Respiratory

Summary

This week I got to know the therapists that work in the respiratory unit, Kim on Monday and Mark on Wednesday. I got to see different patients with different conditions in different units throughout the hospital for example, I saw someone that had Emphysema in one unit and another person with Respiratory Distress Syndrome. I learned very much this week due to the great workers there, they taught me various things such as what Emphysema is and how the different machines operate and what their purpose plays in delivering medical care. The best thing that I got to see was getting to go to the nursery and seeing a newborn that had breathing problems and had a mask on. The worst thing that happened to me was that on Monday, I had to wait for twenty minutes to meet up with an RT, but thankfully, I was allowed to see a nurse try to put an IV into a patient. In general, this week was very good because I got great insight into yet another department and learned so much in so little time.

Technology Observed

BIPAP- This is the mask that is put on patients to deliver oxygen to them. PEEP- This is a function on a machine that uses air pressure to force air out of the lungs, at the end of the breathing cycle. CPAP- Is like PEEP except that it is continuous throughout the breathing cycle. Respirator- In essence, it is life support and aids in breathing by delivering air. 840 Vent System- Has different settings for different patients needs, for example if a patient is in surgery it does much work or very little if it is there for precaution. HI FLO- It is a blender that uses a nasal canula and is used more for patients with COPD(Chronic Obstructive Pulmonary Disorder). I also saw a pulse oximeter- measures blood pressure, oxygen levels, and heart rate.

Diagnostic/Therapeutic Procedures Observed

I saw how one would adjust the oxygen levels for a patient and also how a PEEP machine works for a patient. Also I was shown how medications could ease a patients effort in breathing. A pulmonary function is a test that is used to see how an individuals lungs work.

Diseases/Disorders Observed

Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths. COPD-A disorder that makes it even more difficult to breathe deeply, Hemoptysis- Coughing up blood (can occur from various things).

Medical Terminology/ Abbreviations Encountered

Pneumothorax- A hole in the lung, ABG- Arterial Blood Gases, COPD- A disorder that makes it even more difficult to breathe deeply, Adult Respiratory Distress Syndrome - Usually derives from other diseases, Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths.

Summary

My initial assumption of the unit was it was very small and I later figured out that it was because they are always in different parts of the hospital attending to the patients needs. During my two days there I worked with several Respiratory Therapists, Jesus and Priscilla and Kim. They were all very kind and knowledgeable  about their career and everything incorporated with it, including machines and diseases. Their main duty is to help patients with breathing in different areas such as the ICU or Nursery. All of their equipment is specialized to help patients breathe according to their condition and how much assistance is needed. BIPAP- This is the mask that is put on patients to deliver oxygen to them. PEEP- This is a function on a machine that uses air pressure to force air out of the lungs, at the end of the breathing cycle. CPAP- Is like PEEP except that it is continuous throughout the breathing cycle. Respirator- In essence, it is life support and aids in breathing by delivering air. 840 Vent System- Has different settings for different patients needs, for example if a patient is in surgery it does much work or very little if it is there for precaution. HI FLO- It is a blender that uses a nasal canula and is used more for patients with COPD(Chronic Obstructive Pulmonary Disorder). I also saw a pulse oximeter- measures blood pressure, oxygen levels, and heart rate.

The healthcare professionals all are very kind and do not hesitate to ask each other for help if they are unsure, because they all know the risks of doing something that you do not fully comprehend. They all have to know how to communicate with the different professionals of the hospital because they are always going around different units. The safety procedures they undergo are nothing more than the Universal Precautions of all hospitals because they do not put themselves in any immediate danger and are not subject to any hazardous areas or medicines. Some of the procedures I saw performed were: how one would adjust the oxygen levels for a patient and also how a PEEP machine works for a patient. Also I was shown how medications could ease a patients effort in breathing. A pulmonary function is a test that is used to see how an individuals lungs work.

I learned a lot about how different diseases affect the lungs in their own unique way, some disrupting the breathing pattern and others destroying the actual lung tissue.Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths. COPD-A disorder that makes it even more difficult to breathe deeply, Hemoptysis- Coughing up blood (can occur from various things).Pneumothorax- A hole in the lung, ABG- Arterial Blood Gases, COPD- A disorder that makes it even more difficult to breathe deeply, Adult Respiratory Distress Syndrome - Usually derives from other diseases, Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths. Some skills I saw was the ability to work different machines. At first I was a bit overwhelmed when being introduced into all the machinery that they have to know how to use, but later when the showed me how they work them I saw that it takes a lot of training to be able to use the machines efficiently and and correctly.

