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RESPIRATORY CARE

RESPIRATORY CARE. Careers in Respiratory Care. The Respiratory Therapist’s Main Goal:. To help clients breathe more easily. Best Way: by preventing and treating disease. Two Main Levels of Practice:. CRT-Certified Respiratory Therapist (entry level position)

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RESPIRATORY CARE

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  1. RESPIRATORY CARE

  2. Careers in Respiratory Care

  3. The Respiratory Therapist’s Main Goal: • To help clients breathe more easily. • Best Way: by preventing and treating disease.

  4. Two Main Levels of Practice: • CRT-Certified Respiratory Therapist (entry level position) • RRT-Registered Respiratory Therapist

  5. Education Requirements: • Must graduate from a 2 or 4 year educational program approved by the Committee on Accreditation for Respiratory Care (CoARC). • Must pass the board examinations given by the National Board for Respiratory Care (NBRC). • Have (CPR) Cardiopulmonary Resusitation certification. • Many go on to qualify for (ACLS) Advanced Life Support certification.

  6. Job Responsibilities • Assess the need for therapeutic respiratory procedures. • Determine the potential benefits of the therapy. • Monitor the outcome of the therapy to determine whether the treatment objectives were met.

  7. Additional Training: • Can perform sleep studies. (diagnose the cause of breathing cessation(apnea) during sleeping. • Perform metabolic assessment studies. • Perform cardiac functioning tests. • Specialize in working with infants and children.

  8. The Pulmonary Function Technologist • Needs further training and must pass an examinati0n. • Detects the presence or absence of lung disease. • Measures the effect of a known disease or lung function. • Determines the effects of therapy. • Assesses the risks for surgery. • Evaluates disability or impairment. PFT’s measure lung volume, ventilations, pulmonary spirometry, and gas exchange.

  9. Anatomy and Physiology of The Respiratory System • Nose • Pharynx • Larynx • Trachea • Bronchi • Alveoli • Lungs

  10. The Airways The airways must be kept clear of debris and secretions. (They may cause blockages or disruptions of gas flow into and out of the lungs.) The airway lining must function properly, because it is the lungs’ defense mechanism. The lining helps protect the lungs from inhaled particles such as pollen, cigarette smoke, dust, and most bacteria.

  11. Cilia • Look like hairs that have a “beating” action. • The continual sweeping movement of the cilia keeps the lungs clean and free of debris. • The cilia may not do their job well with people who have infections, smoke, or are exposed to toxic gases.

  12. The Job of the Respiratory System: • To bring oxygen gas into the body. • To expel the carbon dioxide gas from the body. Respiration is the gas exchange process that takes place in the lungs. (Gas exchange takes place in the alveoli.) Ventilation is what makes respiration happen. (It moves oxygen into the lungs and moves carbon dioxide gas out of the lungs.)

  13. Anatomy and Physiology of The Respiratory System • Nose • Pharynx • Larynx • Trachea • Bronchi • Alveoli • Lungs

  14. The Airways The airways must be kept clear of debris and secretions. (They may cause blockages or disruptions of gas flow into and out of the lungs.) The airway lining must function properly, because it is the lungs’ defense mechanism. The lining helps protect the lungs from inhaled particles such as pollen, cigarette smoke, dust, and most bacteria.

  15. Cilia • Look like hairs that have a “beating” action. • The continual sweeping movement of the cilia keeps the lungs clean and free of debris. • The cilia may not do their job well with people who have infections, smoke, or are exposed to toxic gases.

  16. The Job of the Respiratory System: • To bring oxygen gas into the body. • To expel the carbon dioxide gas from the body. Respiration is the gas exchange process that takes place in the lungs. (Gas exchange takes place in the alveoli.) Ventilation is what makes respiration happen. (It moves oxygen into the lungs and moves carbon dioxide gas out of the lungs.)

  17. Diagnostic Therapeutic Procedures: Procedures: • Assess lung function • Determine illness or diseases of the lungs • Prevent lung disease • Treat lung disease

  18. Mechanical Ventilation A client is attached to a machine, known as a ventilator, that helps him breathe.

  19. 2 Main Reasons: • When other respiratory procedures fail to keep the lungs from moving enough oxygen into the bloodstream and from removing enough carbon dioxide from the lungs. • When a client goes into respiratory arrest, which means that the client has stopped breathing.

  20. Respiratory Care Procedures

  21. Oxygen Therapy Oxygen is considered to be a drug. Therefore, a doctor’s order is needed before it can be given to a client.

  22. Three Main Reasons for Oxygen Therapy: • Hypoxemia-Low levels of oxygen in the blood. • Work demands of breathing. Common signs: (1) an increase in the rate and depth of breathing (2) use of accessory muscles (muscles other than the diaphragm, such as the intercostal muscles) (3) cyanosis (bluish color to the skin) • Work of the heart- increase of heart rate when blood oxygen level is low.

