Love love love you! Thank you so much for the in-depth explanations of how these conditions occur and why. You are awesome! My respiratory class loved all your videos!
I’m an ICU RN and I came here to my fabulous RRTs(and student RRTs) for an even better understanding of VBG/ABG. Y’all are amazing….we couldn’t do it without you…especially right now.
I love watching your videos. It is very helpful especially doing it one topic at a time help me to grasp the information better which help me becoming a better skilled RRT! Thank you! Keep up the great job!
But then you'll have some docs, nurses or therapist saying nooo no oxygen because they are a COPD patient. Anyhoo I subscribed to your channel. I've been an RT for 9 years now and have trouble remembering things I've been taught so watching your channel is helping me. But also my problem is second guessing myself.
Maybe so, but that also is a lack of knowledge and even more reason why RTs need to be actively involved at the bedside. Not just doing, but also educating. I just got done telling someone else to never second guess yourself, but always think twice during challenging situations. There's a difference! Thanks for subscribing, watching and commenting!!!
Chronic umm perfect ph with high co2 and high bicarbonate my copd patients. I had one last week with co2 125 after she has been on bippa for an hour. At 125 she was smiling and happy like all was great..
hi, excuse me if it was a silly question, I am the fresher in medicine. related to the last scenario, why do you say the pt is hyperventilating while his co2 is higher than normal? Isn’t the pt is experiencing metabolic alkalosis, so we need to treat him by medicine.
Uncompensated respiratory alkalosis with severe hypoxemia. That’s a chronic retainer and they have low PAO2 a little oxygen 2L cannula. Once you fix the oxygenation problem the patient will probably get back to baseline. If they go too long and the co2 goes on rising and the work of breathing really bad I would use bipap to help with the work breathing and give them a little oxyen alone with help to bring the co2 down. These patients decompensated so quick they wait till the last minute to come to the hospital.
So for that CVF COPD patient that has a high CO2 and it becomes superimposed on AAH we would mechanically ventilate them and reduce his or her breathing rate to increase co2 back to their normal? (And their not hypoxemic)
Hi Davie. Thanks for the comment. Just to clarify the CVF is baseline. So the AAH becomes superimposed on the CVF. We wouldn't necessarily need to rush into intubating this patient. We may be able to keep them off the vent by identifying and addressing the underlying cause of the acute hyperventilation. Hope this makes sense, Davie.
The first question is WHY are they hyperventilating? Hypoxemia, neuro injury, fever, early sepsis, anxiety, pain, flow hunger, volume hunger,, etc? Once you identify and address that, then the hyperventilating should cease. I need more info, Tiffani! And I got your IG message. Thanks for sending it!
Maybe a chronic head injury, but I've never seen a patient compensate to a state of chronic alveolar hyperventilation. I'm sure someone has, I just thinks it's rare.
I'm being diagnosed with respiratory alkolosis...but not treatment has been given so far...it causes hyperventilation and syncope...kindly suggest who should I go to? Is the condition serious? How do I get it treated? Please help asap..thanks
Hello, Irene! The question is what is stimulating the increased removal of CO2. Many things can cause this, ie chronic pain, anxiety, etc. I would seek guidance from a pulmonologist for options regarding management of. Best wishes!!!
Love love love you! Thank you so much for the in-depth explanations of how these conditions occur and why. You are awesome! My respiratory class loved all your videos!
This professor is amazing! Now I understand this topic due to his lecture.
I’m an ICU RN and I came here to my fabulous RRTs(and student RRTs) for an even better understanding of VBG/ABG. Y’all are amazing….we couldn’t do it without you…especially right now.
Thank you, Sarah! We love our RNs here on this channel. Thanks for sharing your kind words and keep up the strong work!!
I love watching your videos. It is very helpful especially doing it one topic at a time help me to grasp the information better which help me becoming a better skilled RRT! Thank you! Keep up the great job!