I appreciate those that helped me at the unit and I found out that there is more to Respiratory than just breathing, I learned that it plays a large role with the ICU and also in making sure the patients body is functioning properly and also that there are many more diseases of the lungs than I was aware of. From what i saw this week i have a new appreciation for the unit and i think it would be an interesting unit to be involved with. 

OR 

Learning Report

this week I worked in the OR, on the first day there wasn't anything going on. but on the second day maya and i saw a surgery performed on someones colon.  i saw many different things like the small and large intestines, colon, and many other body parts, equipment, and different nurses and doctors. I learned about the equipment and how its used and i learned some new vocabulary. the best thing that happened to me this week was probably just being able to see an actual surgery! also it was cool to see the organs and bloody stuff, i didn't know if i'd be able to handle it but i did complete fine. the worst thing that happened to me was probably that on the 1st day i there was nothing going on so it was pretty boring. this feel was a very good week because i saw some pretty cool new equipment and i got to actually see a surgery take place!

Experience record

I:technology 

   1. PlasmaBlade

   2. suture

   3. scalpel 

   4. datex ohmeda anesthesia machine

   

   

II:Diagnostic procedures

  OR didn't have any diagnostics 

III:Therapeutic procedures

 OR didn't have any 

IV:Disease/disorders

  a patients colon was inflamed and it had 2 large masses on it that had to be removed 

Experience journal

  1. PlasmaBlade

  I: as soon as i walked in i had to go down a long hall, go through a door, and go down another long hall. i took like 2 steps fast the front desk and they immediately made me put a hair net on.  they sanitizes many things like the tables and their hands frequently. Maya and i got an orientation of the OR on monday when there were no surgeries going on, and on tuesday we actually got to put on our PPE and watch an operation. as a whole the department works with patients who need surgery surgery after either an accident or an on going condition. the technology i observed there was: 

   1. plasmablade- new equipment used to dissect skin

   3. scalpel- used to cut skin

   2. suture- a stich used by doctors and surgeons to hold tissue together 

   4. datex ohmeda anesthesia machine- a leading supplier of anesthesia and medial mongering technology for hospitals worldwide, approached design concepts to design a compact anesthesia system that meets the changing of needs of clinicians. 

   

II: I observed and heard many different things between body parts and equipment. the atmosphere in the room was very chill and not up tight. my employee works well with others. the surgeons and nurses have good communication between each other to know what to do. the safety procedures in area include a vase information on patients history or current condition.  

III: i didn't have the much knowledge to begin with when i went in there, but now what i left i have learned many new things which I'm sure will help me in the long run! some skills i learned was communication skills between nurses and surgeons. i learned that i need to be more relaxed. talking to the doctors and being friendly makes all the difference

IV: my evaluation of this whole experience was pretty positive! i enjoyed myself a lot more than i thought i would and i came to really enjoy the people who work there. this will benefit my future bc I'm thinking about being a preoperative nurse or a surgeon! i learned a lot of real world information that i probably wouldn't of leaned on my own or just in a regular class. i think my personality fits best with a preoperative nurse. 

plasmablade

suture 

LAB QUESTIONS

1) group A- has only A antigen
    group B- has only B antigen
    group AB- has both A and B antigen
group O- has neither A or B antigen 
 

2)  Each blood type is also grouped by its Rhesus factor, or Rh factor. Blood is either Rh positive (Rh+) or Rh negative (Rh-). About 85% of Americans have Rh+ blood.

Rhesus refers to another type of antigen, or protein, on the surface of red blood cells. The name Rhesus comes from Rhesus monkeys, in which the protein was discovered.

3)

Hepatitis b

A severe form of viral hepatitis transmitted in infected blood, causing fever, debility, and jaundice

Syphilis

A chronic bacterial disease that is contracted chiefly by infection during sexual intercourse, but also congenitally by infection of a developing fetus

Hepatitis c

A form of viral hepatitis transmitted in infected blood, causing chronic liver disease. it was formerly called non-a, non-b hepatitis

Human immunodeficiency

Human immunodeficiency virus, a retrovirus that causes aids

Htlv

Human t cell lymphotropic virus

5) biopasy- medical test involving sampling cells or tissues for examination 

smear- screening used to detect potentially pre-cancerous or cancerous  cells

fluid tissue- fluid that surrounds the cells if multi-cellular animals

6) 110 lbs

7) Depending on your height, sec and weight, you can give up to 2 pints in an automated blood collection. For example, one donor may be able to donate two units of Red Blood Cells, another may donate on unite of Platelets and one unit of Plasma.

