Respiratory care
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In 1993, the New York State (NYS) legislature and governor signed into law the Respiratory Therapy Guide to Practice Education Law to guide and regulate the profession of respiratory care under the auspices of the New York State Education Department. New guidelines were implemented by the New York State Education Department for respiratory therapists (RTs) in 2010 to provide the opportunity for RTs to receive continuing education units (CEUs) when participating as clinical preceptors. This study was conducted in June 2012 to determine the extent to which the NYS RTs are aware of the new licensing guidelines and amendments. ⋯ The findings indicate that more education is needed in NYS to make licensed RTs aware of the 2010 guidelines. Practitioners may require incentives to become actively involved in the clinical education of respiratory care students as their clinical preceptors.
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Tracheostomy wounds are commonly encountered in children but rarely reported. Relatively few treatments are available or have been investigated to manage this problem. Healing times for pediatric tracheostomy wounds are often unpredictable and protracted. Recent use of maltodextrin gel (MD) and a silver alginate sponge (AG) at our institution has demonstrated expedited healing and interest in this novel treatment for tracheostomy wounds. ⋯ Postoperative tracheostomy wounds are common. The use of MD and AG provides an effective and safe treatment for tracheostomy-related ulcers.
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Randomized Controlled Trial Comparative Study
Open-Mouthpiece Ventilation Versus Nasal Mask Ventilation in Subjects With COPD Exacerbation and Mild to Moderate Acidosis: A Randomized Trial.
Open mouthpiece ventilation is efficacious in patients with neuromuscular disease. We used this ventilation technique in patients with exacerbations of COPD with mild to moderate acidosis. ⋯ Open mouthpiece ventilation is a useful technique and may prevent further deterioration of gas exchange in COPD patients with mild to moderate acidosis (similar to traditional NIV delivered by a nasal mask). www.chictr.org registration ChiCTR-TRC-12002672.
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Observational Study
Spirometric Standards and Patient Characteristics: An Exploratory Study of Factors Affecting Fulfillment in Routine Clinical Practice.
Spirometry is an apparently simple test, yet the recommended criteria for acceptability and reproducibility can be difficult to fulfill. This study aimed (1) to prospectively assess the number of tests that meet the American Thoracic Society/European Respiratory Society (ATS/ERS) 2005 acceptability and repeatability criteria in the routine practice of an experienced technician at a referral hospital's lung function laboratory, (2) to identify the most common errors, and (3) to explore patient characteristics possibly associated with failure to meet standards. ⋯ Nearly 15% of the subjects failed to fulfill all the ATS/ERS 2005 criteria for spirometry performed even though they were coached by a qualified and regularly trained technician in a hospital lung function laboratory. The fact that the ATS/ERS 2005 criteria cannot be met by all patients in optimal technical conditions should be further considered and explored.