RESP 201 - Advanced Concepts in Cardiopulmonary Diagnostic Procedures

1. Evaluate data in the patient record
   1. Physical exam to the cardiopulmonary system (heart tones)
   2. Lines, drains, and airways (chest tube, vascular lines, artificial airways)
   3. Laboratory results (CBC, electrolytes, coagulation studies, Sputum C&S, cardiac biomarkers)
   4. PFT (spirometry, lung volumes, DLCO)
   5. Imaging study results (chest radiography, CT scan, ultrasonography and/or echocardiography, PET scan, ventilation/perfusion scan)
   6. Sleep study results (AHI)
   7. Trends and monitoring
      1. Fluid balance
      2. ICP monitoring (pathologies related to ICP)
      3. Pulmonary mechanics (compliance, resistance, work of breathing)
      4. Cardiac evaluation/monitoring results (ECG, hemodynamic parameters)
2. Perform clinical assessment to assess for level of consciousness and orientation, emotional state, and ability to cooperate( Glasgow, calculate CPP)
3. Perform procedures including review of indications, contraindications, and hazards to gather clinical information
   1. Hemodynamic monitoring
      1. PAaO2, CavO2, Qs/Qt, CI, QT, PVR, SVR
   2. Pulmonary compliance and airway resistance
   3. Overnight oximetry
   4. CPAP/NPPV titration during sleep
   5. Cardiopulmonary stress testing
   6. Lung volumes and DLCO inside a PFT lab
   7. Therapeutic bronchoscopy
4. Evaluate procedure results
   1. 12 Lead ECG
   2. Hemodynamic monitoring and calculations (PAaO2, CavO2, Qs/Qt, CI, QT, PVR, SVR)
   3. Pulmonary compliance and airway resistance
   4. Overnight pulse oximetry
   5. CPAP/NPPV titration during sleep
   6. Cardiopulmonary stress test including metabolic study (e.g., 02 consumption/CO2 production, RQ, Energy expenditure) results in a patient’s record
   7. Spirometry outside or inside a pulmonary function laboratory including bronchoprovocation
   8. Lung volumes and DLCO inside a PFT lab
5. Recommend diagnostic procedures
   1. Laboratory tests (CBC, electrolytes, coagulation studies, sputum C&S, cardiac biomarkers)
   2. Imaging studies
   3. Diagnostic and therapeutic bronchoscopy
   4. Bronchoalveolar lavage (BAL)
   5. Pulmonary function testing including bronchoprovocation
   6. ECG
   7. Exhaled gas analysis (CO, and NO (FeNO))
   8. Hemodynamic monitoring
   9. Sleep studies
   10. Thoracentesis
6. Troubleshooting and quality control of devices to assemble/troubleshoot equipment
   1. Blood analyzers (hemoximetry (co-oximetry), blood gas, point of care)
   2. Testing equipment in pulmonary function laboratory
   3. Pleural drainage
   4. Noninvasive monitoring devices (pulse oximeter, capnometer, transcutaneous)
   5. Bronchoscopes and light sources
   6. Pressure transducers
   7. Catheters (arterial, pulmonary artery)
7. Perform quality control procedures
   1. Blood analyzers
   2. Gas analyzers
   3. Pulmonary function equipment for testing
      1. Spirometry results
      2. Lung volumes
      3. DLCO
8. Ensure modifications are made to the respiratory care plan
   1. Recommendations for
      1. Treatment of pneumothorax
      2. Adjustment of fluid balance
      3. Adjustment of electrolyte therapy
      4. Consultation from a physician specialist
      5. Changes in patient position
      6. Mechanical and Noninvasive ventilation
9. Provide respiratory care in high risk situations in a cardiopulmonary emergency excluding CPR
10. Assist a physician/provider in performing procedures
    1. Bronchoscopy
    2. Specialized bronchoscopy (endobronchial ultrasound (EBUS), navigational bronchoscopy (ENB)) including biopsies
    3. Thoracentesis
    4. Chest tube insertion
    5. Insertion of arterial or venous catheters
    6. Moderate (conscious) sedation

Radiology (CT, V/Q, Pulmonary Angiogram, Ultrasound/Echocardiography)

Bronchoscopy

PFT

Quality Control, Quality Assurance (ABG, CO2, CO, FeNo)

Cardiovascular studies (Heart sounds, Echocardiogram, Stress Tests, and EKG)

Hemodynamics (Arterial, Pulmonary Catheters, perform calculations, interpret results, troubleshoot)

Polysomnography (NPPV titration, pulse oximeter, medications)

Arterial/Central lines

Intracranial Pressure Monitoring

Laboratory Studies

Evaluations
Course Addendum - Syllabus (Click to expand)