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Respiratory Care Week Fact # 7
Respiratory Care in Critical Care
Respiratory Therapists are involved each day in Critical Care interventions with Adult, Pediatric and Neonatal patients. We are committed to exhibit best practices by holding advanced certifications in specialty areas. Our profession is about to embark on another specialty credential so recognize your Respiratory Therapists on this last day of Respiratory Care Week for the commitment to education and excellence in Critical Care.
Adult Critical Care Specialty Examination
Development of the New Adult Critical Care Specialty Examination is Now Underway!
The NBRC is excited to announce the upcoming launch of a new specialty examination for respiratory therapists working in adult critical care settings. We sought input from a variety of organizations representing professionals involved in the arena of adult critical care so we could create a valuable credential that your employer, colleagues and patients will recognize and respect.
The new examination program was built on a collaborative effort with other organizations with a vested interest in protecting the public and improving care for adult patients receiving treatment in critical care settings. Because of this effort, the programs have wide support from organizations such as:
 The American Association for Respiratory Care
 The American College of Chest Physicians
 The American Society of Anesthesiologists
 The American Thoracic Society
The Adult Critical Care Specialty Examination program is designed specifically for a respiratory therapist with the RRT credential and experience in the field of adult critical care.
Eligible certificants have already demonstrated advanced knowledge in the field of respiratory care; therefore this examination will focus on competencies unique to therapists practicing in an adult critical care setting and not basic competencies of general respiratory care.

Respiratory Care Week Fact #6

PULMONARY REHABILITATION
Did you know HBMC has a Pulmonary Rehabilitation Program?
For most people, breathing is automatic and something we don't spend much time thinking about; but if you suffer from chronic pulmonary disease, it's not so automatic, and often it's all you can think about. There are many types of pulmonary diseases, most of which stem from chronic lung disease. If a patient suffers from emphysema, chronic bronchitis, asthma, bronchiectasis or interstitial lung disease, they have experienced the stress and anxiety that come from living with a chronic condition that affects their breathing and their life.
Except for transplant situations, damage to the lungs cannot be repaired, but there are ways to compensate. Pulmonary Rehabilitation strengthens the rest of the body, so that the lungs don’t have to work so hard. Physical exercise optimizes the body's ability to use the lung function that’s available and, equally as important, enhances mental and emotional well-being.
The Benefits of Pulmonary Rehabilitation
Hillcrest Baptist Medical Center’s comprehensive Pulmonary Rehabilitation program reduces the impact of pulmonary disease on a patient’s daily life. It helps a patient to:
• Reduce shortness of breath and associated anxiety
• Increase exercise tolerance and the ability to perform normal daily activities
• Increase participation in physical and social activities
• Provide a better understanding of the disease and how to manage it
• Reduce the need for and frequency of hospitalization
• Improve overall quality of life
As one patient put it, "Pulmonary rehabilitation has been a life-saving pathway between inactivity and activity, isolation and socialization, depression and hope, and being an observer of life to an active participant." (Quote from the American Association of Pulmonary Rehabilitation Guidelines for Pulmonary Rehabilitation Programs, 3rd Edition)
Respiratory Therapists are involved in Pulmonary Rehabilitation Programs across the country so as we celebrate Respiratory Care Week we want to recognize our Respiratory Therapists for helping with this program by identifying patients through assessment as front line caregivers.

Great stuff Mike! Appreciate these posts

Respiratory Care Week Fact # 5
Pediatric Respiratory Care in the treatment of
Respiratory Syncytial Virus (RSV)
In the United States, RSV is more common during the winter and spring months. Specifically in Texas this occurs primarily from October to February. For most children and infants, RSV is a virus that can be managed on an outpatient basis. However, about 0.5 to 2 percent of children and infants who develop RSV may require hospitalization and become admitted on our Pediatric unit at HBMC. The disease usually runs its course in one to two weeks. Children who are at risk for developing more severe cases or RSV include the following:
• children/infants younger than 1 year, particularly those between 6 weeks and 6 months
• premature infants
• children/infants with breathing or heart problems
• children/infants with weakened immune systems
• children/infants with weakened immune systems
How is RSV transmitted?
RSV transmission occurs by coming in contact with infectious material either from another individual or inanimate object. The secretions from the eye, mouth, or nose (and possibly from a sneeze) contain the virus. The virus can also survive for many hours on inanimate objects such as doorknobs, hard surfaces and toys. It can also live on human hands for up to 30 minutes.
If the child has been diagnosed upon admission with RSV, how long will he or she be contagious?
After being exposed to the virus, symptoms may not appear for four to six days. An individual with RSV is usually contagious for three to eight days, although this may be longer in younger children.
Symptoms of RSV
The following are the most common symptoms of RSV infections. However, each child may experience symptoms differently. Symptoms may include:
• lethargy and inactivity
• irritability
• poor feeding
• episodes of apnea (more common in infants; an event where an infant may not take a breath for longer than 10 seconds)
• nasal discharge that is usually clear
• fever
• wheezing (a high-pitched sound usually heard on inspiration, breathing in)
• rapid breathing
• cough
• retractions (pulling in) of the chest wall
• nasal flaring
• rattling in the chest that may be felt over an infant's back or chest
How is RSV treated?
There is no cure for RSV, so if the child is infected treatment is supportive (aimed at treating the symptoms present). The care of the child or infant involves treating the effects of the virus on the respiratory system. Because a virus causes the infection, antibiotics are not useful.
Treatment for RSV may include:
• keeping the child well hydrated by encouraging fluids by mouth (if necessary an intravenous (IV) line may be started to give the child fluids and essential electrolytes)
• bronchodilator medications administered in an aerosol nebulizer by a mask or through an inhaler (to open the child's airways)
• supplemental oxygen through a mask, nasal cannula or a heated high flow nasal cannula with monitoring of oxygen levels
• anti-viral aerosol medication (generally used only with very high-risk children)
• mechanical ventilation or a "respirator" (to assist with breathing for a period of time)
We salute the Pediatric Core Team of Respiratory Therapists during Respiratory Care Week as they work in a fast paced environment with the Nursing team on the Pediatric unit during this peak respiratory season that includes RSV patients.

