Sputum Bowl Preliminaries

Sherry Whiteman BHS RRT/Presiding
Teams from the AARC State Societies compete in the preliminary competitions. The top four teams will advance to the Finals on Thursday evening, Dec 11, along with the Student Sputum Bowl finalists.

Supported by an unrestricted education grant from

Opening Session

Thomas J Kallstrom MBA RRT FAARC
AARC Executive Director/CEO/Presiding

AARC Awards Ceremony

The ceremony recognizes the "doers" in the profession, from students to long-established practitioners. Be there and applaud your peers. Today it's them; tomorrow it may be you!

Keynote Address

"First, Do No Harm": Patient Safety & the Role of the Respiratory Therapist

Michael Ramsay MD, Dallas TX
Patricia LaChance , Bowling Green VA

"First, do no harm" is perhaps the most well-known and recited phrase from the Hippocratic Oath. In layman's terms, it means that above all else, caregivers should ensure that their actions do not cause harm to the patient.

If we accept the premise that caregivers (including respiratory therapists) take this oath seriously, why is it then that up to 400,000 preventable patient deaths occur each year as a result of medical errors?

In this year's keynote address, noted patient safety expert and creator of the Ramsay Sedation Score, Dr. Michael Ramsay, will discuss this issue and talk about how and why preventable deaths happen. Most importantly, Dr. Ramsay will discuss the important role of the respiratory therapist to improve patient safety by reducing preventable errors.

In closing, Dr. Ramsay will interview patient advocate Patricia LaChance, whose life was forever changed as a result of an overlooked Obstructive Sleep Apnea diagnosis.

Don't miss this reveting keynote address where respiratory therapists will be put on the front lines in America's fight against preventable deaths.

Supported through an unrestricted educational grant from

Opening of Exhibit Hall

George W Gaebler MSEd RRT FAARC/Presiding
2013/2014 AARC President George Gaebler and President-elect Frank Salvatore opens the Exhibit Hall. As the "Gold Standard" of all respiratory care meetings, AARC Congress 2014 presents to you all the manufacturers and suppliers in the industry. The Exhibit Hall offers attendees an opportunity to see, touch, and manipulate the latest technology in the field and have clinical conversations with manufacturer representatives. Don't miss this great opportunity!

Presenting an OPEN FORUM Abstract

Teresa A Volsko MHHS RRT FAARC, Youngstown OH

The purpose of this presentation is to introduce the neophyte research presenter to the customs, roles, and experience of presenting an OPEN FORUM session. Included will be the stage of an OPEN FORUM presentation that include setting up the poster, interacting with moderators, presenting at the podium, and participating in moderated audience discussion of the research.

Orientation for First-time Attendees

Presented by the AARC Program Committee, Ira M Cheifetz MD FAARC

Are you a first-time attendee with unanswered questions about who to see, where to go, and what to expect from your first AARC Congress? If so, then attendance at this presentation is a MUST for you! This presentation provides first-time attendees with an overview of the entire AARC Congress and includes suggestions on how to maximize your time not only at the educational session, but also at the exhibits and peripheral activities as well.

Evidence-Based Medicine: Translating Research Into Practice

What Is Evidence-Based Medicine?

Natalie Napolitano MPH RRT-NPS FAARC, Philadelphia PA

The practice of medicine is both a science and an art. When aligning a multidisciplinary team we need to rely on the science to set standard practices and protocols to standardize care. Utilization of the current evidence is different than completing new research.

Not All Evidence Is Good Evidence

David Grooms MS RRT, Suffolk VA

Not all published literature is good and not all publications are peer reviewed. When attempting to utilize the published literature to make clinical decisions there is a process to determine a rating of the evidence.

Utilizing Evidence-Based Medicine To Improve Quality of Care

Thomas P Malinowski BSRT RRT FAARC, Fredericksburg VA

Translating evidence into a successful quality improvement program can have many challenges beyond the science. These case scenarios of successful implemented evidence based programs can assist in breaking down some barriers.

Neo-Peds Spotlight Symposium: Controversies in Pediatric Respiratory Care

Early Use of ECMO As a Lung Protective Approach Is Optimal - Pro/Con

Ira M Cheifetz MD FCCM FAARC, Durham NC
Heidi J Dalton MD, Phoenix AZ

ECMO is being used at an increasing rate for refractory hypoxemic respiratory failure in the pediatric and adult populations. Despite this growing experience with venovenous ECMO, the optimal timing for cannulation remains uncertain. In this pro/con session, the presenters will debate the evidence for the early use of ECMO as a lung protective strategy. To show their equipoise, the speakers will flip a coin at the start of the session to determine who presents each side of this important clinical controversy.

