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Basic Respiratory Care I

RT 117

Basic Respiratory Care I

RT 117

Course Description

Prerequisite: Admission to the Respiratory Care Program. RT 118, RT 121, RT 126, and RT 131 must be taken concurrently. Presents the theory and application of skills required for the delivery of the basic respiratory care modalities of medical gases, humidity, and aerosol therapy. Emphasizes treatment of adult and pediatric patients with application to specific disease states. (39-12)

Outcomes and Objectives

Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:

Objectives:

  • Define the types of hypoxia and relate to the associated pathologies and physiological changes.
  • State normal oxygen tensions in the inspired air, the alveoli, and systemic arterial blood.
  • Compute oxygen tensions in the inspired air and the alveolar air for various oxygen concentrations.
  • State the indication for oxygen therapy and describe the clinical signs and symptoms of a hypoxic patient.
  • Define hypoxia, hypoxemia, cyanosis, and dyspnea; use each appropriately, and describe the clinical signs and/or symptoms of each.
  • Describe the process of diffusion across the alveolar/ capillary membrane to the red blood cell.
  • Relate the gas laws to the efficiency of diffusion.
  • Describe the method of oxygen binding to and release from hemoglobin; discuss factors that alter the process; and relate to pathology, physiology, the oxyhemoglobin dissociation curve, and the gas laws.
  • Discuss and demonstrate with the delivery devices (nasal, cannula, masks, reservoir masks, face tent, transtracheal catheters, etc.) the safety features, proper function and appropriate flow rates.
  • State contraindications and hazards of oxygen therapy and describe the clinical signs and symptoms of oxygen toxicity.
  • Demonstrate the appropriate selection of administrative devices and oxygen percentages for clinical application, set up for use, monitor, correct malfunctions, and maintain while in use.
  • State the contraindications and hazards of each delivery device.
  • Describe the methods for determining the effectiveness and appropriateness of oxygen therapy.
  • Describe the use of pulse oximetry to monitor O2 therapy.
  • Demonstrate the appropriate use of pulse oximeters and interpret the results.
  • Discuss the principles and use of hyperbaric oxygenation and relate to the gas laws.
  • Discuss the hazards and contraindications of hyperbaric oxygenation and the regulation involved; name the regulatory agencies.
  • State and discuss other medical uses for oxygen besides respiratory therapy.
  • Discuss chronic obstructive pulmonary disease including causes, changes in airways, the pulmonary parenchyma, and the diaphragm; changes in the external appearance of the thorax and breathing mechanics; changes in normal blood gas values; and the response to oxygen therapy.

Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:

Objectives:

  • Define and appropriately use the terms relevant to aerosol (pneumatic, ultrasonic) and humidity (bubble, passover, cascade, wick, heat moisture exchanger) equipment.
  • Describe and demonstrate the function of the above devices, relating the functions to the gas laws.
  • Describe and indicate the safety features incorporated in the devices, and name each safety system employed.
  • Discuss the factors affecting the efficiency of each device and the relative effectiveness of each.
  • Select devices specifically designed for infant and/or pediatric use.
  • Modify equipment to meet the needs of the infant and/or pediatric patient, if possible.
  • Perform miner maintenance, and increase the effectiveness of each if possible.
  • State the contraindications and hazards of each device.
  • Name the regulatory agencies and discuss the safety considerations regarding each device.
  • Demonstrate the appropriate selection of the proper aerosol or humidity device for clinical application, set up for use, monitor, correct malfunctions and maintain while in use.
  • Compute entrainment ratios according to a formula, compute the total output, and relate to patients' inspiratory flows.
  • State the common entrainment ratios and total flow outputs.

Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:

Objectives:

  • Describe the mucosa of the tracheobronchial tree and the mucociliary escalator.
  • Explain humidity deficits, the clinical implication of a humidity deficit, and methods for correcting the causes of humidity deficits.
  • Describe the indications for aerosol therapy, and relate to pathology and physiological changes for the adult and the pediatric patient.
  • Discuss the types of deposition of particles in the tracheobronchial tree.
  • Describe the methods for determining the effectiveness and appropriateness of aerosol therapy.
  • Deliver pharmacological agents by the aerosol route.
  • Correctly use the appropriate terminology.
  • Discuss the contraindications and hazard of aerosol therapy.
  • Discuss the methods of determining over-hydration through aerosol therapy.
  • Demonstrate appropriate administration of periodic aerosol therapy incorporating patient positioning and breathing techniques to promote maximum mucokenesis, monitor, correct malfunctions of equipment, and maintain equipment while in use.
  • Modify the administration of periodic aerosol therapy based on patient response.
  • Modify treatment techniques to reassure children and encourage their participation if they are able.

Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:

Objectives:

  • List the gases in the atmosphere, the concentration and partial pressure of each.
  • List the gases that are utilized in medical care.
  • State the physical principles, purity standards, method of storage, use and concentrations of each medical gas.
  • Describe the production of common medical gases.
  • Name the regulatory agencies and state the regulations regarding medical gases.
  • Recognize the indications for the various medical gas therapies and relate the pathology, physiology, and the gas laws (gases other than oxygen).
  • State and recognize the contraindications and hazards of medical gas therapies (gases other than oxygen).
  • Select the proper medical gas, concentration, and deliver mode for various medical gas therapies; describe how to set up, administer, monitor, and maintain to safely meet therapeutic goals (gases other than oxygen).

Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:

Objectives:

  • State the types and uses of the various storage systems.
  • Describe the advantages and disadvantages of the types of flowmeters and relate to the gas laws.
  • Name the regulatory agencies and the regulations regarding the various storage systems.
  • Select the appropriate flowmeter for a given clinical situation.
  • State the locations in a hospital where each system would be employed.
  • Demonstrate appropriate use of regulators, reducing valves, and flow meters, check for proper function, identity malfunctions and take action to correct malfunctions of the equipment.
  • State the potential hazards of each system.
  • Safely handle the containers in each storage system.
  • State the types, construction, testing, and safety systems of medical gas piping systems.
  • Name the regulatory agencies and the regulations regarding medical gas piping systems.
  • Describe the typical locations of valves and areas of zones in a hospital piping system and describe their functions.
  • Discuss typical hospital procedures regarding piping systems during various types of emergencies.
  • Identify and demonstrate the medical gas wall outlet quick connect systems.
  • Name and describe the safety systems regarding quick connect wall outlets.
  • Describe the function and construction of medical gas vacuum systems.
  • Name the regulatory agencies and the regulations regarding hospital vacuum systems.
  • Describe the construction, testing, filling, and marking of medical gas cylinders.
  • Name the regulatory agencies and describe the safety systems regarding cylinders.
  • State the sizes and capacities of cylinders.
  • Demonstrate safe handling and transport of small and large cylinders. Check for proper function, identify malfunctions and take action to correct malfunction of the equipment.
  • Relate the gas laws to cylinder usage.
  • Compute the duration of supply for cylinders in use.
  • Describe and identify the types of regulators.
  • Describe the function and calibration of medical gas regulators.
  • Name and describe the safety systems regarding regulators.
  • Describe the advantages and disadvantages of the types of regulators and relate to the gas laws.
  • Select the appropriate regulator for a given clinical situation.
  • Describe and identify the types of flowmeters.
  • Describe the function and calibration of flowmeters.

Demonstrate, through successful completion of written examination and/or return demonstration, the ability to:

Objectives:

  • Describe the various physical and chemical principles used in oxygen analysis and name the principal utilized by each type of analyzer.
  • Select the appropriate analyzer(s) for each clinical use.
  • State the hazards of various types of analyzers in various settings.
  • Calibrate each analyzer.
  • Describe the methods of handling and care of each analyzer.
  • Describe the function of each oxygen/air blender, its alarms, and its flow capabilities.
  • State the potential hazards of oxygen/air blenders.
  • Describe the methods of handling and care of each oxygen/air blender.
  • Construct a system to deliver concise gas mixtures when a blender is not available.
  • Explain the function and use of demand valves.
  • Identify the hazards associated with the use of demand valves.
  • Demonstrate appropriate use of oxygen analyzers, oxygen/air blenders and demand valves, check for proper function, identify malfunctions and take action to correct malfunctions of the equipment.