J. D'Urbano's Blog (13)

Asthma is a chronic lung disease that causes difficulty breathing, and sometimes chest pain, secondary to spasm of smooth airway muscle (bronchospasm), airway inflammation, and increased airway secretions.



In the United States it is estimated that 17.5 million adults, and 7.1 million children, have been diagnosed with asthma. Also in the United States 3,447 people died from asthma symptoms. Worldwide it is estimated that 300 million people have asthma. Currently asthma is costing…

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             For those of you with asthma or COPD a car ride, even a short one, can be the beginning of a nightmare, or a pending life-changing event. One of the keys to living with lung disease is avoiding the triggers. If the triggers are in the air around you that key becomes very difficult to perform. Well, here is a tip that may make it easier.

            Even a short car ride can put you right in the middle of a multitude of extrinsic (or external) asthma/COPD triggers. A few…

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Airway management is really a very broad spectrum term. To most people in healthcare it means simply putting in an endotracheal tube, but there really is a lot more to it than that. Our airway consists of everything from our oral opening all the way down to the small distal terminal bronchioles. Placing an endotracheal tube only involves a small part of that airway. Well, what happens before the tube gets placed? What…

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For many years taking your patients vital has been a standard of practice in all areas of healthcare, from pre-hospital to extended care, and everywhere in between. In today’s world of advanced medical education and technology a new vital sign is gaining popularity in patient care settings. Capnography…





In earlier years capnography was widely misunderstood by healthcare workers. It was believed by many that capnography was intended to estimate their patients’ PaCO2.… Continue

Recently, a colleague approached me with a situation that I actually run into fairly regularly, especially with some of the younger

RT’s. This colleague, one who is still a fairly ‘young’ RT, told me

that one of his intubated patients’ has a cuff leak and asked me if I

would assist him with the pilot balloon repair kit. He’s never actually

used one and was a little uncomfortable. I’m always willing to lend a

helping hand, especially to those who are still willing to… Continue

In this edition of “What’s New in the Air” I focused on Asthma, which currently effects more than 34 million people in the United States. There are approximately 500,000 hospital visits each year due to asthma, and it kills approximately 250,000 people world-wide. Between 1980 and 1994 the prevalence of asthma has increased by 75%, and in children under the age of 5 asthma has increased over 160%. Now for some good news. Read on for something to look forward to in the… Continue

The Cuff or the Catheter…

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First, and foremost, let me start off my saying I'm not a sales person of any kind. I am, however, an avid fan of airway management, as many of us are, so I thought I'd share with you my recent experiences with the GlideScope Video Laryngoscope.



I've been intubating patients for the better part of 15 years now. At my current place of employment my team performs approximately 2 thirds or more of the intubations that take place in the hospital (with the exception of the… Continue

Preface:

The subject of addiction is very complicated and very controversial, with strong opinions that venture off in many different directions. What is written here is of my own personal opinion, and that opinion has been formed based on my personal experiences, and research that I have done during my own personal time. This is a shortened version of one of the chapters of the book I’ve been trying to write for the past few years. I hope to have it completed by the middle of 2010. As… Continue

Capnography refers to the amount and concentration of carbon dioxide (CO2) measured in exhaled gas. But to understand capnography you must first understand that oxygenation and ventilation are two entirely different parameters. While it’s true that they are both related to the respiratory system the two parameters are not related, nor is one affected by the other because they are referring to two very different mechanisms. Oxygenation refers to the amount of oxygen… Continue

Arterial Line Placement

The Battle of the Blood Vessel



Here’s the situation. You’re on duty, assigned to cover the surgery suites. You’re called to the pre-op area and asked to place an A-Line in a patient, who is a known vascularpath, going in for something like a carotid endarterectomy, or a femoral bypass. You put a pressure line together, you break out a sterile field with precision that would make the “Surgeon General” Bow to your presence, and you inject your patient with… Continue

I recently answered a question from another blog site about a favorite movie quote. That was an easy one. The quote was from a 1978 movie called Convoy, in which actor Kris Kristofferson played a truck driver nick-named ‘the Rubber Duck’. He was asked why the Rubber Duck. His answer was something like “well, my daddy always told me to be like a duck. Stay smooth on the surface, and paddle like the devil underneath”. I never forgot that, and I almost live by that to this very day. Here’s an… Continue

My name is John D’Urbano but everyone calls me J.D.. I’ve been a Respiratory Therapist in the Phoenix area since 1992. I’ve spent the first half of my career at a top teaching hospital specializing in Emergency Medicine / Level-1 Trauma, with a strong interest in critical burn injuries. Currently I am working as a Cardiovascular Respiratory Therapist in a very unique program in one of Arizona’s leading healthcare networks. Between these two facilities I’ve been afforded medical education and… Continue