Resp Care
-
Federal funding provides state public and private health care systems the ability to build and maintain a reserve supply of ventilators for emergency response to mass casualty incidents. Studying and planning the ventilator reserve capability requires subject-matter expertise, identification of best mechanical-ventilation practices and quality care standards, and contingency planning. ⋯ This paper discusses the pros and cons of stockpiling ventilators at one site (to be distributed as needed to disaster areas) versus increasing the number of ventilators at all hospitals. Respiratory-device corporations, respiratory professional associations, and respiratory therapists should be involved in the planning and development of respiratory mass casualty response systems.
-
Mass critical care events are increasingly likely, yet the resource challenges to augment everyday, unrestricted critical care for a surge of disaster victims are insurmountable for nearly all communities. In light of these limitations, an expert panel defined a circumscribed set of key critical care interventions that they believed could be offered to many additional people and yet would also continue to offer substantial life-sustaining benefits for nonmoribund critically ill and injured people. ⋯ Nonetheless, Emergency Mass Critical Care currently remains the only comprehensive construct for mass critical care preparedness and response. This paper reviews current concepts to provide life-sustaining care for hundreds or thousands of people outside of traditional critical care sites.
-
Multicenter Study
Attitudes of respiratory therapists and nurses about measures to prevent ventilator-associated pneumonia: a multicenter, cross-sectional survey study.
To understand the reported practices of and adherence to evidence-based guidelines for the prevention of ventilator-associated pneumonia (VAP) among respiratory therapists (RTs) and registered nurses (RNs) in academic and nonacademic intensive care units. ⋯ Consumers, the Centers for Disease Control and Prevention, and other organizations are currently trying to implement mandatory reporting of hospital infections, including VAP rate. Without a definition of VAP suited to individual institutions, an organized data-collection and reporting method, and team-based approaches to preventing and treating VAP, hospitals may not be able to meet these requests and track improvement efforts. Prevention measures need to be translated to bedside practice to improve the outcomes of critically ill patients.