Blogs

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I have been doing PFTs since 1987.  I have always given the bronchodilators via MDI and valve holding chamber.  My current hospital is trying to switch to hand held nebulizer to deliver the bronchodilator.  AARC says the mulitpatient use MDIs are not an infection control issue when used with a valve holding chamber.  Our hospital pharmacy states that this has never been an issue either.  My department uses multi patient use MDIs on all in patients, but want to change for OP PFTs.  Does anyone have any ideas on this subject?  Any opinions or policies that I can use?  I need help.Thank you! Barb Hutchison RRT, AE-C   Charleston, SC
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What are people using for charting for Cardiopulmonary Rehab?  Are you using current electronic charting systems and making forms, and updating your self, or have you purchased a cardiopulmonary rehab specific charting system like scottcare, lsi, etc. if you can please provide me with feedback and also give me the size of your hospital, and how many rehab patients you see in a year, that would be greatly appreciated
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Hi All. My name is Joseph Bernardino and I am the Respiratory Care Manager at Marin General Hospital. We just had The Joint Commission Surveyors here, and i just wanted to inform the respiratory community as to what they focused on. The surveying is now 5 days longs as opposed to 3 days. There were three surveyors, one nurse, one M.D. and one biomedical engineer with extensive history  and experience. All three were kind, bright and knew what they were looking for. I sat with a surveyor for an hour and a half going through patient's charting that were on ventilators. She wanted to make sure that the orders correlated with the charting especially when there were ...
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Heated face tents??

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What are your thoughts on heated face tents? Do we still do heated face tents at other facilities?
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​Does anyone have a protocol or have a link to a study regarding protection for NIV masks or other respiratory devices and which products are best?
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I work in pulmonary rehab and have a pt. with PAP and follicular bronchiolitis. My pt. is on 5 liters of pulsed dosed oxygen, sats are normally 96-97%.  My question is she feels sob with her diagnosis but her sats don't present that she needs that much o2.  Is she wearable or because of her diagnosis needs it no matter what the sats are?  I have been trying to google about her diseases but not getting very far.  Any help would be greatly appreciated!! Background on her...43 y/p, never smoked, African American, has not had the lavage done but is hoping to. thanks! Kim Kim Brunner RR
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Shared Governance

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Hello everyone, ​I was wondering if anyone has shared governance for your departments?  I'm looking to start a unit council/shared governance, and I would like some more information on how unit councils work at your facility.  How do you maintain the success of the council over time?  Thank you, Janelle
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Ventilator Protocol

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Would anyone be willing to share their ventilator protocol. We currently have a protocol for ventilator weaning but not for ventilator management based on ABG results. Any help is greatly appreciated. Thank You, Audra Miville, RRT Supervisor of Respiratory Care MaineGeneral Medical Center Augusta, M
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Recently I had an inservice on a small Belt clip size Ventilator for COPD patient . I thought it was a great device upon dwelling into discussion of the Ventilator with the Vendor. I learned that the claims made on the literature and by the Vendor MC were absolutely bogus. The guy fell flat on his face with my question about. How can you measure the return VT from the Ventilator that you claimed is upto 1200ml. He took me into circles to dodge the question but could not shake off the questions. He finally answered you cannot measure the returned VT from the patient on this little Ventilator.  My question is if you cannot measure the return VT or pressure or any ...
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Ask any respiratory therapist retired or currently practicing:  Which respiratory drug is ordered as a cure all for many ailments? Without any hesitation every respiratory therapist will blurt out the word… ALBUTEROL.    If they do not blurt out the word Albuterol, one must question if they are really a respiratory therapist.   We all have stories of receiving orders to administer Albuterol for some very bizarre reasons in which there are absolutely no indications for its administration.    As therapists, we joke about and make light of it; however, we also become very frustrated because we can spend a good portion of our day administering unnecessary ...
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​Looking for information from folks as to how you identify and implement best practices for ongoing competency assessment. Also curious about the questions below: 1. Is your education department centralized or decentralized at your facility? 2. Is your education department nursing focused or multidisciplinary (Respiratory Care, PT/OT, Radiology, Lab, EVS, etc.) 3. Do you have a New Hire Orientation for all employees? 4. What topics are covered in New Hire Orientation? 5. Do you have unit specific orientation, if so, what is the length of that orientation? 6.  What types of competency assessment verification do you use?  (Donna Wright= test/exams, Return ...
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Over the past 2 1/2 years, I have had the privilege of providing care in the homes of patient's suffering from chronic respiratory failure secondary primarily to COPD. The care model we use is placing these patients on a Trilogy non-invasive home ventilator utilizing AVAPS-AE mode to help maintain CO2 levels, rest their respiratory muscles and provide a source of rescue for exertional shortness of breath. I was a hospital based RT for 10 years. I worked every area of the hospital. I saw patient "X" come into the ED with a COPD exacerbation, be placed on Bi-level NIPPV, pumped full of steroids and bronchodilators, brought back to as close to baseline as possible, ...
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Anyone who has worked in the healthcare field over the past few years has been bombarded with words such as: patient experience, service excellence, community excellence, culture of caring, etc.    These words have always been a part of the healthcare over the years, but in 2012 the usage of these words increased 10-fold.      Why?    Under the Affordable Care Act of 2012, 1% of total hospital Medicare reimbursement was cut. But hospitals could get their pay restored if they had high patient satisfaction scores, and top-performing hospitals could get bonuses.      Because of this, healthcare institutions quickly began enacting strategies to improve patient ...
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​Is anyone charging for NT suctioning? It looks like the CPT code 31720 may work, but I would like to know if anyone is using it successfully. Thanks!
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Hello and Happy New Year   Our facility is looking at implementing Respiratory Driven Protocols in the our NICU. I am looking for some help with this. Does your NICU use RT driven Protocols? If so could you share them with me?
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Does anyone have any idea what to replace Acetylcysteine treatments with? I believe my COPD patient is developing a hacking cough from it and wanted to be able to suggest something to our physician.
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SCAM

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Scams are going around asking for people to send money acting as the President of the state society.  This email went to a person who is not on the board in ND but she knows me and contacted me ASAP. I emailed my board and also am letting you all know to keep an eye out.
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Common Canister

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I am looking for any information from hospitals that have implemented a successful common canister program. Specifically, what is your process for infection control, what regulatory issues have you ran across, and any other issues that arose? Thank you,
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We are in the process of moving away from our current time standard system. We have many non billable procedures that we assign and track, but it is an obsolete system, so are looking at ways to transition out of it, to just assigning billable procedures. This becomes difficult because, as we all know, very little of what we do is billable today. has anyone faced this challenge that would be willing to share your process? Any assistance would be greatly appreciated.
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Heliox Storage

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Where does everyone keep their Heliox tanks? Do you keep one in the RT department on a cart with the regulator in a bag on attached to the cart? Do you have to obtain a tank from your bulk tank storage location (ours is on the loading dock)? I am trying to find a best practice. Thanks, Becky
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