Respiratory therapy最新文献

The state of the art of oxygen delivery to ambulatory patients has evolved remarkably in the past 20 years. Oxygen is established as both safe and effective to use in selected patients with advanced chronic obstructive pulmonary disease. It has clearly been shown to extend life and to improve the quality of life in many patients. It is likely that further advances will make oxygen more suitable, acceptable, and perhaps less costly for a growing number of patients with progressive chronic respiratory diseases marked by hypoxemia and organ system damage.

Fixed-wing aircraft, helicopters, and ambulances all are part of the transport system at this regional perinatal care center, one of only two in Kansas. The neonatal transport teams are made up of respiratory therapists and registered nurses.

As the number of patients requiring chronic ventilator therapy increases, the shortage of facilities for this care becomes more and more acute. Nursing homes are unprepared to accept these patients or unwilling because of problems with reimbursement. Home care is only a limited option, but some innovative approaches at nursing homes in Illinois and Michigan may pave the way for a new health care model.

Quality control and proficiency testing are well recognized as means for evaluating equipment accuracy and technical proficiency use of spirometry in physicians' offices, clinics, and industry has brought attention to the need for standardization of calibration and testing techniques in pulmonary function testing. Minimum specifications for equipment accuracy provide the basis for consistency of interlaboratory measurements, and familiarity with operation, calibration, and maintenance procedures enhances personnel proficiency.

When a young man with terminal cancer requested return to his native country to spend the remainder of his life with family and friends, the medical team assigned to take him home learned firsthand the challenges of caring for a ventilator-dependent patient during a long international flight on a commercial aircraft.

This suburban hospital has succeeded in improving the quality of patient care while cutting costs for both personnel and equipment. The traditionally separate pulmonary, cardiac, vascular, and neurologic services have been combined into a single department. A key element in its success is the training of personnel in multiple job functions.

The scene: a small ICU in a 120-bed community hospital with no resident house staff. Emergency coverage is assigned to the emergency room physician. A patient in the ICU has cardiac arrest. His physician is called but cannot come to the hospital immediately, and the emergency room physician is attending a seriously injured patient. In the critical interim, paramedical professionals must shoulder the heavy responsibilities for decisions and interventions.

Computerization of pulmonary function testing is forcing rewrites of time-honored protocols and shifting responsibilities from technician to machine. Spirometry, in particular, has become a diagnostic test virtually free of manual measurements and calculations; computerization even provides interpretation of the results. Along with these improvements, computerized spirometry also raises questions regarding reference values, interpretive criteria, and standardization.

Successful application of computers in the pulmonary laboratory depends on many factors. The question no longer seems to be whether to have a computer but how to apply it in the most effective manner. Three main steps are involved in the application process: part 1 will examine selection of the computer and of the tasks that it must perform, and part 2 will discuss programming and validation.