Patricia Machanoff is a Respiratory Children’s Educator at The University of Vermont Children’s Hospital at the UVM Medical Center.

For most of us, taking a breath is the most natural thing in the world, done without a second thought.  But, when a person has trouble breathing – especially a small child – it can be a medical emergency.  When this happens, we’ll be there.

Respiratory Therapy is an integral part of the clinical team at The UVM Vermont Children’s Hospital. We take care of children from birth through adolescence including premature infants, those that have asthma, have respiratory problems as the result of trauma, have cystic fibrosis, and so on.

It’s a bit difficult to describe a “typical day” for Respiratory Therapy as we provide services to pediatric patients throughout the hospital.  For example, our day could start in Labor & Delivery to provide respiratory support to a newborn.

During a baby’s delivery, we may arrive moments after the birth, becoming very involved in stabilizing the baby. We may have to intubate the baby (place a tube in their throat) or assist in the intubation. Also we may have to place the baby on some form of breathing support, such as a ventilator or other breathing device.  Once the baby is stabilized, we will help mom and dad to see their baby before we transport the infant to the neonatal intensive care unit (NICU) for the next step in their care.

Once admitted to the NICU, the infant is weighed and placed in the open bed warmer. The infant may have some intravenous lines (IV) placed and blood drawn. We may need to instill a medication into the baby’s lungs, make sure the breathing tube is secure, watch the ventilators volumes for changes, obtain a blood gas and make some appropriate changes to the ventilators settings.

Our next stop for the day might be the Emergency Department to take care of a child in status asthmaticus (having a severe asthma attack). Once there we will have to administer some respiratory medications to help open the child’s lungs. We may need to administer a special gas mix of helium and oxygen called heliox that will be delivered to the child through a mask.

In most cases, the parent is in the room as we take care of the child or baby.  We understand that the nature of what we do – helping children to breathe in a moment of medical crisis –can be a frightening experience for the parents and their children.  Whenever possible (as time is of the essence) we speak to the parent to let them know what we are doing to help decrease their anxiety.  In some cases, we need the parent to partner with us to support the care of their child – for instance, many children do not want to wear the heliox mask – and we need the parent’s help to calm their child during this experience.

The work we do is critically important and we feel privileged to share in the care experience of the infants and children who come to the UVM Medical Center and the Vermont Children’s Hospital in need of our services.

Patricia Machanoff is a Respiratory Children’s Educator at The University of Vermont Children’s Hospital at the UVM Medical Center. 

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