 

8) An anticoagulant is a type of medication that may be used to prevent blood from coagulating or clotting. There may kinds of anticoagulants and they have different ways of acting. The majority of them are medications that are administered to people to prevent blood clotting in certain illness, but sometimes in lab or medical settings an anti-coagulant is used to prevent things like clogging of intravenous lines or of blood clotting in test tubes and syringes. For medical use in people, it’s also important to mention anti-platelet medications, which have a similar purpose to anticoagulants, though the way they work is different.

9) the purpose is to add visual contrast to otherwise transparent objects, so they will be easier to see and study under the microscope.

10)

retic count- blood test that measures how rapidly immature red blood cells called reticulocytes

diff- measures the percentage of each type of white blood cell (WBC) that you have in your blood

ESR- erythrocyte sedimentation rate (ESR) is an easy, inexpensive, nonspecific test that has been used for many years to help detect conditions associated with acute and chronic inflammation, including infections, cancers, and autoimmune diseases.

Hgb-The hemoglobin test may be used to screen for, diagnose, or monitor a number of conditions and diseases that affect red blood cells (RBCs) and/or the amount of hemoglobin in blood. 

Hbs- Hepatitis B tests may be used for a variety of reasons. Some of the tests detect antibodies produced in response to HBV infection; some detect antigens produced by the virus, and others detect viral DNA.

Hct/Crit- The hematocrit may be used to screen for, diagnose, or monitor a number of conditions and diseases that affect the proportion of the blood made up of red blood cells

MCV-The mean corpuscular volume, or "mean cell volume" (MCV), is a measure of the average red blood cell size that is reported as part of a standardcomplete blood count.

MCH-The mean corpuscular hemoglobin, or "mean cell hemoglobin" (MCH), is the average mass of hemoglobin per red blood cell in a sample of blood. It is reported as part of a standard complete blood count

RBC- red blood cell (RBC) count is typically ordered as part of a complete blood count (CBC) and may be used as part of a health checkup to screen for a variety of conditions.

sed rate-Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it may help your doctor diagnose or monitor the progress of an inflammatory disease.

WBC- blood test to measure the number of white blood cells

 

11)

 

            LAB

I.  Learning Report
      This week i worked with a lab technician. while i was there we looked at tissue samples, analyzed urine and blood samples, and looked at different areas in the lab.  i learned about who a pathologist is and what they do, i saw lab equipment such as: hemoglobinometer, chemistry analyzer, coagulation machine, label printer, incubator, and a slide stainer. the best thing that happened to me this week was just seeing all the cool and different equipment, also i went into the storage room that body parts from the OR was stored. i saw body parts like uteruses and gal bladders. the worst thing that happened to me this week was being in the front of the lab (where the patients are). there weren't any patients, so i just went back into the back of the lab. over this week was fair because the second day was boring and kinda a repeat of my first day.

II. Experience Record
    
hemoglobinometer: A whole blood hemoglobin assay is a device consisting or reagents, calibrators, controls, spectrophotometric instrumentation used to measure the hemoglobin content of whole blood for the detection of anemia. This generic device category does not include automated hemoglobin systems.  
coagulation machine: causes a transformation of a liquid or solid into a soft, semisolid, or solid mass. 

slide stainer- stains slides different colors to see what the different chemicals on there do.

there are no therapeutic procedures int the lab. 

also when i was there, there was no disease/disorders determined from the test. 

at the lab the they called the hemoglobinometer a hemo. analyzer.

III. Experience Journal

I. as soon as i walked in i saw a wall. you could turn either left of right, right was the back of the lab where they do all the test, and the left was the out patient area. i worked with a lab technician and she ran diagnostic test on urine, blood, and tissue samples. as a whole the department they receive samples/orders from the OR and ER to run diagnostic test. i saw a

hemoglobinometer: A whole blood hemoglobin assay is a device consisting or reagents, calibrators, controls, spectrophotometric instrumentation used to measure the hemoglobin content of whole blood for the detection of anemia. This generic device category does not include automated hemoglobin systems.  

coagulation machine: causes a transformation of a liquid or solid into a soft, semisolid, or solid mass. 

slide stainer- stains slides different colors to see what the different chemicals on there do. 

II. i saw a few people working in different areas of the back of the lab running test and observing samples. my employee didn't really interact with a lot of people just because she was busy that day and had a lot of work to get done. the communication skills as a department was pretty well. they get orders from the OR/ER to run test. in the area i noticed that everyone at least had on gloves. they scan and run test on various samples and determine what is wrong with the patient. they have a pathologist and hematologist in the lab. 

III. i learned how important the lab is, i always thought the ER and OR were the most important. but without the lab they would never know whats wrong with the patients! for medical terminology she pretty much just said hemo. analyzer. 