Respiratory Care Week Fact # 4
Premature Babies: Lung Development and Respiratory Distress Syndrome
Premature babies are at risk for respiratory distress at birth. Immature lung tissue can make breathing difficult for premature babies. Respiratory distress most often affects premature babies born before 34 weeks. Approximately ten percent of premature babies experience some degree of respiratory distress.
Lung Development in Premature Babies
Lung tissue matures just prior to birth. Before birth, a baby's lungs are filled and supported with amniotic fluid. Lung tissue usually matures by week 34, so babies can breathe air at birth. Immature lung tissue is unprepared for birth, increasing the chance of respiratory distress.
Premature babies lack surfactant, a protein that makes lung tissue elastic. Surfactant prevents the lungs from collapsing, and makes lung inflation easier. Insufficient surfactant leaves respiratory tissue unprotected at birth. Lung tissue may collapse, making breathing difficult. Insufficient lungpower results in low oxygen levels in the blood of premature babies, which in turn leads to respiratory distress.
Role of the Neonatal Intensive Care Unit (NICU) Registered Respiratory Therapist (RRT) with the Team:
Our NICU RRT’s assist in the administration of artificial surfactant to improve Respiratory Distress Syndrome to reduce or eliminate ventilatory support. We salute our NICU RT’s during Respiratory Care Week!

Respiratory Care Week Fact #3
Every year in the U.S. over 392,000 people die from tobacco-caused disease, making it the leading cause of preventable death. Another 50,000 people die from exposure to secondhand smoke. Tragically, each day thousands of kids still pick up a cigarette for the first time. The cycle of addiction, illness and death continues. What can be done to stop smoking? The American Lung Association (ALA) is working to strengthen laws and policies that protect everyone from secondhand smoke and prevent young people from starting. Hillcrest Baptist Medical Center is also committed to helping smokers quit with our ALA smoking cessation programs.
Warning Signs of Lung Disease
WARNING SIGNS
If you have any of these warning signs or symptoms, tell your healthcare provider as soon as possible.
Chronic Cough - A cough that you have had for a month is chronic. This is an important early symptom. It tells you something is wrong with your respiratory system.
Shortness of Breath - Shortness of breath that doesn’t go away after exercising, or that you have after little or no exertion, is not normal. Labored or difficult breathing – the feeling that it is hard to breathe in or breathe out - is also a warning sign.
Chronic Mucus Production - Mucus, also called sputum or phlegm, is produced by the airways. It is a defense response to infections or irritants. If your mucus production has lasted a month, this could indicate lung disease.
Wheezing - Noisy breathing or wheezing is a sign that something unusual is blocking your lungs’ airways or making them too narrow.
Coughing up Blood - If you are coughing up blood, the blood may be coming from your lungs or upper respiratory tract. Whatever the source of the blood, it is a sign of a health problem.
Chronic Chest Pain – Unexplained chest pain that lasts for a month or more – especially if it gets worse when you breathe in or cough – can also be a warning sign.
Spirometry
The quickest and easiest method to diagnose COPD is with spirometry. According to the ATS/ERS guidelines, spirometry should be obtained from all individuals who have symptoms, have/had a history of smoking and/or environmental exposure to smoke or occupational pollutants, and have a family history of chronic lung disease. (For more information about spirometry testing and classification, visit the next section or click here.)

Respiratory Care Week Fact # 2
DRIVE4COPD is a multi-year public health initiative to screen the millions of people who may be at risk for COPD, the nation's 4th leading cause of death.
Link: http://www.drive4copd.com/index.aspx
Launched in February 2010, DRIVE4COPD is a multi-year public health initiative that aims to help people identify symptoms of COPD and take action. Founding sponsor, Boehringer Ingelheim Pharmaceuticals, Inc. has joined forces with a cross-section of organizations, including the AARC, Country Music Association, the COPD Alliance, the COPD Foundation, NASCAR®, and the US COPD Coalition, on this large-scale education and awareness campaign to help bring COPD to the forefront.
COPD includes chronic bronchitis, emphysema or both. It is a progressive disease that causes irreversible lung damage, so early diagnosis and disease management are critical to helping patients breathe better. The unified efforts of the DRIVE4COPD partnering organizations help people identify the symptoms of COPD and take action to see if they may be at risk. Because it is a largely unrecognized disease, the DRIVE4COPD campaign offers a brief five-question screener to help people identify their risk for COPD.
For many, taking the screener may be the first time they have considered if they are at risk for COPD. Those who score at risk for COPD are encouraged to begin a dialogue with their healthcare professional.
DRIVE4COPD is working to put the brakes on COPD through diverse channels, including art, music, sports, live events and online activities. Through these endeavors DRIVE4COPD is fulfilling its mission to educate Americans with the message that early COPD screening and detection may help those with COPD to breathe easier.