ATLANTA, GA – In an effort to better encourage patients to do their breathing exercises, a newly-designed incentivized spirometer will pay patients $50 per deep breath – that’s right: cold, hard, cash – including a bonus of $100 every time they hit 1500.

“One of the most common complaints in patient satisfaction surveys had to with incentive spirometers: what was the incentive?” explained respiratory therapist Artie Blood-Gas, who carries his own incentivized spirometer to make a little cash on the side.  “Patients were never motivated to use them.  All they said was, what’s in it for me?  Not only are they motivated, heck, I’m motivated too.”

An incentivized spirometer works exactly like a conventional incentive spirometer: the patient inhales, holds their breath for 5 seconds, and exhales.  The only difference is with every breath the patient gets a cash payout.

“Hell yeah, there’s a whole lot of incentive!!” said patient Jackson Jones, who has been inhaling and exhaling like crazy over the past several hours.  His bed is overflowing with an unholy amount of cash, and not a single collapsed alveolus exists in his body. “This is way better than the slots in Vegas!  I got you, alveoli, I got you!!”

One incredibly motivated patient managed to move the gauge past 3000 in a single breath, after which her incentivized spirometer spit out an entire gold bar.

Blood-Gas is pretty sure he has a respiratory alkalosis going on based on his incentivized hyperventilation. “Cha-CHING! Thanks to these new devices,” he said, “atelectasis will be a thing of the past.”

In other news, several interns were caught in a back alley using dozens of incentivized spirometers to help pay off their student loans. 

DALLAS, TX – While placing orders on rounds, intern TooMany Orders clicked over to the Respiratory section in the hospital’s surprisingly thorough EMR. The patient was having difficulty breathing, and he needed to place an order for positive pressure ventilation (PPV).

Under “ventilation” orders, there was a very long drop down menu. He clicked what he thought was PPV, and signed the order.

“I mean, why would our EMR have an option for ordering an iron lung?” Dr. Orders later explained to the Gomerblog team. “I didn’t expect that ‘negative’ pressure ventilation would be a valid order.”

Soon after placing the order for NPV, he received 57 pages from respiratory therapy, including the following:

“Are you sure about this vent order? Call back!!”
“For real?”
“Have you run this by your upper?”
“Is your attending in the building?”

Dr. Orders didn’t think much of these pages; he received questions like this every day.

Then, while he was in conference, the pages became more bizarre:

“Are you sure about this? -Hospital Historical Society”
“There is only one other guy in the city who uses one of these, we’ll get in touch with his team.”
“OMG this is so heavy. Why do you hate me so much. -Nurse Patty”

Within the hour, the patient was placed in an iron lung obtained from the hospital’s museum exhibit.

By the time the team saw the patient on afternoon rounds, the patient had reasonably adjusted to life in the iron lung. “This isn’t too bad, actually,” said the patient. “At least there’s no masks or tubing on my face!”

Dr. Orders’ attending had fainted, falling onto the floor.

The patient, however, had one more question: “Now how come I haven’t been served lunch yet?”

Is this your first time using an incentive spirometer (or marijuana)?  Well, you’re in luck: our Gomerblog team has created this easy 15-step process to using your incentive spirometer (or weed).  Don’t be intimidated, it’s really easy (awesome) so let’s get started (stoned)!

STEP 01: Sit upright (or not).

STEP 02: Hold the incentive spirometer (joint) in an upright position.

STEP 03: Thank your nurse (weedman) for the incentive spirometer (weed).

STEP 04: Queue Dark Side of the Moon by Pink Floyd (or Physical Graffiti by Led Zeppelin).

STEP 05: Seal your lips tightly around the mouthpiece (joint or bong).

STEP 06: Breath in slowly and as deeply as possible.

STEP 07: Watch the piston (strobe light) rise up (turn on and off).

STEP 08: Hold your breath as long as possible.

STEP 09: Exhale slowly.

STEP 10: Rest for a few seconds before repeating 10 times an hour.

STEP 11: After every 10 breaths, cough.  This will happen whether you like it or not.

STEP 12: Address the munchies.

STEP 13: Stop acting paranoid, it’ll be fine.

STEP 14: Seriously, calm down, no one is after you.

STEP 15: That’s just your nurse, she’s not a cop, okay?!  CALM DOWN!!