IV. my experience as a whole was fairly good. this experience gave me a new appreciation for the lab and the workers in there. i dont think this will benefit my future very much because its still something I'm not very interested in. i think my personality fits best with the out patient area because i work better with people.  

slide stainer

PT/OT

Learning report

this week worked in the physical and occupational therapy unit, i worked with a few different therapist. i saw many different things like exercises, equipment, and forms of treatment. I learned about the equipment and how its used and i learned some new vocabulary. the best thing that happened to me this week was probably just seeing how the patients and the therapist interacted with each other, they were very chill and relaxed and it was just fun to talk to them. the worst thing that happened to me was probably that on the 2nd day i went back into PT/OT it was a lot of the same patients i saw the first day. this feel was a good week because i saw some pretty cool new equipment and i got to actually talk and ask questions to the therapist. 

Experience record

I:technology 

   1. exercise band

   2. ultrasound

   3. aquaciser

   4. recumbent bike

   5. pelvic traction 

II:Diagnostic procedures

  PT/OT didn't have any diagnostics 

III:Therapeutic procedures

  1. thermotology

  2. exercise band 

  3. calf stretch board

  4. exercise ball

  5. pelvic traction

  6. electric stimulation

  7. hydrotherapy 

IV:Disease/disorders

  1. shoulder buritis- A bursa is a tiny fluid-filled sac that        functions as a gliding surface to reduce friction between tissues of the body. Buritis is inflammation of a bursa. When injury or inflammation           of a bursa around the shoulder joint occurs, shoulder bursitis is present.

  2. A bulging disk extends outside the space it should normally occupy. The bulge typically affects a large portion of the disk, so it may look a little like a hamburger that's too big for its bun. The part of the disk that's bulging is typically the tough outer layer of cartilage. Usually bulging is considered part of the normal aging process of the disk and is common to see on MRIs of people in almost every age group.

V:Medical terminology

  1. thermotherapy- heat therapy 

  2. hydrotherapy- therapy with water 

  3. crotherapy- cold therapy 

  4. electrical stimulation- treatment to waken muscle and never         movement and communication 

  

Experience journal

  I: as soon as i walked in i saw the therapist getting ready for patients. they sanitizes many things like the beds/tables, exercise balls, and more. they sanitized anything patients might come in contact with. I worked with a physical therapist and she worked under the main physical therapist/over looker go PT/OT area. as a whole the department usually works with patients that are recovering from a surgery.Other patients are older and just need help with ADLs (active daily living). the technology i observed there was: an exercise band which is a starchy band given to each patient (patients do not share these), an ultrasound, which is not used what it is commonly used for. in PT/OT ultrasounds are used for deep penetration within the muscles (patient doesn't feel it, an aquaciser which is pretty much in underwater treadmill. it is used for patients who need exercise that doesn't cause any strain or discomfit upon the body. In the water, because there is boyency, there is not much pressure put onto joints. the hot water tempurature  also loosens the muscles.recumbent bike which build patients endurance, also pelvic traction machine which in my patient's case, helped to open vertebrae slightly and relives pain. 

II: I observed and heard many different things between treatment option and what the patient ate for lunch that day. the atmosphere in the room was very chill and not up tight. my employee works well with others. doesn't interact with other PT's just because they are usually so busy with theirs. but the therapist's have good communication between eachothehr ti know what do do. the safety procedures in area include a vase information on patients history or current condition.  exercise band. thermotology was used in the area when patient needed hot packs on his neck, calf stretch board is a price of equipment allows exercise and a large range of motion. pelvic traction does what i just said. an aquaciser which is pretty much in underwater treadmill. it is used for patients who need exercise that doesn't cause any strain or discomfit upon the body. In the water, because there is boyency, there is not much pressure put onto joints. the hot water tempurature  also loosens the muscles.recumbent bike which build patients endurance, also pelvic traction machine which in my patient's case, helped to open vertebrae slightly and relives pain. 

III: i didn't have the much knowledge to begin with when i went in there, but now what i left i have learned many new things which I'm sure will help me in the long run! some skills i learned was communication skills between patient and health care professional. i learned that i need to be more relaxed with patient. talking to them and being friendly contributes the patients happiness. 

IV: my evaluation of this whole experience was pretty positive! i enjoyed myself a lot more than i thought i would and i came to really enjoy the people who work/are treated there. this will benefit my future bc I'm thinking about going into sports medicine and i am interested in sports medicine therapy. i lean red a lot of real world information that i probably wouldn't of leaned on my own or just in a regular class. i think my personality fits best with the sports medic therapist bc i know a lot about sports and its an easy  topic i can relate to which will make the patient more comfortable. 

