AARC Explores 2023 Pathway Guide

Lecturer: Terry Volsko, MBA, MHHS, RRT, FAARC

Interfacility transport of pediatric and neonatal patients for specialized medical care is an integral part of health delivery systems. In the United States, approximately 200,000 newborns, infants, and children in are transported yearly to a higher level of care. Securing and maintaining a patent airway is an essential component of neonatal and pediatric critical care provided during transport. This lecture will highlight the factors that impact airway management during air or ground transport, the challenges with providing advanced airway care at the referral institution and during the mode of transport as well as present methods to enhance safe and effective airway care during interfacility transport.

Lecturer: Andrew Miller

Critical asthma is a common reason for children to require admission to the pediatric intensive care unit. Children are often treated with noninvasive respiratory support modalities such as high-flow nasal cannula, noninvasive ventilation, and helium-oxygen mixtures. This lecture will cover the pathophysiology of critical asthma, the mechanisms of action for each type of respiratory support, and the evidence supporting each strategy.

Lecturer: Dr. Wes Ely, MD, MPH

This presentation will describe the difficulties that we as health care professionals are currently experiencing in our desire to provide the best care to ICU patients in the midst of the COVID pandemic. I will explain a scientifically proven method for amplifying humanism and dignity so that we can work, one patient at a time, to resurrect. I will use the power of human story to identify aspects of patient suffering that are epidemic within the pandemic and offer hope and strategy for rebuilding what was lost amid the pandemic mayhem and discuss a path forward.

Lecturer: Douglas Gardenhire, EdD, RRT, FAARC

Respiratory care pharmacology continues to change. Many respiratory therapists may be unaware of changes that exist in the medications used today. This lecture will discuss additions and deletions of agents used in respiratory care. The presenter will provide an update on newer medications as well as inform attendees about agents no longer in use.

Lecturer: Patrick J. Dunne, MEd, RRT, FAARC

In 1999, the US Institute of Medicine released its seminal report To Err is Human: Building a Safer Health Care System. The report, initially met with skepticism, estimated that between 44,000 to 98,000 preventable deaths occur each year in the US. However, several subsequent studies suggested that the number may actually be way higher. As a result, the US health care delivery system embarked on a decades-long concerted effort to reduce preventable harm to patients, regardless of site of care. Unfortunately, the COVID pandemic ushered in an unprecedented wave of clinical and administrative challenges, seriously disrupting established processes and priorities, including patient safety. This presentation will review the essential elements of a meaningful patient safety initiative, and why respiratory therapists must make a renewed commitment to providing safe and equitable care in all practice settings.

Lecturer: Dr. Timothy Girard, MD, MSCI

Evidence suggests that early mobilization can improve outcomes — but in what way, and why? This presentation will provide a review of the evidence for early mobilization and offer practical advice on how to best implement the practice at the bedside.

Lecturer: Dean Hess, PhD, RRT, FAARC

COPD exacerbation is a common cause of hospital admission around the world. Management includes oxygen therapy, aerosol therapy, non-invasive ventilation, medication administration and if required invasive ventilation. This lecture will explore how escalation of therapy should be guided by physical assessment and physiologic measures. It will also discuss how respiratory therapists should drive the use of oxygen therapy and non-invasive ventilation based on patient response and device performance. Mechanical ventilation of the COPD patient requires expertise in monitoring flow limitation and effecting auto-PEEP. Maintenance of blood gases, lung protection and aerosol delivery. Ventilator liberation and post-extubation treatment also require understanding the evidence base.

Lecturer: Robert L. Chatburn, MHHS, RRT, RRT-NPS, FAARC

Mechanical ventilation is ubiquitous to intensive care from neonates to adults. The terminology surrounding mechanical ventilation is manufacturer-specific and jargon still prevails. To provide evidence-based mechanical ventilation, clinicians must be able to communicate regarding the operation of mechanical ventilation. Evidence-based treatment requires that the critical care team be lock step chapter and verse, yet ventilator complexities often place the team on different pages and sometimes in different books. This lecture will provide a method of teaching mechanical ventilation terminology and operation based on a set of principles and how we speak about mechanical ventilation in a consistent and meaningful way.

Lecturer: Jie Li, PhD, RRT, RRT-ACCS, FAARC

Prone position has long been known to reduce mortality in mechanically ventilated patients with ARDS who have moderate to severe hypoxemia. With the advent of COVID-19, the use of so-called ‘awake prone’ has become popular despite mixed results in the literature. Typically, mechanically ventilated patients are heavily sedated in the prone position, but more recently encouraging spontaneous breathing has been encouraged with a wide range of results. Finally, prone position during ECMO has been evaluated to determine the potential benefits. The literature on each will be explored in this lecture.

Lecturer: Kathy Rye, EdD, RRT, RRT-ACCS, RRT-NPS, FAARC

Respiratory Therapists were an instrumental component of the health care team that helped me stand again after a life-threatening bout with COVID-19 in 2020. The closing session will encourage RTs to stand together as we endeavor to move the profession forward in an environment that has been forever changed by the pandemic.