Respiratory care clinics of North America
-
Respir Care Clin N Am · Sep 2004
ReviewThe "best" tidal volume for managing acute lung injury/acute respiratory distress syndrome.
An inappropriate tidal volume setting can overstretch and injure the lung. Maximal stretch, tidal stretch, frequency of stretch, and rate of stretch are all implicated in such injury. ⋯ Clinical trials have shown that limiting maximal and tidal stretch improves outcomes, even if gas exchange is partially compromised. Current strategies should focus on limiting tidal and maximal stretch as much as possible.
-
Respir Care Clin N Am · Sep 2004
ReviewEmergency airway management in orbit: an evidence-based review of possibilities.
It is likely that the first responder to a medical emergency in space will be a nonphysician. Terrestrial experience has shown that even under optimal conditions experienced clinicians can have difficulty establishing an airway. Establishing and maintaining a patent airway is essential to ensuring a successful outcome from cardiopulmonary resuscitation or respiratory failure secondary to trauma or acute illness. ⋯ For minimally trained care providers the airway will also be the first route of administration of resuscitative pharmacologic agents. It is therefore of paramount importance that the method for securing and airway permit a successful outcome when used by nonphysician crewmembers during medical emergencies in space. This article evaluates airway management in the microgravity environment and applies to both the International Space Station and the Space Shuttle, whether operating independently or docked.
-
Respir Care Clin N Am · Sep 2004
ReviewWhat is the role of high-frequency ventilation in adult respiratory distress syndrome?
The goal of positive-pressure mechanical ventilation is to provide respiratory support to a patient while allowing the underlying diseased lungs to heal. Research using both animal models and humans suggests that positive-pressure ventilation can injure the lung through both overdistension and under recruitment. ⋯ High-frequency ventilation provides such a strategy of mechanical ventilation. This article examines the utility of using high-frequency modes of mechanical ventilation in supporting the patient with ARDS.
-
Capital equipment and technology administration, as outlined in this article, is one of many responsibilities for managers of respiratory care. Planning for 1, 5, and 10 years, strategic budgeting, and systematic evaluation of existing and future devices will assist in creating a successful equipment and technology program. A successful capital equipment and technology program will enable respiratory care practitioners to treat patients effectively with the proper tools for success.
-
Respir Care Clin N Am · Jun 2004
ReviewPractitioner competency assessment and career ladders as a recruiting and retention tool.
The assessment of competency for respiratory care practitioners involves a thorough understanding of what defines competence, the development of a well-planned, continuous process that starts with new employee orientation, and a clearly communicated set of staff expectations. Career ladders are a tool that can be used to aid staff retention and recruitment, thereby reducing multiple costs associated with a high employee turnover rate, and to encourage professional development and accountability while achieving important departmental objectives.