The Gold Standard in Respiratory Care Meetings

2007 AARC Respiratory Congress
Advance Program


Tuesday, December 4

8:30 A.M.–11:55 A.M.
The Annual RESPIRATORY CARE Journal Symposium

The Institutional Review Board and You

8:30 A.M.–8:55 A.M.
The Historical, Ethical, and Legal Background for Research Involving Human Subjects
Todd W Rice MD, Nashville TN
Current laws, regulations, and principles involving research on human subjects have evolved in the context of Western history and ethics. This presentation reviews the major events, concepts, and developments that have produced our present-day institutional review boards and defined their role in research.

Hear top speakers.

9:00 A.M.–9:25 A.M.
What Is an IRB, and What Does It Do?
Jonathon D Truwit MD, Charlottesville VA
This presentation reviews the purpose, composition, and function of an institutional review board, as well as its role in research involving human subjects.

9:30 A.M.–9:55 A.M.
Informed Consent: What Does It Mean, What Are the Problems, and How Can They Be Avoided?
Margaret J Neff MD MSc, Seattle WA
Informed consent for participation in research may seem straightforward in concept, but it can be neither clear nor simple, particularly when critically ill patients are involved. This presentation defines and describes informed consent and how to avoid its numerous associated problems.

10:00 A.M.–10:25 A.M.
Doing Research on Protected Populations, Including Children, Pregnant Women, Prisoners, and Employees
Karen J Schwenzer MD, Charlottesville VA
This presentation discusses the special challenges posed by research involving subjects and patients in these and other special groups, and offers practical tips for avoiding associated problems and pitfalls.

10:30 A.M.–10:55 A.M.
Chart Reviews, Case Reports, and Waiver of Consent for Research
Margaret J Neff MD MSc
What is the role of HIPAA and the IRB in research involving existing data, as in chart review? Under what circumstances does a case study or case report require IRB approval? In what types of studies in what settings can informed consent be waived?

11:00 A.M.–11:25 A.M.
Practical Tips for Working Effectively with Your IRB
Karen J Schwenzer MD
This presentation lists common mistakes made by researchers and offers practical advice for making interactions with the IRB efficient and hassle-free.

Compete to win a trophy.

11:30 A.M.–11:55 A.M.
What If You Don’t Have an IRB?
Todd W Rice MD MSc
Not all research is done at large medical institutions. This presentation addresses the conceptual and practical issues involved in informed consent and IRB approval for research carried out in outpatient facilities, home care services, and small institutions without established IRBs.

8:30 A.M.–9:00 A.M.
The Evolution of Respiratory Care: Part III: 1987–2007
David J Pierson MD FAARC, Seattle WA
The last 20 years have brought breathtaking changes to respiratory care: evidence-based medicine, clinical practice guidelines, ventilator-induced lung disease, noninvasive ventilation, and the AARC’s Journal in Index Medicus. This final installment in a 3-part series completes the story of how we got here—as a subject area, a profession, and a 40,000-member professional association celebrating its 60th anniversary.

8:30 A.M.–9:15 A.M.
Pediatric Respiratory Care 101
The Essentials of Pediatric Respiratory Care for the Adult Clinician
Donna Hamel RRT FAARC, Durham NC
Do you work in a general care and emergency department setting and only occasionally care for infants and children? If so, are you prepared for your next pediatric patient? This presentation will review the basics of pediatric respiratory care for the adult care clinician.

8:30 A.M.–10:25 A.M.
Issues in Long-Term Oxygen Therapy
8:30 A.M.–9:05 A.M.
Best Practices for Non-Delivery LTOT Systems
Jacquelyn McClure RRT FAARC
Melbourne FL

This presentation will review the newest technology in home oxygen generation devices, specifically those that allow patients unlimited A.M.bulation without the need for home delivery of replacement oxygen. The speaker will discuss best practices to ensure that the device selected is capable of providing sufficient supplemental oxygen during all activities of daily living.

Meet new people.

9:10 A.M.–9:45 A.M.
New LTOT Technology and Air Travel
Joseph Lewarski RRT FAARC
Mayfield Heights OH

The Federal Aviation Administration has approved portable oxygen concentrators for commercial air travel. This lecture will focus on the technical foundation of a POC, the requirements for use on a commercial aircraft, including clinical and technical considerations for in-flight use.

9:50 A.M.–10:25 A.M.
Exercise and LTOT: Factors That Influence Effective Delivery
Robert McCoy RRT FAARC, Apple Valley MN
Exercise is one of the more challenging situations for the new portable oxygen concentrators utilizing oxygen conserving technology. POCs do have certain limitations in terms of maximum oxygen production. This lecture will discuss the variables to consider with different POCs when titrating a patient during exercise.

Airways And Their Care

Supported by an unrestricted educational grant from IKARIA
9:30 P.M.–11:25 P.M.
Clinicians present the results of their scientific studies. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand on the information presented.