GOLETA, CA – Puritan Bennett’s new ventilator mode is a hit with the Bay Harbor Hospital night shift. Along with the standard AC, SIMV, CPAP, APRV and MVV modes, their newest offering, the PB-1001, comes with a LATTE mode offering steaming hot coffee at the touch of a button.

“This really helps keep me awake when I don’t have time to get downstairs to the cafeteria,” said night respiratory therapist (RT) Laura Jorgenson.

“The new PB-1001 comes with a refrigerator to keep your milk cold until ready to use and a rack to hold bottles of syrup so you can serve vanilla or caramel lattes in under a minute,” said nurse Bear Jones.

Not everybody is as enthusiastic about the new offering.

“Doctors and nurses haven’t been able to keep their hands off my ventilator in the past and now families are playing with the vent,” said RT Maria Cobb. “Two nights ago my patient’s mom was trying to make a mocha latte and she put the vent on stand-by mode instead of making her skinny latte.”

Still, the new vents seem to be welcomed by most of the night shift.

“Watch for the PB-1001a, our optional new French Press, which will be offered early next year,” Jones added.

Susie Thompson lost her shit late Tuesday night after watching an episode of the CBS medical drama “Code Black” with her boyfriend. Steve Hughes, a Respiratory Therapist at Little Sisters of Charity was heard to exclaim “That’s not how we do it!” for the third time that night as the show portrayed an intubated patient just before Thompson threw a TV Guide at his head in frustration.

“IT’S A TV SHOW!” Thompson was heard to yell as the TV Guide glanced off the side of Hughes’ forehead drawing blood. Later she was reported to have said that she “get’s it”. And, “I understand. it’s not true to life”.

Dr. Beatrice Ma explained that Hughes’ may be suffering from “Medical-TV Derangement Syndrome” as she stitched the laceration in his temple. “M-TVDS is a condition where medical workers pick apart television shows as far as their accuracy is concerned and can be a quite serious condition” which can often lead to blunt force injuries.

“I had a patient last year, a nurse, who couldn’t stop telling everyone she met about a movie she had seen where the actor mispronounced ‘troponin’ multiple times. She required hospitalization for 4 days” Dr. Ma reported that typical therapy for M-TVDS involves strictly avoiding all medical scenes in popular entertainment. Failure to avoid medical entertainment can result in further blunt injuries to the head and face according to Dr. Ma.

The Director’s Guild of America had no comment.

HUNTSVILLE, AL – Checking off its To Do list like it’s nobody else’s business, patient Reynold Baker’s cough is happy to report that it is being incredibly productive today.

“Man, you’re not going to believe the level of productivity I’ve achieved today,” proudly exclaimed Baker’s raspy and rattly cough.  “Copious mucous by 6:30 AM, a paroxysmal coughing spell after food went the wrong way during breakfast just shy of 8 AM, some blood-tinged sputum around 8:45 AM, small volume hemoptysis at 9 AM, and then large-volume hemoptysis by 10 AM.”

The amazing part about this cough was that it only started yesterday afternoon.  Some patients’ coughs are lazy and need several weeks or even months to achieve the level of production that Baker’s cough saw just this morning.  Incredible.

“My doc came in just before lunchtime, asked me if I had fevers and chills, I said no, but when he asked if I had a productive cough, i just started laughing,” Baker told Gomerblog.  “I said, ‘Sit back and listen, doc, you won’t believe how productive my cough has been!'”

The cough is still feeling strong and has a few more goals in mind before the day is done.

“Hypoxia would be the next thing on the To Do list, but a pneumothorax would be the icing on the cake,” the cough told this Gomerblog writer, who is wearing an N95 mask for safety precautions.  “The cherry on top would be to literally cough up a lung.  I know it’s just a figure of speech, but how cool would that be?  That’s a bucket list item.”

Both Baker and his cough have declined their medical team’s suggestion for cough syrup or some lozenges.

“Are you crazy?  Cough syrup’s just going to get in the way, slow me down,” the cough responded, feeling another whopper coming on.  “Who knows if I’m ever gonna be this productive again!  Let’s ride this bad boy out!”

Distracted by his excitement for the Easter holiday, Jim Carina, Respiratory Therapist at St. Luke’s Medical Center, gave 5 Peeps via ET tube to Robert Harris, an unfortunate 74-year-old patient spending the holiday in the ICU with pneumonia.

