for some splurges and I like beer, but I can still run a couple miles at a time and I have to keep in shape to keep up with my wife she runs all the time and workouts out at the gym a lot to. This is stuff I like to do, its instilled in me from my years of Football, Swim team, baseball, and 10 years in the military, Im just putting this out there so people dont call me a hypocrite. Anyways whats you opinion? Drive on RTs

I was contacted by this website HAI Watch to try and pass on the information on this site about Healthcare aquired infections(HAI) and their "Not on my watch" campaign to further educate healthcare workers about new things involving this HAI. This site has a backing of KIMBERLY-CLARK HEALTH CARE. This site seems to be worth checking out for some good information about helping out combating HAIs. Im not a all affiliated with this HAIwatch site or getting any kickbacks from it, I just thought it sounded interesting and it seems like a worthy site for some upcoming information. Tjere are also about 5 youtube videos on here talking about HAIs. Let me know what you think.

Its becoming that time of year for another bout of respiratory problems, the allergy season. This time of year brings on the great problem called Hay Fever and there are more than 35,000,000 Americans who suffer from this type of problem. Hay Fever is a type of allergen rhinitis triggered by pollens from different plants this time of year because they are all beginning to grow. Some major players in the problem of pollen are the Birch tree which can cause problems for 15-20% of suffers and then the largest player for people who suffer from the type of problem is grass pollen, it is estimated that 90% of hay fever sufferers are affected by grass pollen. Hay Fever is not caused by a virus its caused from a allergen. Hay fever can begin at any age, youre most likely to develop it during childhood to early adulthood. Its common for the severity of reactions to change over the years and for most people the symptoms tend to diminish slowly, often over decades. Some common trigger of Hay Fever can include: * Tree pollen, common in the spring * Grass pollen, common in the late spring and summer * Weed pollen, common in the fall * Spores from fungi and molds, which can be worse during warm-weather months * Dust mites or cockroaches * Dander (dried skin flakes and saliva) from pets such as cats, dogs or birds * Cockroaches * Spores from indoor and outdoor fungi and molds Some of the signs to look for in a allergen problem are: * Sneezing more than usual * Eyes that continually water * Cold symptoms that last more than 10 days without fever * Repeated ear and sinus infections * Prolonged loss of smell or taste * Frequent throat clearing or hoarseness * Persistent coughing * Sinus pressure and facial pain * Swollen, blue-colored skin under the eyes (allergic shiners) * Decreased sense of smell or taste Where this comes in for Respiratory Therapy is the coughing, doctors really like to give nebs for coughing to help it stop so there goes our case load in the E.R. more neb treatments for coughing. Asthma though is one problems which often occur along with Hay Fever, along with Sinusitus, Eczema, and Ear infections. The best way for these patients to limit problems to these allergens is to keep from being exposed to much to these allergens: * Close doors and windows during pollen season. * Dont hang laundry outside — pollen can stick to sheets and towels. * Use air conditioning in your house and car. * Use an allergy-grade filter in the ventilation system. * Avoid outdoor activity in the early morning when pollen counts are highest. * Stay indoors on dry, windy days. * Use a dehumidifier to reduce indoor humidity. * Use a high-efficiency particulate air (HEPA) filter in your bedroom. * Avoid mowing the lawn or raking leaves, which stirs up pollen and molds. * Wear a dust mask when doing outdoor activities such as gardening. These are just some ideas I found reading about this online and if you suffer from hay fever you might want to take some of these precautions. There are quite a few types of medications which help with Hay Fever: * NASAL CORTICOSTEROIDS. These nasal sprays help prevent and treat the inflammation caused by hay fever. Examples include fluticasone (Flonase), fluticasone (Veramyst), mometasone (Nasonex) and beclomethasone (Beconase). * ORAL CORTICOSTEROIDS. Corticosteroid medications in pill form, such as prednisone, are sometimes used to relieve severe allergy symptoms. * ANTIHISTAMINES. These oral medications and nasal sprays can help with itching, sneezing and runny nose, but have less effect on congestion. Older over-the-counter antihistamines such as diphenhydramine (Benadryl) and clemastine (Tavist) work as well as newer ones, but can make you drowsy. Newer oral antihistamines are less likely to make you drowsy, but are more costly than the older antihistamines. Over-the-counter examples include loratadine (Claritin, Alavert) and cetirizine (Zyrtec). Fexofenadine (Allegra) is available by prescription. The prescription antihistamine nasal spray azelastine (Astelin) starts to relieve symptoms within minutes of use. It can be used up to eight times a day, but can cause drowsiness. Side effects include a bad taste in the mouth right after use. * DECONGESTANTS. These medications are available in over-the-counter and prescription liquids, tablets and nasal sprays. Over-the-counter oral decongestants include Sudafed, Actifed and Drixoral. Nasal sprays include phenylephrine (Neo-Synephrine) and oxymetazoline (Afrin). Because oral decongestants can raise blood pressure, avoid them if you have high blood pressure (hypertension). Oral decongestants can also worsen the symptoms of prostate enlargement, making urination more difficult. Dont use a decongestant nasal spray for more than two or three days at a time because it can cause rebound congestion when used longer. * CROMOLYN SODIUM. This medication (NasalCrom) is available as an over-the-counter nasal spray that must be used several times a day. It helps relieve hay fever symptoms by preventing the release of histamine. * LEUKOTRIENE MODIFIERS. Montelukast (Singulair) is a prescription tablet taken to block the action of leukotrienes — immune system chemicals that cause allergy symptoms such as excess mucus production. It has proved effective in treating allergic asthma, and its also effective in treating hay fever. Like antihistamines, this medication is not as effective as inhaled corticosteroids. * NASAL ATROPINE. Available in a prescription nasal spray, ipratropium bromide (Atrovent) helps relieve a severe runny nose by preventing the glands in your nose from producing excess fluid. Its not effective for treating congestion, sneezing or postnasal drip. The drug is not recommended for people with glaucoma or men with an enlarged prostate. This turned out longer than I expected it to but as a Therapist I figured it something we will deal with in the coming months and one little more tidbit of information about Hay Fever: Hay fever doesnt mean youre allergic to hay. Despite its name, hay fever is almost never triggered by hay, and it doesnt cause a fever. Keep driving on RTs.

