ARDS and the Trauma Victim

Joe Hylton BSRT RRT-NPS CPFT EMT-P, Charlotte NC

ARDS is a devastating clinical syndrome that frequently impacts trauma victims. Early recognition and treatment can significantly affect mortality, even in the transport environment. This presenter will discuss how trauma victims are uniquely susceptible to developing the syndrome. Recognition and interventions for conventional treatment of ALI/ARDS will be discussed.

Independent Lung Ventilation in the Patient with Severe Unilateral Lung Injury

Keith D Lamb RRT ACCS, Des Moines IA

How do you ventilate a patient who has received severe damage to one lung without causing damage to the other? The presenter will give an overview of how independent lung ventilation can achieve similar goals to that of traditional mechanical ventilation. Case studies and examples of how this can be achieved at the bedside will be discussed.

Airway Management of the Trauma Victim

Brady Scott MS RRT-ACCS, Chicago, IL

Trauma patients can present some of the most challenging airway scenarios. This presentation will cover intubation techniques with the spinal cord injury patient, severe facial trauma, and other out-of-the-box situations. What types of equipment should be kept on hand? What levels of competence are needed for these types of intubation techniques? These and other questions will be answered during this presentation.

Break

Transport of the Trauma Victim

Joe Hylton BSRT RRT-NPS CPFT EMT-P

Trauma patients are often the most tenuous and usually require transport to an alternate facility better equipped to manage the patient's injuries. This presentation will cover the key challenges in inter- and intra-hospital transport. Strategies will be provided on how to avoid common pitfalls and mistakes.

Specialized Hemodynamic and Physiological Monitoring of the Trauma Patient

Matthew T Davis RRT, Baltimore MD

Multiple etiologies of shock are common in the trauma patient. Hypovolemia, spinal injuries, traumatic brain injury as well as direct injury to the heart make ensuring end organ and tissue perfusion a difficult challenge. This presentation will talk about the latest in monitoring the trauma patient including StO2, PbO2, and hemodynamic monitoring.

Lunch - On Your Own

Mechanical Ventilation and TBI; How to Ventilate the Traumatic Brain Injured Patient

Carl R Hinkson MS RRT-NPS ACCS FAARC, Seattle WA

Ventilating the TBI patient can be a challenge. This presentation will cover approaches to reducing intra-cranial pressure and how the ventilator may help or hurt in the process. The role of the respiratory therapist will be discussed.

Can Airway Pressure Release Ventilation (APRV) Prevent ARDS in Trauma Patients?

Nader M Habashi MD FACP FCCP, Baltimore MD

Patients with traumatic injuries are at a greater risk of developing several forms of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) from indirect lung injury such as aspiration lung injury, fat embolism lung injury, transfusion-related lung injury, and sepsis-related lung injury. Furthermore, trauma victims may also suffer direct pulmonary insult from pulmonary contusion, ventilator-associated pneumonia, and post-operative respiratory failure. All these types of lung injury generally require mechanical ventilator support. However, mechanical ventilation can result in ventilator-associated lung injury (VALI) and potentiate these forms of lung injury. Although the majority of the literature has been focused on the management of ARDS, little has been described on the prevention of ARDS. Can modifications to the way we use the ventilator actually prevent ARDS development?

Mechanism and Pathophysiology of Spinal Cord Injuries

Keith D Lamb RRT-ACCS, Des Moines IA

This lecture will discuss the mechanism and pathophysiology of traumatic spinal cord injuries (SCI). The most current evidence-based literature on the treatment of this patient population will be shared. The presenter will conclude by discussing the future of SCI treatment and prevention.

Break

Respiratory Care of the Trauma Patient with Spinal Cord Injury

Maria Madden RRT ACCS, Baltimore MD

This lecture will discuss ventilator strategies, bronchial hygiene, and other therapies specific to respiratory care as it relates to the management of the spinal cord injured patient. Timing of tracheostomy and diaphragm pacing will also be discussed.

