Respiratory care clinics of North America
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Respiratory mucosal and lung structures and functions may be severely impaired in mechanically ventilated patients when delivered gases are not adequately conditioned. Although under- and over-humidification of respiratory gases have not been defined clearly, a safe range of temperature and humidity may be suggested. During mechanical ventilation, gas entering the trachea should reach at least physiologic conditions (32 degrees C-34 degrees C and 100%relative humidity) to keep the ISB at its normal location. ⋯ Full saturation of inspiratory gases is likely when water condensation is observed in the flex tube [91,92]. Nevertheless, no clinical parameter is accurate enough to detect all the effects of inadequate conditioning [45]. When mechanical ventilation is extended beyond several days, adequate conditioning of respiratory gases becomes increasingly crucial to prevent retention of secretions and to maximize mucociliary function; a requirement that respiratory gases reach at least physiologic conditions is appropriate.
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Respir Care Clin N Am · Mar 2006
Sleep medicine management: clinic-based, laboratory testing, and durable medical equipment.
The patient who is suffering from a sleep disorder is seeking help for one of the basic necessities of life: a good night's sleep. For all those who have developed a problem in sleeping, whether it is physiologic or psychologic, the sleep medicine profession can be literally a lifesaver.
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Wakefulness, NREM sleep, and REM sleep are three distinct states of existence. Each state has characteristic behavioral and physiologic patterns,and each has specific neurophysiologic mechanisms associated with its generation and control. Structures in the brainstem use various neurotransmitters to influence higher brain structures in the midbrain and cortex. ⋯ Further progression into the deepest sleep stages 3 and 4 is defined by the occurrence of high-amplitude, low-frequency EEG activity. The progression of sleep stages occurs in cycles of 60 to 120 minutes throughout the sleep period. Various circadian environmental and ontologic factors affect the pattern of sleep stage occurrence.
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The capacity to perform critical thinking in respiratory care may be enhanced through awareness and education to improve skills, abilities, and opportunities. The essential skills for critical thinking in respiratory care include prioritizing, anticipating, troubleshooting, communicating, negotiating, decision making, and reflecting. In addition to these skills, critical thinkers exhibit certain characteristics such as critical evaluation, judgment,insight, motivation, and lifelong learning. ⋯ Web-based curriculum and technologic advances have created opportunities such as bulletin boards, real-time chats, and interactive media tools that can incorporate critical thinking. Many concerns and controversies surround the assessment of critical thinking, and individuals who administer critical thinking tests must be aware of the strengths and limitations of these assessment tools, as well as their relevance to the workplace. The foundational works reported in this article summarize the current status of assessment of critical thinking and can stimulate further investigation and application of the skills, characteristics, educational strategies, and measurement of critical thinking in respiratory care.
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Respir Care Clin N Am · Sep 2005
ReviewAssociate in science degree education programs: organization, structure, and curriculum.
After years of discussion, debate, and study, the respiratory care curriculum has evolved to a minimum of an associate degree for entry into practice. Although programs are at liberty to offer the entry-level or advanced level associate degree, most are at the advanced level. The most popular site for sponsorship of the associate degree in respiratory care is the community college. ⋯ The value of associate degree education at the community college level is well established. It is affordable, accessible, and responsive to the local health care industry it serves. It is likely to enjoy acceptance and popularity until its curricular limitations and time constraints no longer allow it to meet the needs of the respiratory care profession.