  • Improved Quality of Care With Standardized Tracheostomy Management Protocols—Lynn Lenz RRT, La Crosse WI
  • A Study of Exhaled Nitric Oxide in Patients With Airways Diseases—Yu-Hwa Chang MPH, Tai-Po City, Chia-yi, Taiwan
  • Clinical Profiles and Outcomes of ICU Patients With Herpes Simplex in Respiratory Secretions—Karl Ludwig, Provo UT
  • Bench Study to Evaluate the Use of Acoustic Reflectometry to Measure Endotracheal Tube Obstruction—Robert Stone RRT, Cape Girardeau MO
  • A North American Survey of the Determinants of Tracheostomy Decannulation—Dean Hess PhD RRT FAARC, Boston MA
  • Respiratory Therapists Can Successfully Support a Teaching Institution’s Airway Management Program in the Emergency Department—Jhaymie Cappiello RRT, Raleigh NC
  • Bench Evaluation of an Indirect Calorimetry System Using On-Airway Sensors—Joseph Orr PhD, Salt Lake City UT
  • Biting-Caused Compression Damage of a Metal Wire-Reinforced Silicon Endotracheal Tube: A Case Report—Robert Hase MSc, Seattle WA
  • Number of Days on Mechanical Ventilation Prior to Unplanned Extubation Associated With a Higher Rate of Reintubation—Vijay Subramaniam MD, Pittsburgh PA
  • Bench Study: Examining Two Methods of Cuff Leak During Adult HFOV—John Emberger RRT, Newark DE
  • Development of a Pre-Procedural Sedation Airway Assessment Tool to Determine Potential Need for Intervention During Procedural Sedation—Jim Fielder, RRT, Bellevue WA
  • Comparison of Two Methods for Monitoring Airway Responsiveness Before and After the Administration of Methacholine—Katrina McDonald CRT, Rochester MN

8:30 A.M.–10:45 A.M.
Interventional Pulmonology: It’s All New!
8:30 A.M.–9:00 A.M.
Endobronchial Valves for the COPD Patient
Momen Wahidi MD, Durham NC
Endobronchial valves are a new innovation in the treatment of COPD. This presentation will describe the techniques for placement and care with endobronchial valves.

9:05 A.M.–9:35 A.M.
Argon Plasma Coagulation, A New Role for the RT
William D Cohagen RRT FAARC, Phoenix AZ
Take a glimpse into argon plasma coagulation for the treatment of tracheal granulomas and stenosis. This presentation will focus on the respiratory therapist’s role in the procedure.

Participate in social functions.

9:40 A.M.–10:10 A.M.
Thermoplasty for Asthma
Momen Wahidi MD
Thermoplasty is a new and exciting treatment for asthma. This presentation will describe the physiology and care of the bronchial thermoplasty.

10:15 A.M.–10:45 A.M.
Development of an Interventional Pulmonary Service
David Misselhorn RRT, St Louis MO
Interventional pulmonology involves more than bronchoscopy and thoracentesis assists. Unique opportunities presented to therapists in our hospitals include assisting with percutaneous tracheostomy placement, endobronchial ultrasound procedures, bronchopulmonary ablation, bronchial stent placement, etc. The speaker will share his experiences of assisting with development of an interventional pulmonary program from the ground up.

8:30 A.M.–10:45 A.M.
AARC Leadership Institute
8:30 A.M.–9:00 A.M.
Leading High Performance Teams
George W Gaebler MS Ed RRT FAARC
Syracuse NY
Participants will understand some of the fundamental components of high-performance teams as well as strategies for developing and implementing them.

9:05 A.M.–9:35 A.M.
Working with Integrity
Ruth Krueger-Parkinson MS RRT, Sioux Falls SD
Participants will understand the basics of working in a compliant world and that compliance goes beyond law and ethics. They will be given methods for prevention and detection of issues, tools for constant improvement, and basic help with these concerns.

9:40 A.M.–10:10 A.M.
Delegation and Accountability
Scott Reistad RRT CPFT, Denver CO
Participants will be able to understand the importance of delegation and how to filter what should and should not be delegated. Learn to teach accountability and coach for results regarding accountability.

10:15 A.M.–10:45 A.M.
The Beauty of Fierce Conversations
Ken Thigpen RRT, Jackson MS
Participants will understand the importance of enduring the discomfort of having difficult conversations as well as the benefits recognized in improved performance and necessity in achieving desired outcomes.

Home Care. Case Studies.

Supported by an unrestricted educational grant from IKARIA
9:30 P.M.–11:25 P.M.
Clinicians present the results of their scientific studies. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand on the information presented.