Shock Resuscitation

Nader M Habashi MD FACP FCCP

Shock is inadequate tissue perfusion, which presents clinically as hemodynamic instability and organ failure. This results in difficulty delivering metabolic substrates (oxygen) at the cellular level, and results in anaerobic metabolism. In trauma patients, loss of blood volume, cardiac injury, tension pneumothorax, and spinal cord injuries are typical. Shock is a common cause of death in trauma, second only to traumatic brain injury. This presentation will discuss the pathophysiology of shock, initial management of shock in trauma, and how mechanical ventilation influences hemodynamics in the unstable injured patient.

Tobacco Treatment Guidelines, Evidence, and Brief Intervention Strategy

Susan Rinaldo Gallo MEd RRT CTTS FAARC, Durham NC

This session introduces the current recommended tobacco treatment guidelines and the evidence that supports them. The impact of tobacco use on morbidity and mortality will be discussed with implications for the health care system. A brief intervention strategy (Ask, Advise, Refer) will be explained and demonstrated.

Contribution of Tobacco Use to Morbidity and Mortality

Steven A Schroeder MD, San Francisco CA

Smoking is a primary determinant of morbidity and mortality. This physician presenter will discuss the physiology and relationship of tobacco use to morbidity/mortality. Add this information to your educational arsenal for tobacco interventions. Your patients will be glad you attended.

Break

How To Respond To Those Not Ready or Willing To Quit

Susan Rinaldo Gallo MEd RRT CTTS FAARC, Raleigh NC

A strategy for addressing patients unwilling to quit tobacco use (5 Rs) will be explained. Participants will learn how to identify where a client is on the spectrum of quit contemplation. Examples of responding to various stages of quit contemplation will be demonstrated and practiced.

Interventions/Reinforcement

Jonathan Waugh PhD RRT RPFT CTTS FAARC, Birmingham AL

How does the typical adult respond to a tobacco cessation intervention? High school students? Or younger? What types of reinforcement will they respond to? This presentation will discuss strategies for intervention and reinforcement and how they should be incorporated into a tobacco cessation program. The presenter will provide examples of both intervention and reinforcement and how to maximize their effect.

Lunch - On Your Own

Pharmacologic and Other Support Aids for Tobacco Cessation

Steven A Schroeder MD

Pharmacotherapies and other support aids can enhance the quit rates of most smokers. As the pre-eminent experts in tobacco cessation counseling, respiratory therapists should be well informed as to all of the available cessation aids on the market. The presentation will detail aids and discuss strategies to incorporate them into a tobacco cessation program.

Case Study Discussion

Amber Galer RRT, Salt Lake City UT - Discussion Leader (with Program Faculty)

Several case studies will be presented with audience interaction. Discussion will include counseling objectives and medication selection with comparison of recognized guidelines. Recommendations for addressing special populations will be included.

Tobacco Prevention for Elementary School Age Children

Jonathan Waugh PhD RRT RPFT CTTS FAARC

This demonstration of how to present tobacco prevention and lung health information focuses specifically on the elementary school age group. A presentation currently used with this age group will be demonstrated along with related activities to engage interest and enhance understanding. Recommendations for addressing school teacher concerns will be provided, and the demonstrated materials will be made available to the audience for use in their own communities.

Tobacco Prevention for Middle School versus High School Students

Amber Galer RRT

Tobacco prevention and cessation approaches for middle school versus high school age children will be contrasted and demonstrated. The type of information appropriate for this age group, supporting activities, and useful props will be demonstrated, and the presentation will be made available to the audience for use in their own communities. Creative media for exposing commonly held myths and tobacco marketing strategies for teenagers (and specifically young women) will be showcased.

Break

Starting a Tobacco Cessation Program for In-patients

Susan Rinaldo Gallo MEd RRT CTTS FAARC

A plan for starting a hospital-based tobacco-cessation program will be outlined with solutions for common challenges. Integration with hospital information systems and partnering with other health care professionals will also be addressed.