But then you'll have some docs, nurses or therapist saying nooo no oxygen because they are a COPD patient. Anyhoo
I subscribed to your channel. I've been an RT for 9 years now and have trouble remembering things I've been taught so watching your channel is helping me. But also my problem is second guessing myself.
Maybe so, but that also is a lack of knowledge and even more reason why RTs need to be actively involved at the bedside. Not just doing, but also educating. I just got done telling someone else to never second guess yourself, but always think twice during challenging situations. There's a difference! Thanks for subscribing, watching and commenting!!!
I enjoyed this because I learned some new info with the AAH…and the question was a good one and I’m happy that I was thinking it was D.
Glad you got the question correct! Thanks for watching and commenting!!
@@RespiratoryCoach yvw I will continue to watch your very informative videos which do help so many of us understand better plus learn new things.
Chronic umm perfect ph with high co2 and high bicarbonate my copd patients. I had one last week with co2 125 after she has been on bippa for an hour. At 125 she was smiling and happy like all was great..
LOVE the AAH part. New info for me and I'll look smarter! Well, hopefully LOL
Thanks for these videos!!
You are so welcome!! Thank you for watching!
hi, excuse me if it was a silly question, I am the fresher in medicine. related to the last scenario, why do you say the pt is hyperventilating while his co2 is higher than normal? Isn’t the pt is experiencing metabolic alkalosis, so we need to treat him by medicine.
Uncompensated respiratory alkalosis with severe hypoxemia. That’s a chronic retainer and they have low PAO2 a little oxygen 2L cannula. Once you fix the oxygenation problem the patient will probably get back to baseline.
If they go too long and the co2 goes on rising and the work of breathing really bad I would use bipap to help with the work breathing and give them a little oxyen alone with help to bring the co2 down. These patients decompensated so quick they wait till the last minute to come to the hospital.
When your presented with a chronic COPD, how to do you give them Ipap and Epap setting?
Can you show us what vent changes (if any) can be made based off these examples? Thank you :D
Absolutely, Amber! Stay tuned!
So for that CVF COPD patient that has a high CO2 and it becomes superimposed on AAH we would mechanically ventilate them and reduce his or her breathing rate to increase co2 back to their normal? (And their not hypoxemic)
Hi Davie. Thanks for the comment. Just to clarify the CVF is baseline. So the AAH becomes superimposed on the CVF. We wouldn't necessarily need to rush into intubating this patient. We may be able to keep them off the vent by identifying and addressing the underlying cause of the acute hyperventilation. Hope this makes sense, Davie.
very very helpful and pratical，thank you
best coach ever .
How would you fix a patient that is hyperventilating in respiratory alkalosis at a subacute where you don't have capabilities at the hospital does
The first question is WHY are they hyperventilating? Hypoxemia, neuro injury, fever, early sepsis, anxiety, pain, flow hunger, volume hunger,, etc? Once you identify and address that, then the hyperventilating should cease. I need more info, Tiffani! And I got your IG message. Thanks for sending it!
Dude, thank you so much. I’m doing a lot of review for my TMC coming up, and this is so helpful. Blood gasses give me trouble at times.
Hey Xyphor! Glad to see you again. You're very welcome. Let us know how the TMC goes. Best wishes!
is there chronic patient lives with low co2? unlike copd ,they live with high co2
Maybe a chronic head injury, but I've never seen a patient compensate to a state of chronic alveolar hyperventilation. I'm sure someone has, I just thinks it's rare.
I'm being diagnosed with respiratory alkolosis...but not treatment has been given so far...it causes hyperventilation and syncope...kindly suggest who should I go to? Is the condition serious? How do I get it treated? Please help asap..thanks
Hello, Irene! The question is what is stimulating the increased removal of CO2. Many things can cause this, ie chronic pain, anxiety, etc. I would seek guidance from a pulmonologist for options regarding management of. Best wishes!!!
Tricky initially cos I paused it after the choices have been given and assumed I didn't know any other data hehe.
Yeah, I screwed that part up. LOL My bad. Thanks for playing along though.