Blogs

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I have a question for the Sleep Community: I am investigating the possibility of performing IV channel HST in skilled nursing facilities on Medicare/Caid patients who have OHS/OSA & have been ordered for NIPPV. These patients have never had a PSGT before (or if they did, it was several years ago). They cannot go to a sleep center because of their morbid obesity. Quite a few of them have BMIs well over 45. Would CPT 95800 or HCPCS G0400 be billed as part of a RUG bundle while the patient is in the SNF or can it be billed under Part B? Has anyone had any experience with this population in SNFs who may be able to advise me? I posted this question to the Coding ...
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Pharmacies can now label in-hospital medications on admission for home dispensing at discharge, so patients with chronic respiratory conditions can take home the multi-dose canisters that they paid for. I found a website that walks facilities through the process of being licensed to dispense these medications and the paperwork and equipment needed to institute the procedure to get rid of this type of medication waste. It will save the patient, insurance companies, and the US government thousands of dollars per year, by eliminating the need for patients to repurchase medications that could have been dispensed by the hospital. Patients can continue on their current ...
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The latest installment of COPD Navigator LIVE, in which I discuss a recent expert panel consensus statement from Spain concerning overused (as well as overlooked) 'standards' of care in the COPD world.  Plus, the latest COPD news and questions from the COPD community! Join me every Friday at noon Eastern for new installments, featuring the latest COPD news, discussion of topics impacting the community, and community questions answered LIVE!  http://www.facebook.com/copdnavigato
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Does anyone know of any standards regarding giving nebulizer treatments while a patient are on high flow oxygen. I would think someone at 60 l/m would not get any medication with a mouth piece nebulizer. I also have staff putting the treatment inline which you would think the medication gets diluted to nothing. Any ideas, literature or is there any gold standards? Thanks
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The latest installment of COPD Navigator LIVE, in which I discuss the use of action plans (sometimes called rapid response plans) to quickly react to early warning signs of exacerbations.  Plus, the latest COPD news and questions from the COPD community! Join me every Friday at noon Eastern for new e
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So in the future our ventilator data will automatically go into the EMR. What then becomes of the old "ventilator check" model that should be a patient assessment and check anyway. What role will the RT play now that they don't have to document numbers into a computer entry? I have lots of ideas and was wondering if anyone is already in this boat.
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About a year ago, I started doing weekly Facebook Live programs for the COPD information and support group I run on that platform (called COPD Navigator,   https://www.facebook.com/groups/copdnavigator).   Over the course of the year, the program has evolved from basic Q-and-A to a segmented program with recent news updates, a half-hour educational session, and wrapping up with the traditional live question and answer period.  I then do a little editing and upload an 'archive' version to YouTube.  Over the past few months, technical issues have prevented me from adding to the archive, but things seem to be ironed out, and I have relaunched the series. Please ...
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Hello:) I was recently hired at a surgical hospital to help develop their respiratory care department and was wondering if there were other RTs that work strictly at a surgical center and/or hospital. If so, please reach out to me! I would love to connect & share ideas!!
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​Has anyone conducted studies to establish best practice regarding weaning neonatal setting during NIPPV? We are looking to establish some standards using assessment, day of life, gestational age etc. I'm hoping someone has conducted some trials and initial work in this regard. Thanks
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Retaining RT's

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How are you ensuring that your departments are fully staffed? Do you float RT's through multiple facilities? How are you ensuring that your students are staying with your organization upon completion of school? ​
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Why Ask Why?

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Originally published January 5, 2018 on LinkedIn .  Follow me there! "There are no right answers to wrong questions."    - Ursula K. Le Guin We respiratory therapists are a stubborn bunch. That often helps us provide excellent care, in the face of a system that doesn't always understand what we do or the value we provide. But almost as often, that same bull-headedness blindfolds us to answers that should be fairly obvious. This week (as in most weeks), the   question of professional membership   arose in the respiratory Facebook world. The usual suspects came forth with the usual arguments for and the usual arguments against. If there was ever ...
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​Does anyone have any experience with managing a SNF that takes trach's and Vents?  With hospitals starting to overflow beyond IP capacity on an almost daily basis hospitals are now looking to SNF's to take patients with trach's and vents. I would love to talk to someone else who is experienced with managing a SNF RT department.  The idea that nursing and RT will share "tasks" is a very difficult way to staff,  and when there are callouts- the RT's are expected to absorb all the RT related work, which is difficult to achieve.  There is reluctance in wanting to staff 2 RT's 24/7, however nursing call outs & vacancies appear to be up and down. In my mind ...
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​We have started an initiative to identify patients most at risk for developing refractory hypoxemia and VILI. The following patient types are who we target: Obesity hypoventilation syndrome Pneumonia Fluid overload Bilateral atelectasis Impending / actual ARDS High FIO2 demand (>.5) PEEP requirements >8cmh2O Once we identify these patients, we perform optimal peep studies using an incremental peep titration and monitoring SpO2, BP, drive pressure We perform these once a shift. By doing this, we are hoping to not only decrease our probability of VILI, but our incidences of VACs as well. Is anyone out there doing anything like this?
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​Just curious if your departments hold a policy on the cleaning of RT equipment? If so, what do they entail? Thanks
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Have a great week celebrating!!!
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sputum bowl

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So happy to announce, My team and I won the Sputum Bowl in our NJ Shore Conference last Thursday! Thank God.
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The Oklahoma Society is looking for motivated individuals who are interested in being involved with our board for the 2018 year. If you are interested in getting involved, please contact me. Also please if you haven't already, follow our page Oklahoma Society for Respiratory Care on Facebook and checkout the website at www.oksrc.org
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What do you guys think? Is it wise to inform the patient not to tap the nebulizer reservoir after it sputters? Can it put the patient at risk for possible reinfection especially for patients with chronic lung disease? Please include reference to support answer. Than you for everyone's input.
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Could anyone share how they integrated RRT into ER staff, In stand alone ER?
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Hi friends. I have a situation on my hands that turns out to be a whole lot larger than originally perceived. I could really use help as I am at a loss here.... As a clinical specialist, part of what my role entails is to identify needs within a hospital and RT dept, and find solutions that work well with all. Level 1 trauma and NICU, Peds and adult CF center, huge hospital--I have discovered a hospital RT dept in a state like I've never seen before. I was in a meeting with an RT supervisor and a veteran RT to discuss the details surrounding secondhand info that they had been sharing equipment between CF kids, specifically our vest therapy device. The meeting ...
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