Respiratory DiseasesWe have to cease simply doing and begin asking questions

We have to cease simply doing and begin asking questions


Have you ever ever discovered your self in a state of affairs the place a medical intervention is prescribed, and it seems illogical and pointless to you? And also you get pissed off, and maybe grumble below your breath? But, out of respect for the physician’s order, you comply. 

Lately, I encountered such a state of affairs involving the usage of a 1 LPM nasal cannula for an toddler displaying retractions and wheezing, regardless of optimum oxygenation ranges on room air. The notion that 1 LPM nasal cannula would make a major distinction appeared doubtful at finest.

Curiosity propelled me to query the reasoning behind this choice, solely to be met with the response, “As a result of the physician ordered it; it is protocol.”

Whereas protocols undeniably play an important function in standardizing care, my inquisitive nature craved extra. Is it not pure to want a deeper understanding of the science guiding these interventions? 

So, I requested my query one other means; “Does it not frustrate you that docs order stuff like this?” And she or he mentioned, “Nicely, the protocol says it’s going to lower the affected person’s work of respiration?” 

You as soon as once more grumble below your breath. Such trivial solutions clearly glad my buddy. However they don’t fulfill me; they solely appear to attract me deeper in frustration. 

It is price remembering that docs, like everybody else, are fallible. For over 30 years, we administered quite a few respiration remedies with IPPB below the idea that it might power respiratory drugs deeper into the airways. When the research lastly emerged, it revealed that each one this did was overinflate wholesome alveoli.

So, is not it believable that issues at the moment deemed “protocol” would possibly at some point be confirmed by science to be equally “delusional”?

Many hospital protocols function on algorithms, producing a numerical output based mostly on quite a lot of components from our assessments. Nevertheless, these numerical outcomes stay subjective; one physician would possibly rating a 5, one other a 2, and a respiratory therapist, maybe, a 3. Even when we attain a consensus on the following process, there is no assure that including 1 LPM to this affected person brings about any optimistic change.

So, whereas we unquestionably observe orders, the pursuit of understanding the “WHY” and “HOW” stays paramount in healthcare. No physician would possibly explicitly order 1 LPM nasal cannula, but this analogy underscores the significance of questioning and looking for comprehension in our medical practices.

In any other case we’re simply creating work that isn’t wanted. And, to make a case to administration, this provides superfluous fees to the invoice. It is also a attainable explanation for respiratory remedy burnout, frustration,  and apathy. 

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