RESP 209 - Advanced Clinical Applications in Critical Care and Specialty Rotations

1. Retain knowledge, skills, and competency from pre-requisite courses.
2. Evaluate Data in the patient record:
   1. Lines, drains and airways (chest tube, vascular lines, artificial airways)
   2. Laboratory results (CBC, electrolyte, coagulation studies,Sputum C & S, cardiac biomarkers)
   3. PFT results (spirometry, lung volumes, DLCO)
   4. 6 minute walk test results
   5. Imaging studies (chest radiographs, CT, PET, V/Q, Ultrasound/Echocardiography)
   6. Maternal and perinatal/neonatal history (Apgar, gestational age, LS ratio)
   7. Sleep study results (AHI)
   8. Trends in monitoring results:
      1. Fluid balance
      2. Intracranial pressure monitoring
      3. Noninvasive (pulse-oximetry, capnography, TCM)
      4. Cardiac evaluation/monitoring results (hemodynamic parameters, ECG)
3. Perform clinical assessment by interviewing
   1. Activities of daily living
   2. Learning needs (literacy, learning styles, culture)
4. Perform clinical assessment by inspection
   1. Status of a neonate (apgar score, gestational age)
5. Perform clinical assessment by reviewing chest radiography
   1. presence of foreign bodies
   2. presence or change in Cardiopulmonary abnormalities (pneumothorax, pleural effusion, consolidation, pulmonary edema, pulmonary artery size)
6. Perform Procedure to Obtain Gather information
   1. Noninvasive (pulse oximetry, capnography, TCM)
   2. Peak flow
   3. Oxygen titration with exercise
   4. Cardiopulmonary calculations (PA-aO2, Vd/VtP/F, OI)
   5. Hemodynamic monitoring
   6. Apnea monitoring
   7. Apnea test (brain death determination)
   8. CPAP/NPPV titration during sleep
   9. Cardiopulmonary stress testing
   10. 6 minute walk test
   11. Spirometry outside or inside of a pulmonary function laboratory
   12. Lung volumes inside a pulmonary function laboratory
7. Evaluate procedure results
   1. Noninvasive monitoring (pulse oximetry, capnography,TCM)
   2. Peak flow
   3. Oxygen titration with exercise
   4. Cardiopulmonary calculations (PA-aO2, Vd/Vt, P/F, OI)
   5. Hemodynamic monitoring
   6. Apnea monitoring
   7. Apnea test (brain death determination)
   8. Overnight pulse oximetry
   9. CPAP/NPPV titration during sleep
   10. Cardiopulmonary stress testing
   11. 6 minute walk test
   12. Spirometry outside or inside a pulmonary function laboratory
   13. Lung volumes inside a pulmonary function laboratory
8. Recommend diagnostic procedures
   1. Bronchoscopy (Therapeutic and Diagnostic)
   2. Bronchoalveolar lavage (BAL)
   3. Pulmonary function testing
   4. Noninvasive monitoring with (pulse oximetry, capnography,TCM)
   5. Exhaled gas analysis (CO, NO (FeNO))
   6. Hemodynamic monitoring
   7. Sleep studies
   8. Thoracentesis
9. Assemble and Troubleshoot equipment
   1. Medical gas delivery, metering, and/or clinical analyzing devices (concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzer)
   2. Heliox delivery device
   3. Nitric oxide delivery device
   4. Spirometers (portable)
   5. Pleural drainage
   6. Noninvasive monitoring devices (pulse oximetry, capnography, TCM)
   7. Bronchoscopes and light sources
   8. Hemodynamic monitoring devices
      1. Pressure transducer
      2. Catheters (arterial, pulmonary artery)
   9. Long term oxygen therapy
10. Perform quality control procedures
    1. Pulmonary function equipment for testing
       1. Spirometry results
       2. Lung volumes
       3. Diffusion capacity
    2. Noninvasive monitors
11. Maintain a patent airway such as laryngectomy tube and speaking valves
12. Support Oxygenation and Ventilation
    1. Initiating and adjusting high frequency ventilation
    2. Perform lung recruitment maneuvers
13. Administer specialty gases (heliox, NO)
14. Ensure modifications are made to the respiratory care plan
    1. Terminates treatment based on life threatening and adverse event
    2. Recommends
       1. Starting treatment based on patient response
       2. Treatment of pneumothorax
       3. Adjustment of fluid balance
       4. Consultation from a physician specialist
15. Ensure modifications are made to pharmacological interventions
    1. Pulmonary vasodilators
    2. Cardiovascular drugs
    3. Antimicrobials
    4. Sedatives/hypnotics
    5. Analgesics
    6. Narcotic antagonist
    7. Benzodiazepine antagonist
    8. Neuromuscular agents
    9. Diuretics
    10. Surfactants
16. Provides respiratory care in high risk situations
    1. Cardiopulmonary emergencies excluding CPR
    2. Disaster management
    3. Land/air patient transports between hospitals
17. Assist a physician/provider in performing:
    1. Bronchoscopy (therapeutic, diagnostic)
    2. Thoracentesis
    3. Tracheotomy
    4. Chest tube insertion
    5. Insertion of venous or arterial catheters
    6. Moderate (conscious) sedation
    7. Cardioversion
18. Initiate and conduct patient and family education
    1. Safety and infection control
    2. Home care and related equipment
    3. Life style changes (smoking cessation, exercise)
    4. Pulmonary rehabilitation
    5. Disease/condition management (Asthma, COPD, CF, Tracheostomy Care, Ventilator Dependent)

• Advanced cardiopulmonary diagnostic techniques
• Invasive monitoring of the cardiopulmonary system
• Noninvasive monitoring of the cardiopulmonary system
• Quality control procedures
• Adult critical care
• Pediatric critical care
• Neonatal critical care
• Alternative care sites
• Assisting physician with special procedures
• Patient and family education

Procedures:

• Newborn Assessment/Resuscitation (Basic Airway Care - Bulb Suctioning)
• Pediatric Assessment
• Pediatric and Neonatal Mechanical Ventilator Rounds
• Spirometry
• Cleaning and Disinfection
• Regionally determined
  TOTAL PROCEDURES: varies with the campus

 
Course Addendum - Syllabus (Click to expand)