6 mL/kg Is the Optimal Tidal Volume for Pediatric ARDS - Pro/Con

Pro: John H Arnold MD, Boston MA
Con: Neal J Thomas MD MSc, University Park PA

Although 6 ml/kg is commonly accepted as the optimal tidal volume for adults with ARDS, conclusive data in pediatrics are lacking. The optimal tidal volume for infants and children with ARDS is unknown and may be lower (or higher) than 6 ml/kg. This interactive pro/con presentation will debate the available data and the various thoughts on the optimal tidal volume for pediatric acute lung injury.

Pulmonary Rehabilitation Best Practices

Program Essentials

Connie Paladenech RRT RCP, Winston-Salem NC

Come to this presentation and learn all you've ever wanted to know about developing a world-class pulmonary rehabilitation program.

Candidate Selection and the Individualized Treatment Plan

Gerilynn L Connors RRT MAACVPR FAARC, Falls Church VA

The Individualized Treatment Plan (ITP) is the structural foundation for a comprehensive PR program. This presentation will demonstrate how your outcome success is critically dependent upon how complete, thorough, and all-inclusive the data is documented.

Patient Training and Education

Connie Paladenech RRT RCP

PR is NOT just an exercise program but a comprehensive therapeutic treatment plan that has a strong educational component. What topics should be covered? How do you train your staff to be effective teachers and coaches? Attend this lecture to find out!

The COPD Foundation and PR

Scott Cerreta RRT, Washington DC

Why invent the "wheel" and waste time and money? The COPD Foundation has developed extensive patient education programs for the COPD patient and your pulmonary rehabilitation program can utilize their expertise.

Bringing It All Together: Outcomes, Marketing and Community

Carl Willoughby RRT, Eureka CA

Come to this presentation to discover how to most effectively market your program to the community. Put your good outcomes to work for you!

Successful Billing and Documentation Processes in Pulmonary Rehab

Gerilynn L Connors RRT MAACVPR FAARC

There are many challenges associated with pulmonary rehabilitation reimbursement. This program will review the important aspects of coding and documentation for reimbursement for comprehensive pulmonary rehab programs.

Year in Review 2014

Patient Safety

Dean R Hess PhD RRT FAARC, Boston MA

A discussion of important papers related to patient safety that were published in 2014.

Mechanical Ventilation

Keith D Lamb RRT-ACCS, Des Moines IA

A discussion of important papers related to mechanical ventilation that were published in 2014.

Airway Clearance

Shawna L Strickland PhD RRT-NPS AE-C FAARC, Irving TX

A discussion of important papers related to airway clearance that were published in 2014.

COPD

Ruben D Restrepo MD RRT FAARC, San Antonio TX

A discussion of important papers related to COPD that were published in 2014.

Asthma

Kathleen M Deakins MSHA RRT-NPS FAARC, Cleveland OH

A discussion of important papers related to asthma that were published in 2014.

Aerosol Delivery Devices

Timothy R Myers MBA RRT-NPS FAARC, Irving TX

A discussion of important papers related to aerosol delivery devices that were published in 2014.

Developing an Outpatient Breathing Disorders Center to Impact COPD Transition of Care

Anil C Singh MD MPH, Pittsburgh PA

This lecture targets how a pulmonologist-led and respiratory therapist-staffed breathing disorders center can supplement post discharge COPD care during the critical 30-day post discharge period. Additionally, the center provides in depth respiratory services for the primary care physician who partners with the center for pulmonary function testing, GOLD staging, COPD medication best practices, accurate ADL oxygen titration, and dyspnea management skills as part of a COPD network of excellence.

Aerosol Therapy During Mechanical Ventilation - What Is the Evidence?

Bruce K Rubin MD MEngr MBA FAARC, Richmond VA

Bonchodilators, steroids, mucolytics, antibiotics ... a remarkable number of medications are delivered as aerosols to the intubated patent. There are dozens of bench and clinical studies evaluating novel ways to administer aerosols during mechanical ventilation. But what is the clinical evidence that these therapies are beneficial? Data, anyone?

"Let's Have Lunch Grandma": Successful Aging and Nutrition

Mary K Hart MS RRT AE-C FAARC, San Antonio TX

Adequate nutrition in older adults is a public health issue that therapists need to be prepared to address. This presentation will address the unique nutritional needs of the elderly patient.

The "Oxygen Assessment": It's All About the "O₂"

Katrina Hynes RRT CPFT, Rochester MN

The "Oxygen Assessment" is a comprehensive service laboratories can offer their patients. This presentation will discuss your role as a clinician, the art of the oxygen titration, the high-points of patient education, and key parameters to document to ensure Medicare/Medicaid reimbursement.

