all.things.pac@gmail.com Posted December 29, 2015 Share Posted December 29, 2015 Hi there, I'm a 2014 grad and I had a lot of help getting into and through PA school and I'm just someone who wants to pay it forward. I'm just trying to reach out to people who were in my shoes. I started a website dedicated not only to pre-pa students but also current students and practicing PA's. I'm adding new things everyday--so far I have a good bit of information up geared towards didactic year and clinical year--resources, how to survive etc.. I'm also open to any suggestions anyone has as to what they would want help with in their process to becoming a PA-C! I'm adding new things every day and I plan on adding a lot of blogs related to my clinical experience. Example--this week I'm working on a blog about oxygen delivery methods...when to use each of them and how they work. This was something I didn't get a lot of in school and I have been learning on the fly. My hope is that by sharing my experiences I help make other's journey's easier and add some patient experience :) Web Address: www.allthingsphysicianassistant.com E-Mail: all.things.pac@gmail.com You can also follow me on instagram @all_things_pa_c for fun things such as medical satire, quick hit knowledge and probably a pic or two of my dog snuck in there! I also have a blog portion related to MANY different topics from picking your elective rotation specialty, my experiences as a traveling PA and things that I learn on the job in my patient interactions (as mentioned above) I'm just getting started so expect lots of information to be added on a daily/weekly basis. Good luck to everyone and I hope you find my information helpful! :) Link to comment Share on other sites More sharing options...
polarbebe Posted December 30, 2015 Share Posted December 30, 2015 Nice blog. I see that you are preparing a post on oxygen delivery methods. The ones that I see in the ICU are: nasal cannula, ventimask, face tent, non-rebreather, high flow nasal cannula, trach collar, CPAP (BIPAP is more for ventilation) and advanced airways such as endotracheal tubes, trachs, LMAs. Something really important to stress is the actual FiO2 the patient receives for these different modalities (which vary depending on patient effort and respiratory rate) for example non-rebreather is not 100% though many people assume it is. Link to comment Share on other sites More sharing options...
all.things.pac@gmail.com Posted January 2, 2016 Author Share Posted January 2, 2016 Thank you so much!!! I'm learning a lot actually as I go through this and I was finding a pattern in the importance of FiO2. It's all pretty cool! I found what I think is a pretty good site respirator therapy cave blogspot. I got information from a couple of different places. I would love to hear your feedback whenever it goes up (hopefully in the next few days)--I've spent a decent amount of time on it! Thanks again for the pointers. you mentioned 1 or 2 devices I haven't looked at yet and will make sure to include before I publish :) Link to comment Share on other sites More sharing options...
SERENITY NOW Posted January 3, 2016 Share Posted January 3, 2016 Glanced through your blog and it looks great so far. Really enjoyed reading your posts about your experience with patients and your thought process as your work through the cases; I hope you have more of those coming! Thanks for putting it together. Link to comment Share on other sites More sharing options...
polarbebe Posted January 4, 2016 Share Posted January 4, 2016 Before starting in the ICU, I had next to no critical care knowledge or understanding of oxygenation. RTs really taught a great deal but a deeper understanding was developed working with the intensivists (also trained as pulmonologists) and pulmonary fellows. Excellent blog post but I will make a caveat about non-rebreathers, they do not deliver 100%. First they don't have a tight seal, no cuff on an ETT to prevent air escaping around the mask. Second, NRBs usually set to 8-15 liters per minute but when a patient is on a non-rebreather the reservoir size is 1L. It is not uncommon for a patient to have a minute ventilation of 16-20+ liters per minute. If they have a high minute ventilation due to whatever reason (pain, anxiety, metabolic acidosis, etc. ) they will quickly exhaust the reservoir and their minute ventilation exceeds the rate of pure oxygen coming from the tubing and will then entrain room air FiO2 0.21 and that mixes with the pure oxygen. So actual Fio2 delivery is dependent on patient minute ventilation (something you mentioned in your blog but didn't exactly explain why)... and never 100% to the patient. Link to comment Share on other sites More sharing options...
all.things.pac@gmail.com Posted January 8, 2016 Author Share Posted January 8, 2016 Thank you guys for all of your feedback!!! I will look back at the post and try and integrate some of the things mentioned! :) Link to comment Share on other sites More sharing options...
bothomas Posted April 19, 2016 Share Posted April 19, 2016 As a respiratory therapist and hopeful PA I appreciate this! You'd be surprised how many PA's, NP's, and even MD's I deal with that don't really have the whole oxygenation/ventilation thing worked out. I live and work in rural NC and we have a lot of what I call 3rd world country doctors. The Venturi and non-rebreather masks are grossly misunderstood and improperly used. Most of the 3rd world MD's do not understand the use of the Venturi and avoid it because they never will admit they don't know something. Demand for flow vs need for fio2 and oxygenation vs ventilation is the most commonly misunderstood thing in the 3 rural hospitals I have worked. Unfortunately we don't have a pulmonary doc and just have to deal with the hospitalists. The few doc's and NP's that have started to trust me have realized we can spare a lot of intubation and worse by just selecting the appropriate fio2. Just an example...I came on shift to an elderly COPD patient who had been on a non rebreather for roughly 20 hours. I mentioned to our Hatian Dr about oxygen toxicity and the patients normal values and my concerns. The Dr told me to place him on bipap and to get my intubation gear. "Fixing" every ABG for chronically compensated respiratory acidosis and chronic hypoxia is also a major problem. Sorry I'm rambling! I'll definitely check your site! Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Max PA17 Posted April 19, 2016 Share Posted April 19, 2016 As a respiratory therapist and hopeful PA I appreciate this! Sent from my iPhone using Tapatalk A fellow RT! Welcome! Good luck in applying, your experience and knowledge will be very helpful in school. :) Link to comment Share on other sites More sharing options...
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