This is a picture of me during my MNT rotation at Lehigh Valley Hospital helping out at our National Nutrition Month table in March. Hi! My name is Cassie Lacko and I am a Sodexo Dietetic Intern at the Allentown campus. I am in the middle of my concentration rotation, MNT, which I am completing at Lehigh Valley Hospital in Allentown, PA. This is where I have completed all of my clinical rotations as well, and I am excited to spend more time here as it is a Level 1 trauma center with a Pediatric hospital, Burn Center and multiple ICUs, so I have had some really great opportunities and learning experiences while interning here. I have come to really enjoy working in the inpatient setting of the field of Dietetics, and have formed an interest in nutrition support and working in an ICU setting. I constantly feel challenged while interning with the many RDs with their Certified Nutrition Support Clinician (CNSC) credential, but I have learned so much from them and am really appreciative of everything they have taught or shown me. While interning with the Burn Dietitian in the Burn Center, I had the opportunity to watch a metabolic cart, or indirect calorimetry, be performed on a patient. This patient was very overweight, had multiple amputations, and many burns/wounds. The Registered Dietitian and I had previously worked together and used predictive equations to estimate this patient’s calorie needs and tube feed regimen, but we felt that a metabolic cart would be useful in order to confirm if the patient is getting the proper nutrition they need to heal their burns. I got to help the Respiratory Therapist perform the metabolic cart, which was a very cool experience! The metabolic cart measures the exchange of oxygen and carbon dioxide, and in the end it gives a number of calories the patient needs per day based on this exchange. It also gives a Respiratory Quotient, RQ, which should be between 0.8 and 1. An RQ below 0.8 means the patient is being underfed, and an RQ above 1 means the patient may be being overfed. At the end of this metabolic cart test, this patient’s RQ was 0.92, and their calorie needs were almost exactly what we estimated! It was so rewarding to see our collaborative knowledge of energy needs estimation pay off, and it is also nice to know that this patient is getting the proper nutrition they need for their burns to heal. I am very grateful for this experience, and I am looking forward to what the rest of my MNT rotation brings!