Clearing the Air Using Transparent Leadership

Matthew P Trojanowski MSc RRT, Abingdon MD

Leaders and their team members function in a dynamic environment. Unfortunately, this environment can become polluted with rumors and assumptions when a leader fails to exercise transparency. The presenter will take attendees on a journey to clear the air in the "Land of Misinformation," where assumption pollution has reached an all-time high and threatens the area's sustainability. Our only chance to save the "Land of Misinformation" is with the power of transparent leadership. Attend this lecture and learn how transparent leadership can clear the air in even the most heavily polluted environments.

Arterial Blood Gas Quality Assurance - "Doing the Right Thing Right"

Susan Blonshine RRT RPFT AE-C FAARC, Mason MI

A sound quality assurance program is imperative in preventing and eliminating erroneous arterial blood gas results. We will discuss the current quality models and the impact that shortfalls in the path to work flow process will have on quality patient data.

Aerosolized Vasodilators are Equivalent to Inhaled Nitric Oxide in Safety and Efficacy

Pro: Richard H Kallet MS RRT FAARC, San Francisco CA
Con: Richard D Branson MSc RRT FAARC, Cincinnati OH

Inhaled nitric oxide has changed therapy for treatment of pulmonary hypertension and refractory hypoxemia. The cost of frequent off-label use is significant. As a cost-saving measure, aerosolized vasodilators have been used. Are these drugs as effective and safe? What do the data say? If inhaled nitric oxide was inexpensive, would we ever consider inhaled vasodilators?

An Interactive Quiz: What Is Your Home Care IQ?

Respiratory Home Care Situations Quiz - Part I

Gary Jeromin MA RRT, Ann Arbor MI

The Home Care Respiratory Clinician faces the daily challenge of resolving both clinical situations and requirements for insurance reimbursement. This interactive quiz session will pose both clinical situations as well as practical questions regarding prescriptions, equipment selection, reimbursement qualifications, and equipment application. We will cover the gamut from ventilators and oxygen administration, to Rad devices and airway clearance. As a participant, you will have the chance to respond to the questions by a polling device (clicker). Are you up to the challenge?

Respiratory Home Care Situations Quiz - Part II

Angela King RPFT RRT-NPS, Leo IN

The Home Care Respiratory Clinician faces the daily challenge of resolving both clinical situations and requirements for insurance reimbursement. This interactive quiz session will pose both clinical situations as well as practical questions regarding prescriptions, equipment selection, reimbursement qualifications, and equipment application. We will cover the gamut from ventilators and oxygen administration, to Rad devices and airway clearance.

Transitioning from Student to Professional: Getting Credentialed and Employed

Bill Galvin MSEd RRT CPFT AE-C FAARC/Presiding

What It Means To Be a Professional!

Crystal L Dunlevy EdD RRT RCP, Columbus OH

This presentation will provide an overview of the profession of respiratory care to include its evolution, role and value. Emphasis will be placed on the characteristics and traits of a professional and the critical importance of being involved and maintaining professional membership.

Acquiring Your Credential: Success on the Written Exams

Bill Galvin MSEd RRT CPFT AE-C FAARC, Gwynedd Valley PA

The presentation will address factors essential for success in the examination process. It will cover preparatory issues, what you will experience onsite, as well as test-taking strategies and techniques. Emphasis will be placed on the NBRC Therapist Multiple-Choice Examination.

Acquiring Your Credential: Success on the Clinical Simulation Exam

Bill Galvin MSEd RRT CPFT AE-C FAARC

The presentation will serve as a sequel to the previous presentation and will address the factors essential for success on the NBRC Clinical Simulation Examination. It will cover such issues as exam content, structure, and unique strategies for progressing through a branching logic type of examination.

Securing Employment: Marketing and Networking Yourself to that Dream Job

Cheryl A Hoerr MBA RRT CPFT FAARC, Rolla MO

This presentation will provide an overview of the job search process to include: developing the cover letter, resumé, interview skills and measures that will prepare one for meaningful and satisfying employment.

Nobody Likes a Deadfish Handshake: Helpful Hints for an Interview

Christy McAllister RRT BHS, St Louis MO

Developing a resumé and preparing for a job interview can be very daunting. This presentation will provide you with helpful hints to the application and interview process to assist you in preparing for every part of the interview process.