Im posting this to reach out for a family I know who is having hard times right now with medical problems. The mother of this family is having to deal with her 9 year old son in a pediatric ICU and needs some extra prayers to get this boy to turn around. This 9 year old child has been having small strokes and is in and out of a coma. He was starting to turn around a little bit and was off he ventilator for a couple days then had another stroke which put him back in a coma state and again on the ventilator. This child was born with hydroencephalitis and had an operation to place a shunt in his brain and the parents were told he would not live to be more than 2 years old. Well he is 9 and was doing everything a normal child would do, did good in school, loved the Iowa Hawkeyes, and played with his friends and brother. These current events started when he went in for a checkup on his shunt and things went bad, this was about 2 weeks ago. The medical staff at the medical center he is at are still trying to track down what is going on and the cause of the strokes but nothing is promising yet at this time, but we are still hopefull. What makes this so hard for the mother of this child is that just over a year ago her husband, this boys father, lost out on his battle with brain cancer and he was only 39 years old. This woman now has to deal with her youngest son possible not pulling through which would be devastating to her as this would be 2 major losses to her family in under 2 years. Something like this would be hard to fathom by most people, and she has another son to stay strong for with all this going on. Im just asking for a little prayer, thought or anything just to help this family get through this time of need and sadness. I do believe there is the possibility of the power of prayer and thought to help people in need. Thank you for any thoughts and prayers, and if you where wondering, this boys name is Jack, and her is a HUGE Iowa Hawkeyes Fan like his father was.

I was recently reading through the April 2009 AARC journal magazine and there were predictions on different health care topic which would affect RTs. One I saw that interested me was: "There will be a national shortage of all health care providers in all sectors, Even those who frequently interact directly with patients." This struck me as interesting because you would thinks with the unemployment rate as high as it is this would be a job sector which people would maybe flock to because of the job security of there always being sick people to take care of, but I guess this isnt so. I starting thinking about this and realized there are large portions of society who are hardly even tapped to work as health care workers. These people would be the men of the United States. If you work in the health care sector think about it, who so you see mainly working directly with patients as a majority? Women right. There you can even break it down even more, these would mostly be white women also as a majority. Now Im not trying to bring in the race card its just a observation and I tried looking up some facts which I could find on this topic. As for men in the health care workforce I wasnt able to find a overall men in health care number but I found a number for male nurses. According to the American Nursing Association only 6% of all RNs are male. Here in this article: "Is there a male nurse in the house?" about 7.5% of male nurse graduates leave the profession within 4 years of graduating. These are not good numbers. Now when we look at the minority sector of the health care work force I found out that 1/4 of our population is made up of African American, Hispanic and American Indians but only 10% of them are in the health care field, this is according this this article: Diversity in Health care. This leaves a lot of possibilities for more health care workers. Why dont more men work in the health care field? I believe its the stigma and stereotype of women always being the nurses. When I say nurse I do picture a female and its because of stereotype. Men also are not normally brought up to be caregivers like mothers. More men should really look into health care because were going to need to fill the gaps if this prediction is correct. Honestly there are a lot of perks, good pay, stability, job security, air conditioning and heat, hot looking nurses, friendly atmosphere, and the list goes one. If we are to fill these gaps in health care jobs were going to need to disperse of the stigma of men being in health care other than being doctors. Like we all know, Respiratory Therapy is a good field, and the women dig us.

