RESP 108 - Clinical Applications in Advanced Assessment and Care of a Cardiopulmonary Patient

1. Retain knowledge, skill and competencies from prerequisites courses.
2. Recall and review policies and procedures for the hospital and Respiratory Care Department
3. Evaluate data in the patient record
   1. Monitor trends (non-invasive capnography)
4. Perform clinical assessment by interviewing to evaluate:
   1. Smoking history
   2. Environmental exposures
   3. Activities of daily living
5. Perform clinical assessment by inspection to assess skin integrity (pressure ulcer, stoma site).
6. Perform procedures to gather clinical information
   1. 12 lead ECG
   2. Non-invasive monitoring (capnography)
   3. Blood gas sample collection and analysis and/or hemoximetry (co-oximetry)
   4. Pulmonary Mechanics (VE, VT, NIF, VC, MEP)
7. Evaluate procedures results
   1. Non-invasive procedures (capnography)
8. Recommend Diagnostic Procedures
   1. Non-invasive monitoring (capnography)
9. Assemble and troubleshoot equipment
   1. Secretion clearance devices (HFCWO, vibratory PEP, IPV, insufflation/exsufflation devices)
   2. Patient breathing circuits (CPAP/BiPAP)
10. Perform airway clearance and lung expansion techniques
    1. Postural drainage, percussion or vibration
    2. Mechanical devices HFCWO, vibratory PEP, IPV, insufflation/exsufflation devices)
    3. Hyperinflation techniques (PEP, PAP)
11. Supports oxygenation and ventilation by initiating and adjusting mask or nasal CPAP and noninvasive ventilation
12. Ensures modifications are made to modalities (e.g., hyperinflation, airway clearance) included in the respiratory care plan by:
    1. Treatment termination for life threatening adverse events
    2. Recommending initiation of treatment based on patient response
    3. Discontinues treatment based on patient response
13. Utilizes evidence based medicine principles
    1. Classification of disease severity
    2. Recommendations for changes in therapeutic plan when indicated
14. Maintain records specifying therapy administered, date, time, frequency of therapy, medication, and vital signs (paper or electronic charting)
15. Provide respiratory care in high risk situations
    1. Medical emergency team (MET)/rapid response team
    2. Patient transport within a hospital
16. Conduct patient and family education
    1. Safety and infection control
    2. Home care and related equipment
    3. Lifestyle changes (e.g. smoking cessation, exercise)
    4. Disease management

Hospital policies and procedures / hospital orientation

Electrocardiograms

Capnography

Airway clearance devices (e.g., vibratory PEP/Flutter, Acapella, TheraPEP, etc…)

Hyperinflation (EzPAP, AccuPAP, CPAP)

Directed cough techniques

Chest physiotherapy

HFCWO

Arterial blood gas punctures and analysis

Within a hospital patient transport

Medical emergency team (MET)/Rapid Response Team

Case studies with care plans

Evaluations

Procedures:

1. 12 Lead EKG
2. Arterial Blood Gas Puncture
3. Hyperinflation (EzPAP, CPAP)
4. Bronchial Hygiene (CPT, Vibratory Pep)
5. Directed Cough Technique
6. Capnography (noninvasive)
7. Tracheostomy Change
8. Noninvasive Ventilation Initiation
9. Noninvasive Ventilation Round
10. Pulmonary Mechanics (VE, VT, NIF, VC, MEP)
    TOTAL PROCEDURES: 10