You've Given All You've Got and They Want More

You've Given All You've Got and They Want More: Dealing with Stress and Time Management - Seek First to Understand

Garry W Kauffman MPA FACHE RRT FAARC, Winston-Salem NC

Feel like you don't have enough time to take care of your staff, patients, physicians, nurses, and other customers? You're working 12-hour days, doing more than ever, getting less (if any) recognition for your extra efforts, and the boss wants even more? The answer isn't doing more of the same. Learn some effective tips and techniques for lowering your stress, effectively using your time, and feeling more confident in your abilities and value to your staff, your boss, and your organization. In this first part of two sessions, we'll start the process of improving our management of time and stress by reviewing the different types of stress. What will be revealed is how the use and prioritization of time and stress are interrelated.

You've Given All You've Got and They Want More: Dealing with Stress and Time Management - Committing to the Change

Garry W Kauffman MPA FACHE RRT FAARC

Building on our understanding of time management and stress, this session will add the dimension of burnout. We’ll review the signs and symptoms of burnout, which mental health professionals indicate is the ultimate destructive consequence of an individual’s inability to manage time and stress at suitable levels. Participants will be provided with a validated burnout tool that will reveal their degree of burnout. Based on the information gleaned in this confidential survey tool, participants will receive a template and develop an action plan to steer them off the path to burnout, and take the path that will provide each person with a time management plan, stress management plan, and burnout avoidance plan. Individuals who have participated in this two-part program have overwhelmingly indicated that they have a better understanding of time, stress, and burnout and have been able to make a demonstrable and positive change in their personal and professional lives.

Fighting COPD Begins With Diagnostics

Frederic D Seifer MD FCCP, Shelbyville TN

Challenges associated with the management of chronic obstructive pulmonary disease (COPD) are gaining more and more attention as changes in health care legislation and reimbursement begin to reward quality and cost containment for chronic diseases. This lecture will educate on the importance of effective COPD screening and case-finding in today’s changing health care landscape.

Spirometry and Diffusion Capacity Is All You Really Need - Pro/Con

Pro: Matthew J O'Brien MS RRT RPFT, Madison WI
Con: Jeff Haynes RRT RPFT, Nashua NH

With the growing emphasis on cost containment in health care, are testing profiles like 'complete' or 'full' PFTs really necessary? What patient population(s) do spirometry and diffusion studies alone fit best? Two seasoned professionals will debate these questions.

Improving COPD Acute Care

Implementing Improvements To Reduce COPD Hospital Length of Stay

Francis Gott III MBA RRT, Newark DE

Attempting to reduce the hospital length of stay for COPD patients includes a multidisciplinary approach to implementing best practices for COPD care as well as implementing a clear plan of care. This discussion will cover best practices and how to implement them in your hospital to improve inpatient care of the COPD patient.

Implementing Improvements To Reduce Hospital Readmission of COPD

John S Emberger RRT FAARC, Newark DE

It is imminent that COPD will become a CMS hospital value-based purchasing diagnosis. Understanding your hospital COPD readmission rate and implementing enhancements to help keep COPD patients from being readmitted will become important for the financial security of hospital. This lecture will discuss how to initiate a process improvement to reduce COPD readmissions.

Professors' Rounds: Dueling Experts

PEEP in ARDS Must Be Optimized Using Transpleural Pressure

Pro: Ray H Ritz BA RRT FAARC, Newbury MA
Con: Eddy Fan MD, Toronto Ontario

Defining optimum PEEP for patients with ARDS has been under debate for over 30 years. Attention to reduction of alveolar stress with low tidal volume ventilation and failure to demonstrate significant improvement with high versus low PEEP in randomized trials combined with low tidal ventilation has reduced the interest in determining optimal PEEP. A recent report showing surprising improvement in survival by targeting individual optimization of lung compliance using transpleural pressure determination has resurrected interest in this important treatment modality. An expert clinician on each side of this debate will explain their own view of the literature and how they actually decide on optimal PEEP in their daily patient care.

AARC Program Committee Spotlight - The Changing Horizon: New Models of Health Care and the Role of the Respiratory Therapist

Integrating Respiratory Therapists in Accountable Care Organizations (ACOs)

Vernon R Pertelle MBA RRT CCM, Oceanside CA

Today's health care environment under the Patient Protection and Affordable Care Act has created significant opportunities for respiratory therapists to deliver clinical services and case management for patients who are diagnosed with COPD. Accountable Care Organizations (ACOs) require the expertise of respiratory therapists in coordination with physicians and physician extenders to help improve health outcomes, demonstrate meaningful use of resources and prevent reimbursement penalties due to readmissions.