Tonight I had a patient I was assessing for out therapy driven protocols and was reading this persons xray and I noticed a word I have never came across before in my medical travels and it was describing a type of atelectasis: Discoid Atelectasis which is also known as Plate Atelectasis. Now being the good RT that I am, I had to do and look it up so I could do a proper assessment of this patient and what I found was interesting to me and I thought I would share it with anyone who might read this blog of mine. Discoid or platelike atelectasis is a form of atelectasis which has s disc or platelike appearance on a xray which is linear or horizontal position. They often look like a CD or a dinner plate and thought to occur from shallow breathing or hypoventilation which can occur after a abdominal or thoracic surgery. It can be also seen in other conditions such as painful breathing, general anaesthesia, pulmonary embolism, ascites and diaphragmatic paralysis. There is really no different type of treatment for this versus any other type of atelectasis because it is just a term to describe what is seen on the xray but overall its still just atelectasis. Really there is not to much alarming about this its just something I came across and have never seen so I thought I would share it with everyone and hopefully if you come across this in a report you will now know that those radiologist are talking about because it seems they like to try and stump us, but because of the Internet things can be looked up quickly now. If you didnt know, now you know ... Drive on RTs.

Doctors are a interesting bunch, there are good ones, interesting ones, bad ones, ones we are not sure how they got through medical school but overall they are a interesting bunch.

I ran across this article and thought is was interesting: COLORADO MAN TO BE THE FIRST COPD OXYGEN PATIENT ALLOWED TO RUN IN BOSTON MARATHON! Its about a man who is oxygen dependent, diagnosed with COPD and is the first person with COPD allowed to run the Boston Marathon. This person is on some serious O2, when asked what is prescription is he responded: "I have been on supplement oxygen for 4 years. My current prescription is 4-6 liters at rest and 7-18 liters when I’m active or exercise." Now thats some serious O2 he is on for exercise, just think how many tanks he might go through in a 26 mile race. This guy has already completed 2 full marathons, 14 half marathons, 1 ten mile, a 5 mile, 4 times did the 10k the Bolder Boulder, a bunch of 5ks and climbed 2 14,000 plus foot mountains. Quite amazing. He says that he went through 5 tanks a marathon and was lucky to have friends to help with the changing of tanks when needed. This is pretty amazing for a COPD oxygen dependent person to do and it just shows their is life after a COPD diagnosis, you just have to take care of yourself and work to acheive some added health to help cope with the problem. To add to his accomplishments on March 10 of this year he finished the Climb Chicago event for the American Lung Association. 4 buildings; 180 floors; 360 flights; and 2340 stairs, for a time of 1:06:13. Really amazing, that would hurt me. Well hope that article was inspiring and hopefully this guy can inspire other COPD patients in the future. Drive on RTs.

* Viral * Bacterial * Fungal * Parasitic * Comunity Aquired * Hospital Aquired * Severe Acute Respiratory Syndrome(SARS)

If you want more information on the different types of pneumonia just go look it up, many sites are out there with this information.

Now if you noticed in my title of this post Im talking about Peds VS. Adult pneumonias. The reason I am talking about this is because my hospital will isolate all pediatric patients for Droplet Precautions if they have any lung problems, including pneumonia. Now my question is why do we just isolate the kids with pneumonia and not the adults with pneumonia? This I am confused about, but I do understand the the underlying virus or bacteria which cause pneumonia could be contagious but why more so in kids than adults?

With our kids we need to gown and mask but with adults nothing extra as of precautions is taken which is perplexing to me as I cannot find a decent answer to this question and unfortunately I dont see the Peds doc very ofter as I work nights.

So if anyone can shed some light on this for me I would be much obliged, but until then I will keep searching and wearing my gown and mask for the kids, but Im sure we would look less scary to them without that garb on.

Thanks for reading

Keep driving on RTs.