   

recumbent bike

exercise band

aquaciser

recumbent bike

aquaciser

pink eye

 

PINK EYE

so this week i got pink eye and wasn't able to go to the hospital. so instead i will inform you about pink eye!

WHAT IS PINK EYE? 

Pink eye, or conjunctivitis, is redness and inflammation of the membranes (conjunctiva) covering the whites of the eyes and the membranes on the inner part of the eyelids. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood, but they occur in adults as well. Pink eye can occur in people of any age. Overall, however, there are many causes of pink eye. These can be classified as either infectious or noninfectious. Pink eye does not cause any changes in vision.

What Causes Pink Eye?

The primary types of conjunctivitis, based on cause, are:

• Viral conjunctivitis. Caused by a virus, like the common cold. This type of pink eye is very contagious, but usually will clear up on its own within several days without medical treatment.
• Bacterial conjunctivitis. Caused by bacteria, this type of conjunctivitis can cause serious damage to the eye if left untreated.
• Allergic conjunctivitis. Caused by eye irritants such as pollen, dust and animal dander among susceptible individuals. Allergic conjunctivitis may be seasonal (pollen) or flare up year-round (dust; pet dander).

    Viral pink eye:
 Viral pinkeye is often caused by an adenovirus, which is a           common respiratory virus that can also cause a sore throat or upper respiratory infection. The herpes virus can also cause viral pinkeye.

Symptoms of viral 
pinkeye include:

1. Redness in the white of the eye.
2. Swelling of the eyelids.
3. itching or burning feeling of the eyelids.
4. Swollen and tender areas in front of the ears.
5. A lot of tearing.
6. Clear or slightly thick, whitish drainage.

Viral pinkeye symptoms usually last 5 to 7 days but may last up to 3 weeks and can become ongoing or chronic.

Viral pink eye is very contagious. If the pinkeye is caused by a virus, the person can usually return to day care, school, or work when symptoms begin to improve, typically in 3 to 5 days. Medicines are not usually used to treat viral pinkeye, so it is important to prevent the spread of the infection. Pinkeye caused by a herpes virus, which is rare, can be treated with an antiviral medicine. Home treatment of viral pinkeye symptoms can help you feel more comfortable while the infection goes away.

  Bacterial pink eye:

An infection may develop when bacteria enter the eye or the area around the eye. Some common infections that cause pinkeye include:

1. staph infection.
2. haemophilus influenza type b (Hib).
3. cat scratch disease
4. gonorrhea

Symptoms of bacterial pinkeye include:

• Redness in the white of the eye.
• Gray or yellow drainage from the eye. This drainage may cause the eyelashes to stick together.
• mild pain.
• Swelling of the upper eyelid, which may make the lid appear to 
• droop (pseudoptosis).

The discharge commonly accumulates after sleeping. Affected children may awaken most unhappy that their "eyes are stuck shut," requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial pink eye is treated by repeated warm washcloths applied to the eyes and requires antibiotic eyedrops or ointment prescribed by the doctor.

•  

Allergic pink eye 

Allergy medications often can help prevent or shorten bouts of allergic conjunctivitis. Sometimes these medications must be started before allergy season or allergy flare-ups begin. Ask your doctor for details.

 Symptoms of allergic pink eye include: 

Watery, burning, itchy eyes; often accompanied by stuffiness and a runny nose, and light sensitivity. Both eyes are affected. Not contagious.

SIGNS AND TESTS:

• examination of eyes
• swab of conjunctiva for analysis 

TREATMENT:

The treatment depends on the cause. 

Allergic conjunctivitis may respond to allergy treatment. It may disappear when the allergen that caused it is removed. cool compresses may help soothe allergic conjunctivitis. 

Antibiotic medication, usually eyedrops, is effective for bacteria conjunctivitis. Viral conjunctivitis will disappear on its own. Many doctors give a mild antibiotic eye drop for pink eye to prevent bacterial conjunctivitis. 

You can soothe the discomfort of viral or bacterial by applying warm compresses (clean cloth soaked in warm water)to your closed eye. 

PREVENTION:

Viral and bacterial pinkeye are contagious and spread very easily. Since most pinkeye is caused by viruses for which there is usually no medical treatment, preventing its spread is important. Poor hand-washing is the main cause of the spread of pinkeye. Sharing an object, such as a washcloth or towel, with a person who has pinkeye can spread the infection.

  

good hygiene can help prevent the conjunctivitis: 

• change pillow cases frequently 
• do not share eye cosmetics
• do not share towels or handkerchiefs 
• handle clean contact lenses properly
• keep hands away from the eye
• replace eye cosmetics frequently 
• wash hands often