Workshop Summary

Jonathan Waugh PhD RRT RPFT CTTS FAARC

A summary review of the key points and learning objectives from the course will be discussed.

Emphasis on Patient Safety: the Affordable Care Act

Bill Lamb RRT CPFT FAARC, Wentzville MO

The foundation of the ACA lies in its ability to drive costs out of health care. While there are many mechanisms in place to accomplish this, delivering care that mitigates or eliminates hospital-acquired conditions, sentinel events, and avoidable readmissions is at the forefront of the care delivery model. Therefore, patient safety initiatives are essential for the survival of any healthcare provider. This program discusses patient safety, evidence-based practice, and reviews the role of the respiratory therapist in providing appropriate, safe patient care.

NIV - Skin Breakdown

Robert M Kacmarek PhD RRT FAARC, Boston MA

Skin breakdown and pressure ulcers have become a staple in patient assessment by nursing. Regulatory issues, national patient safety goals, and transparency in publicly reported data largely drove this change in practice. On the heels of this come opportunities for the respiratory therapist. While skin breakdown from patients receiving non-invasive ventilatory support is not new, the emphasis to monitor it is. This presentation will review best practices in assessment, identification, treatment, and continual monitoring for skin breakdown with the respiratory patient receiving NIV.

Break

Sentinel Events, Critical Incidents, and Near Misses

Steven E Sittig RRT-NPS FAARC, Rochester MN

Although much focus is placed on sentinel events and critical mistakes, oftentimes, more can be learned from near misses. Systems for reviewing and learning from sentinel events, critical incidents, and near misses will be discussed. Suggestions for implementing systems to learn from medical errors will be offered. Updated processes and data on these events will also be presented.

Checklists: Getting Help From the Experts

April Gochberg PhD RRT-ACCS, Cincinnati OH

Checklists have been used since the 1920s in aviation with undisputable improvements in safety. Unfortunately, they have been slow to migrate into the delivery of healthcare…or have they? This presentation will review the journey taken by The Christ Hospital in Cincinnati to incorporate checklists into every day practice. Soliciting input from Boeing, the respiratory therapy department was successfully able to develop, simulate, and implement safety checklists into the care of the mechanically ventilated patient. The presenter will teach you how to do the same.

Mass Respiratory Failure

Lewis Rubinson MD PhD, Baltimore MD

This session will focus on how a pandemic event will impact acute care facilities and the provision of mechanical ventilation. The respiratory therapist's role in these events will also be discussed.

SNS Stockpile: Ventilator Allocation and Storage/Maintenance

Eileen Malatino RN MS, Atlanta GA

This session will describe how SNS ventilators are requested and delivered. In addition, the presenter will discuss how the SNS ventilators are stored and maintained.

A Clinician's Perspective: The SNS Ventilators

Richard D Branson MSc RRT FAARC, Cincinnati OH

The Strategic National Stockpile consists of three specific mechanical ventilators. This session will discuss the capabilities of all three mechanical ventilators.

SNS Hands-on Ventilator Training

This session will provide the respiratory therapist with the opportunity to gain hands-on experience with all three SNS ventilators.

Mass Respiratory Failure

Lewis Rubinson MD PhD, Baltimore MD

This session will focus on how a pandemic event will impact acute care facilities and the provision of mechanical ventilation. The respiratory therapist's role in these events will also be discussed.

SNS Stockpile: Ventilator Allocation and Storage/Maintenance

Eileen Malatino RN MS, Atlanta GA

This session will describe how SNS ventilators are requested and delivered. In addition, the presenter will discuss how the SNS ventilators are stored and maintained.

A Clinician's Perspective: The SNS Ventilators

Richard D Branson MSc RRT FAARC, Cincinnati OH

The Strategic National Stockpile consists of three specific mechanical ventilators. This session will discuss the capabilities of all three mechanical ventilators.

SNS Hands-on Ventilator Training

This session will provide the respiratory therapist with the opportunity to gain hands-on experience with all three SNS ventilators.