Keeping Respiratory Therapists at the Center of Patient-Centered Medical Homes (PCMHs)

Vernon R Pertelle MBA RRT CCM

The care and treatment of a patient who is diagnosed with respiratory disease must consider the whole patient and should be centered on the patient's needs. A new approach to managing complex respiratory conditions to keep patients at a stable state in the low-cost environment (their homes) must ensure that the health care team has a thorough understanding and knowledge regarding all components of respiratory modalities and technology used to treat patients. The 'new normal' includes systems of care within ACOs and Patient Centered Medical Homes (PCMHs) that include respiratory therapists with specialized training in managed and integrated care systems.

Respiratory Medical Device Education Programs in an ACO To Improve Outcomes

Robert McCoy RRT, Apple Valley MN

Respiratory medical device training and education helps physicians, nurses, physician extenders and case managers focus on the complex scientific, technical and quality assurance problems encountered with respiratory medical devices for patients diagnosed with chronic respiratory disease. Comprehensive education and training programs empowers key stakeholders with decision-making ability to improve health outcomes in an ACO or PCMH.

Open Forum #1 - Aerosols/Drugs - Part I

Researches and clinicians present the results on bread-and-butter issues in respiratory care. Audience and authors review the posters during the first part of the session. A brief oral presentation (no slides) and audience questions and discussion allow presenters to expand on the work featured on the poster.

Supported by an unrestricted educational grant from

Open Forum #2 - Monitoring/Equipment - Part I

Researches and clinicians present the results on bread-and-butter issues in respiratory care. Audience and authors review the posters during the first part of the session. A brief oral presentation (no slides) and audience questions and discussion allow presenters to expand on the work featured on the poster.

Supported by an unrestricted educational grant from

Creating, Executing and Sustaining a Departmental Strategic Plan

Matthew P Trojanowski MSc RRT, Abingdon MD

Strategic plans are only effective when they are actually put into action. A major reason that strategic plans become nothing more than empty words and fancy diagrams is that the actual people with the capacity to execute the plan are kept out of the loop until the final product is revealed. The speaker will discuss ways that leaders can use transparency to engage key stakeholders and increase the likelihood of a strategic plan's success.

Aerosolized Acid Exposure and the Evaluation of Cough

Katrina Hynes RRT CPFT, Rochester MN

The 24-hour laryngopharyngeal pH probe is a simplistic diagnostic procedure that measures pH levels of the upper airway which may be a cause for cough secondary to gastric reflux. The procedure and how to interpret the graphical presentation of the data will be explained. In addition, we will discuss the clinical utility in evaluating cough.

Eliminating the Endotracheal Tube

High Flow Nasal Cannula: Principles and Practice

Alex T Rotta MD FAACP FCCM, Cleveland OH

Despite limited outcome data, high flow nasal cannula is gaining increasing popularity in the pediatric and neonatal population. This session will review the concepts, available data, and principles underlying the use of this technology.

Pediatric Noninvasive Ventilation for Acute Respiratory Failure

Lee Williford RRT, Durham NC

Pediatric non-invasive ventilation is being used at an increasing rate in the acute care setting to avoid or limit the need for intubation and invasive mechanical ventilation. This presentation will highlight the rationale and available data supporting this approach. Speculation on the future of pediatric noninvasive ventilation will be offered.

Stop Giving Humans Sodium Bicarbonate Infusions To Correct Metabolic Acidosis!

Matthew T Davis RRT, Baltimore MD

Metabolic Acidosis is a common phenomenon that occurs in the Intensive Care Unit. The standard of care for treating this disorder is the infusion of sodium bicarbonate IV. This process is no longer supported by the evidence and should immediately be stopped. This lecture will teach you how to correct the metabolic acidosis by fixing the actual problem. The evidence will show that infusing sodium bicarbonate may increase the morbidity and mortality of your patient.

2014 AARC Respiratory Therapist Human Resource Study Results

Shawna L Strickland PhD RRT-NPS AE-C FAARC, Irving TX

The AARC conducted the Respiratory Therapist Human Resource Study in 2014. This presentation will discuss the results of the study, data trends noted since the first human resource study, and the implications of the data on the respiratory therapy workforce.

Beyond Low Tidal Volumes for ARDS in 2014

Neil R MacIntyre MD FAARC, Durham NC

This presentation will review the most current evidence-based ventilatory management for adult patients with ARDS. This will include pressure- and volume-limited ventilation, optimal levels of PEEP, the use of recruitment maneuvers, and the place of adjuncts such as prone positioning and inhaled vasodilators.

Screening & Follow Up of Lung Volume Reduction Coil Treatment in Patients with Emphysema

Matthew J O'Brien BS RRT RPFT, Madison WI

Already approved in Europe, multiple coil placement using bronchoscopy offers hope for patients with severe emphysema. Learn about one site's experience in providing screening and follow-up pulmonary function measures.