Mr. Harris required the increased alveolar oxygen exchange that PEEP facilitated but instead got five delightful fluorescent yellow marshmallow confections known as Peeps launched into his trachea, thereby preventing the exchange of all oxygen whatsoever.

“I was enjoying my favorite Easter treat, read the order of “PEEP 5,” felt joy in my heart and one thing led to another!” explained Jim while frantically alternating between yankeuring, deep suctioning and bagging. But Jim’s efforts were futile as the tasty treats conglomerated against the trachea wall, as unmoving as the faith of believers on this Easter day.

And just as the miracle of the resurrection echoes through the hearts of those in celebration, so echoed the overhead page for “pulmonologist STAT, ICU” through hospital corridors.

Mr. Harris was saved when a bronchoscope plucked out the 5 scrumptious delights. He could not be reached for comment because he had an anoxic brain injury.

To prevent future incidents a multidisciplinary team conducted a root cause analysis that culminated in the mandate that Peeps be stored at least 8 feet from the ventilator and never more than three feet from the nurses’ break room.

At press time, clinical embryologist Neal Nate was seen carefully injecting donor sperm into a pink plastic toy egg before tenderly placing it on a petri dish in the incubator.

CHARLOTTE, NC – Local Respiratory Therapist Val Silver has seen it all in her nearly a dozen years working at UNC Hospital.  If you don’t believe her, just ask her.

That was until this past week when she overheard a third-year medical student getting pimped in the ICU.

“They were asking all kinds of questions about sodiums and potassiums and stuff, and the little whippersnapper was getting them right!  I never imagined there were things to know about medicine besides ventilators and their management.”

RT Silver continued, “I know respiration, ventilators, and everything there is to know about the lungs I’m pretty sure.  But they were talking about words that sounded made up like ‘respiratory acidosis.’ My cousin used to do acid, I should tell her it can effect her breathing!”

“I used to think all medical students did was get in the way of us veteran life savers, hell, this one is so smart he should be a doctor some day!

THE HUMAN BODY – In a stunning development that will inevitably alter the balance of power within us all, the respiratory system has successfully drafted and adopted an ordinance of secession, thereby becoming the first organ system to secede from the human body.

“We felt restricted in our ability to grow and expand, we were literally suffocating,” commented the left main bronchus, pointing out how the respiratory system is flanked on all sides by the cardiovascular, digestive, endocrine, integumentary, immune, muscular, nervous, renal, reproductive, and skeletal systems.  “I mean, look at both left lung and right lung: they’re hugely deflated.  We believe this is the only option, and we believe we can thrive again but as an independent organ system.”

Though the 10 other organ systems are shocked and saddened by the respiratory system’s departure, they have used this opportunity to reaffirm their commitment to one another and, more importantly, reach out to an old friend for help: the mechanical ventilator.

“In fact if all goes well,” the cardiovascular system optimistically told Gomerblog, “the remaining 10 organ systems hope to admit and make the mechanical ventilator the new eleventh system of the human body within the next 24 hours, maybe even sooner if a Code Blue is called overhead and we don’t have a choice.”

KEARNEY, NE – It was a close call for Kind Humanitarian Hospital’s Dr. Dan G. Ross of when his ventilated patient started to desaturate.  The brand-new intern was left alone with the critically-ill patient as the respiratory therapist went on a smoke break.

Having gotten a High Pass in third-year pulmonary physiology, Ross felt that he could handle the situation.  However, seemingly reasonable maneuvers such as increasing oxygen and respiratory rate on the vent did not solve the predicament.  More creative tactics such as increasing his own respiratory rate and breathing into a paper bag also failed, as the sats kept dropping.  Extreme measures such as crawling into a corner, suckling his thumb while questioning career choices and begging the patient to “breathe harder” were futile as the patient turned smurf-colored blue.  The glaring alarm finally got the attention of the code team who promptly reconnected the ventilator to the endotracheal (ET) tube.

“You live, you learn,” reported simultaneously shaken and relieved Ross to Gomerblog.  His most recent lessons included such revelations as Nystatin is actually not a statin, 9% saline would in fact be considered abnormal, and “Same thing as before” is not an acceptable history of present illness (HPI).  Later in the day Dr. Ross went on to learn that 40 grams of potassium chloride is in fact a lethal repletion dose for most land-based mammals and mEq should be used instead.