Resp Care
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Eight adult manual resuscitators were compared with regard to weight, dimensions, number of parts, possibility of misassembly, durability, self-reinflation time, average stroke volume with male and female operators using one hand and two hands, maximum cycling rate at room temperature and low temperature, delivered oxygen concentration, per cent demand ventilation, and ease of use. Of the devices tested, the Robertshaw and the Hudson Lifesaver had design problems in the oxygen delivery system, reducing the effective cycling rates. ⋯ The Puritan PMR delivered low oxygen concentrations and its valve required a screwdriver for disassembly and cleaning: a possible misassembly hazard was also noted. The Air-Shields Ambu Mark II, the Laerdal II, and the Penlon units rated high with respect to the tested variables, with the Penlon and Laerdal II devices achieving oxygen concentrations greater than 95%.
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Increasing demands by society in the United States for better, more efficient, and readily available health care have led to development of numerous categories of health practitioners. After a decade of vigorous growth, the emergence of new kinds of specialized health personnel raises questions of legal authority and quality of care. The multiplicity of health care professions often results in duplication of effort, fragmentation of services, and overlapping of job responsibilities, which contribute to ineffective regulation of health care personnel. ⋯ Respect for professionalism has diminished in the public eye as consumers are questioning whether the elaborate, multiple, and costly mechanisms of current credentialing really protect society. Three types of credentialing currently in use are accreditation of institutions and educational programs, licensure of practitioners, and certification or registration of practitioners. These mechanisms of credentialing are not adequately assuring the competency of health practitioners; therefore, proposed alternatives such as institutional licensure, administrative regulation, national certification, and proficiency examinations should be explored.
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The Suggested Guidelines for Respiratory Therapy Home Care that are published here are just that--suggested guidelines. This document is the fourth draft on the topic as prepared by the Professional Standards Committee of the American Association for Respiratory Therapy. ⋯ Even then the final document must be approved by the AART's Board of Directors, Board of Medical Advisors, and House of Delegates. Comments on these suggested guidelines, and suggestions for changes or additions to them, should be mailed to George A West RRT, Respiratory Care Department, COX-3, Massachusetts General Hospital, Boston MA 02114.