  23. Oxygen Delivery Devices • Nasal Cannula • Simple Mask

  24. Nasal Cannula • Commonly used device to provide low-flow oxygen therapy. • The main advantage is the client can eat and speak comfortably when it is in use. • Can deliver 1 to 6 liters per minute of supplemental oxygen. • Often used for long-term oxygen therapy. (ex. COPD)

  25. Simple Mask • Designed to fit over a client’s nose and mouth. • Oxygen percentage varies. (most common reason-the difficulty is getting a tight seal with the mask). • Can deliver between 35 and 50 % of oxygen, depending upon the client’s ventilation rate and depth.

  26. Monitoring Oxygen TherapyIf oxygen therapy is effective: • The client should think more clearly and become less restless. (More oxygen is reaching the brain.) • Shortness of breath will decrease and color may improve (noticeable in the skin, nail beds and mucous membranes) • Vital signs should come closer to normal (heart and respiratory rates should move toward their normal levels). • The oxygen value from an arterial blood gas test will rise to an acceptable level for that client . (A normal value is 80 – 100 mm Hg for most clients.) • Pulse oximetry values will improve. (This measures the amount of hemoglobin saturated with oxygen (SpO2).)

  27. Hazards of Oxygen Therapy Since oxygen is a drug, harmful effects may occur if it is not delivered properly. Some hazards are: Oxygen toxicity, Retinopathy of prematurity and Atelectasis

  28. Oxygen toxicity: • A serious, even life-threatening, condition that may occur if too much oxygen is delivered for too long a period of time. • May show early signs if a normal person breathes 100% oxygen for longer than 12 to 24 hrs. • Some symptoms include : sore throat, difficulty with breathing, cough, and chest discomfort.

  29. Retinopathy of prematurity (ROP) • Caused by high oxygen levels in infants. • Retinopathy is a disorder of the retina that may lead to blindness

  30. Atelectasis • (lung collapse) may occur when high concentrations of oxygen reduce the amount of nitrogen (a gas that keeps the lungs open) to the lungs.

  31. Medicated Aerosol Therapy

  32. Sometimes a client needs medication to open up the airways delivered directly to the lungs. An example would be an asthma attack, when the airways become constricted.

  33. Advantages of Aerosolized Medications • Smaller doses of a drug. (inhaled directly to the lungs) • Can act very quickly. • Side effects are reduced. (doesn’t travel through the bloodstream. • Convenient, easy and painless. • Can be used at home.

  34. Disadvantages of Aerosolized Medications • Difficult to administer correct dose. • Clients may be unable to administer the device correctly. • Health care providers may not know how to use or instruct the client on how to use the device.

  35. Types of Drugs Given by Aerosol • Nasal decongestants • Bronchodilators • Antiasthmatics • Corticosteroids • Mucolytics • Antimicrobials

  36. Nasal Decongestants • Squeeze bottles-decreases flow of blood to vessels of the nose, shrinking the vessels and opening up the nasal passages. (Ex. A cold and stuffy nose)

  37. Bronchodilators • Drugs that increases the diameter of the airways of the lungs, making breathing easier. (Ex: asthma attack, bronchospasm-excessive secretions)

  38. Antiasthmatics • Asthma attacks are often caused by allergic reactions. • These drugs reduce the allergic response.

  39. Corticosteroids • Used when a client has inflammation of the airways, often for moderate to severe persistent asthma • Helps airways become swollen to help prevent or reduce late-phase asthma (can be severe and may occur hours after an initial asthma attack).

  40. Mucolytics • Used when a client has lung disease with thick secretions, making it easier for them to be expectorated or cough out.

  41. Antimicrobials • Antibiotics used to treat a number of bacterial, fungal and viral pulmonary infections.

  42. The Metered Dose Inhaler (MDI) • A cannister containing a pressurized gas propellant and medication that has a measured amount of medication.

  43. Add-On Devices to MDI Spacer, holding chamber and extension device. • Prevents the aerosol from being sprayed into the eyes or face. • Spacer add-on helps make the partical size of the aerosol consistent so that more particles are able to get deep into the lungs. • With the add-on device, the aerosol is created in the chamber, giving the client more time to inhale the particles into the lungs instead of being deposited in the mouth.

  44. Evaluating Aerosol Therapy • Listen to the breath sounds before treatment and note any improvement after treatment. • Ask the client whether he feels better after the treatment and check his appearance and reactions. • Use a pulmonary function before and after treatment.

  45. Hyperinflation Therapy • Lung expansion therapy use to prevent or treat lung collapse. • Can be caused by tumors, large amounts of mucous in the airways that prevent ventilation to an area of the lung, or consistently breathing small amounts of air and not fully expanding the lungs. (The client is sedated or in pain and then breathes deeply.) • Preventing or treating atelectasis requires deep breathing or secretion removal to keep the airways open at all times.

  46. Indications of Hyperinflation Therapy Examples are clients who: • Have had surgery to the chest wall or the upper abdominal region. • Have neuromuscular disease. • Have spinal cord injuries. • Are bedridden. • Have chronic lung disease that causes excessive mucous production (chronic broncitis or cystic fibrosis).

  47. Incentive Spirometry • The most common therapy (IS) performed using devices that give the client a visual clue by showing him the numbers signifying volume.

  48. Indications for (IS) • Have had upper abdomen surgery • Have had thoracic (chest) surgery • Have COPD and are or have undergone surgery • Bedridden for a long time • Heavy smokers undergoing or have undergone surgery

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