RESP 205 - Advanced Respiratory Care and Comprehensive Review

1. Evaluate data in the patient record
   1. Patient history (history of present illness, orders, medication reconciliation, progress notes, DNR status/advance directors, and social, family, and medical history)
   2. Physical exam relative to the cardiopulmonary system (vitals, physical findings)
   3. Lab data (CBC, electrolytes, coagulation, C&S, Sputum, cardiac biomarkers)
   4. Blood gas analysis and/or hemoximetry (co-oximetry)
   5. PFT results (spirometry, lung volumes, DLCO)
   6. Imaging studies (chest radiographs, CT, PET, V/Q, Ultrasound/Echocardiography)
   7. Maternal and perinatal/neonatal history (Apgar, gestational age, LS ratio)
   8. Trends in monitoring:
      1. Fluid balance
      2. Vital signs
      3. Ventilation liberation parameters
      4. Pulmonary compliance, airway resistance, work of breathing
   9. Cardiac evaluation/monitoring results (ECG and hemodynamic parameters)
   10. Determination of a patient’s pathophysiological state
2. Perform clinical assessment by interviewing to assess environmental exposures
3. Perform clinical assessment by inspection:
   1. General appearance
   2. Characteristics of the airway (patency, Mallampati, tracheal shift)
   3. Cough, sputum amount, and character
   4. Status of a neonate (APGAR, gestational age)
   5. Skin integrity (pressure ulcers, stoma site)
4. Perform clinical assessment by palpating
   1. Pulse, rhythm and intensity
   2. Accessory muscle activity
   3. Asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and tracheal deviation
5. Perform clinical assessment by performing diagnostic chest percussion
6. Perform clinical assessment by auscultation to assess:
   1. Breath sounds,
   2. Heart rate and rhythm
   3. Blood pressure
7. Perform clinical assessment by reviewing a chest radiograph to assess:
   1. Quality of imaging (patient position, penetration, lung inflation)
   2. Presence and position of airways, lines, and drains
   3. Presence of foreign bodies
   4. Heart size and position
   5. Changes in cardiopulmonary abnormalities (pneumothorax, pleural effusion, consolidation, pulmonary edema, pulmonary artery size)
   6. Presence or change in diaphragm, mediastinum or trachea
8. Perform procedures to gather clinical information:
   1. 12 lead ECG
   2. Mechanics of spontaneous respiration (tidal volume, minute volume, MIP, and vital capacity)
   3. Blood gas collection
   4. Blood gas analysis or hemoximetry (co-oximetry)
   5. Hemodynamic monitoring
   6. Pulmonary compliance and airway resistance
   7. Plateau pressures
   8. Spirometry inside or outside a pulmonary function laboratory
   9. Lung volumes inside of a pulmonary function laboratory
   10. Test of respiratory muscle strength (MIP, NIF)
9. Evaluate procedure results:
   1. 12 lead ECG
   2. Mechanics of spontaneous respiration (tidal volume, minute volume, MIP, and vital capacity)
   3. Blood gas analysis or hemoximetry
   4. Hemodynamic monitoring
   5. Pulmonary compliance and airway resistance
   6. Cuff management (tracheal and laryngeal cuff pressure and/or volume)
   7. Spirometry inside or outside a pulmonary function laboratory
   8. Lung volumes inside of a pulmonary function laboratory
10. Recommend diagnostic procedures:
    1. Laboratory tests (Electrolytes, CBC, coagulation studies, sputum culture, C&S, cardiac biomarkers)
    2. Imaging studies
    3. Blood gas or hemoximetry (co-oximetry)
    4. ECG
    5. Hemodynamic monitoring
11. Assemble and troubleshoot equipment
    1. Medical gas delivery interfaces (masks, cannula, heated high flow nasal cannula)
    2. CPAP/NPPV with patient interfaces
    3. Mechanical ventilators
    4. Artificial airways
    5. Blood analyzers (hemoximetry (co-oximetry), blood gas, point of care)
12. Supports oxygenation and ventilation
    1. Initiates and adjusts continuous mechanical ventilation
       1. Continuous mechanical ventilation
       2. Noninvasive ventilation
    2. Utilizes ventilator graphics (waveforms, scales)
    3. Liberates patient from mechanical ventilation
13. Ensures modification in respiratory care plan by terminating therapy based on life threatening responses
14. Ensures modification in the respiratory care plan by recommending:
    1. Starting therapy based on patient response
    2. Treatment of pneumothorax
    3. Liberating from mechanical ventilation
    4. Extubation
    5. Discontinuing therapy based on patient responses
    6. Changing patient position
    7. Changing oxygen therapy
    8. Changing humidification
    9. Changes airway clearance techniques
    10. Hyperinflation
    11. Changes mechanical ventilation parameters and settings
15. Ensure modifications are made to the care plan by recommending pharmacological interventions
    1. Bronchodilators
    2. Anti-inflammatory drugs
    3. Mucolytics
    4. Proteolytics
    5. Cardiovascular drugs,
    6. Surfactants
    7. Changes drugs, dosages, administration frequency, mode, or concentration
16. Utilize evidence-based medical principles or clinical practice guidelines in the determination of pathophysiological state, treatment of disease conditions, and recommending changes to care plan
17. Successfully complete Therapist Multiple Choice Assessment Examination with a cut score of 66%
18. Must complete Clinical Simulation Self-Assessment Examination

REMEDIATION:

All exams must be completed as scheduled. If a student fails to meet the cut score, they must review their individual exam with faculty members to determine the areas of  weakness. Students will be allowed one additional week of study, then they must re-attempt the self-assessment exam. Students are responsible for all expenses during the re-attempts. This process will be continued until the student meets the cut score for each examination.

COURSE CONTENT: Topical areas of study include -  

Selected Respiratory Care Review

• Respiratory Pharmacology
• Mechanical Ventilation
• Infection Control
• PFTs

Cardiopulmonary Pathology

Evaluations (Therapist Multiple Choice Exam, Clinical Simulation)

 
Course Addendum - Syllabus (Click to expand)