Resp Care
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Cardiopulmonary resuscitation (CPR) training programs exist to enhance knowledge and skills retention. However, they do not ensure that effective CPR will be performed by trainees or resuscitation teams. One aspect of CPR effectiveness is the ability of the team to respond to an emergency call in a timely manner. ⋯ We believe that BLS education for hospital employees should include and emphasize oxygen delivery for resuscitation.
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The effectiveness of collaborative self-management of respiratory disorders has been most clearly demonstrated in asthma. In both adults and children with severe asthma requiring emergency care and hospitalizations, collaborative self-management can decrease not only the need for emergency care and hospitalization but also time lost from work and school, thereby increasing the patients' ability to be full and active participants in the community. Collaborative self-management is best provided in a comprehensive program that includes ready access to healthcare professionals, education, behavioral therapy, and peak-flow monitoring. ⋯ Even if medical investigations had not demonstrated any beneficial effects of collaborative self-management, patients have the right to participate in decisions affecting their healthcare and are increasingly exercising that right. Respiratory care practitioners are in a unique position to enhance collaborative self-management. In the home environment, RCPs can foster smoking cessation and serve as a liaison between patients and physicians.(ABSTRACT TRUNCATED AT 400 WORDS)
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Review Comparative Study
Center-based vs patient-based diagnosis and therapy of sleep-related respiratory disorders and the role of the respiratory care practitioner.
Unlike center-based laboratories that follow prescribed technical standards, patient-based studies lack technical standardization. Whereas center-based studies are usually performed by technicians who have met certain professional criteria, patient-based studies can be performed by anyone, even those without clinical training. Although guidelines are currently being developed to direct the use of unattended monitoring in the home, a need exists for specific guidelines that delineate professional qualifications for those who initiate and titrate therapy for patients with sleep-related respiratory disorders. ⋯ A need exists for multicenter, peer-reviewed, controlled studies to establish standard recording variables and machine specifications for unattended monitoring devices. Also, the role and cost-benefit ratio of unattended monitoring in healthcare delivery need to be defined. Therefore, with the demand for technology-oriented research, clinical outcome studies, and professional standards, more respiratory care practitioners have the opportunity to expand their practice into the field of sleep medicine.
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Review Comparative Study
Novel strategies for delivering oxygen: reservoir cannula, demand flow, and transtracheal oxygen administration.
Oxygen-conserving devices can decrease costs because less oxygen is used. However, they may also add costs due to the more complex equipment involved (ie, device and catheter replacement). Oxygen is relatively expensive. ⋯ By promoting mobility and improving adherence to continuous oxygen therapy, oxygen-conserving systems may increase the amount of oxygen used, thus offsetting savings. It is shortsighted to focus only on reducing the costs of oxygen administration. Attention also needs to be directed to patient outcomes such as functional status, use of healthcare services, and quality of life.