  • Early High Frequency Oscillatory Ventilation Intervention in the Adult Post Surgical Acute Lung Injury Patient: A Case Study—Ramona Herrington, Martinez GA
  • Delivery of Inspired Gas in the Differential Diagnosis of a Bronchopericardial Fistula: A Case Study—Natasha Fencl, Churchville PA
  • The Course of SMA in the Home Care Patient: 3 Case Studies—Bruce Estrem, Roseville MN
  • Mechanical Ventilation Simulation—Transitioning Patient From Critical Care Ventilator to Home Care Ventilator—Dawn Selhorst RRT-NPS, Wilmington DE
  • A Mathematical Model for Predicting Home Oxygen Technology Attrition Rates and Rental Life Operating Under a 36 Month Payment Cap—Joseph Lewarski RRT FAARC, North Ridgeville OH
  • Evaluation of a Novel Device to Titrate Portable Oxygen Systems—Robert McCoy RRT FAARC, Apple Valley MN
  • A Bench Study to Determine and Compare the Maximum Total Dose Volume vs Maximum “Useful” Dose Volume of 33 Oxygen Conserving Devices—Ryan Diesem, Apple Valley MN
  • Pericardial Tamponade Associated With Primary Signet Ring Cell Carcinoma of the Lung—Vijay Subramaniam MD, Pittsburgh PA
  • The Difficulty in Oxygenating an Ambulatory Severe Chronic Obstructive Pulmonary Disease Patient—Vijay Subramaniam MD, Pittsburgh PA

8:30 A.M.–10:50 A.M.
Management of COPD Exacerbations: An Evidence-Based Medicine Approach
8:30 A.M.–9:00 A.M.
Douglas S Gardenhire MS RRT-NPS, Atlanta GA
This presentation reviews the actions and uses of bronchodilators in managing exacerbations of chronic obstructive pulmonary disease, including choice of agent, delivery system, and dosing schedule, plus adverse effects and how to minimize them.

Enjoy educational opportunities.

9:05 A.M.–9:35 A.M.
Marcos I Restrepo MD, San Antonio TX
This presentation reviews the data supporting antibiotic use in exacerbations of COPD, including microbiological considerations, patient selection, and how to choose an appropriate agent.

9:40 A.M.–10:10 A.M.
Ruben D Restrepo MD RRT
San Antonio TX

This presentation reviews the data supporting the use of corticosteroids in COPD exacerbations, and provides evidence-based guidelines for choice of agent, dose, and regimen.

10:20 A.M.–10:50 A.M.
Noninvasive Ventilation
David L Vines MHS RRT FAARC, San Antonio TX
This presentation reviews the evidence supporting the use of noninvasive ventilation in exacerbations of COPD, and provides guidance on patient selection, interface settings, and other practical aspects of using this life-saving therapy.

8:30 A.M.–11:25 A.M.
Topics in Neonatal Mechanical Ventilation
8:30 A.M.–8:55 A.M.
Inhaled Nitric Oxide for the Premature Infant
Sherry E Courtney MD, New Hyde Park NY
Although the use of inhaled nitric oxide has become standard of care for full-term infants with pulmonary hypertension, its use in the premature infant population remains controversial. This presentation will summarize the recent literature on this complex subject.

Become a speaker.

9:00 A.M.–9:25 A.M.
Weaning from Mechanical Ventilation: Pathophysiology Matters
Donald M Null Jr. MD, Salt Lake City UT
Length of mechanical ventilation is directly proportionate to morbidity. The goal is to minimize length of ventilation and, thus, optimize the chance for successful extubation. This presentation will discuss strategies to safely minimize the length of ventilation with a focus on pathophysiology.

9:30 A.M.–9:55 A.M.
High-frequency Ventilation for the Neonate
Steven M Donn MD, Ann Arbor MI
When should high-frequency ventilation be used for neonatal respiratory failure? This presentation will review the indications for high frequency ventilation and the advantages and disadvantages of oscillatory and jet ventilation.

10:00 A.M.–10:25 A.M.
Airway Graphic Analysis
Steven M Donn MD
Despite the fact that many critical care ventilators have airway graphic monitors, this information is too often neglected in the care of the neonate. This presentation will present a systematic approach to airway graphic analysis using specific clinical examples.

10:30 A.M.–10:55 A.M.
Closed Loop Control of Oxygen
Mark Rogers RRT, Yorba Linda CA
Oxygen toxicity remains a major concern. This presentation will review the toxic effects of oxygen and identify the patient populations most at risk. A novel approach to this age-old problem is closed loop control of oxygen. New advances in this technology will be discussed.

11:00 A.M.–11:25 A.M.
HFVP: Is It Really Necessary?
Donald M Null Jr. MD, Salt Lake City UT
HFVP is a novel approach to the care of mechanically ventilated neonates. This presentation will focus on advantages and disadvantages of this unique approach.

Devices/Techniques/Results—Part 3

Supported by an unrestricted educational grant from IKARIA
1:00 P.M.–2:55 P.M.
Clinicians present the results of their scientific studies. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand on the information presented.

  • A Performance and Cost Comparison of Four Valved Holding Chambers During Simulated Uncoordinated Breathing—Paul McGowen RRT, Tucson AZ
  • Demand-Flow Improves Maintanance of Spontaneous Breathing During HFOV in Pigs—Karel Roubik PhD, Kladno, Czech Republic
  • Doses of Isoflurane to Decrease Peak Inspiratory Pressures in Patients With Life-Threatening Bronchospasm: A Retrospective Chart Review—Christine Duclos, Boston MA
  • Establishing and Implementing Inhaled Nitric Oxide (iNO) Guidelines in Adult Intensive Care Units: Impact on Duration of iNO Therapy—Bradley Taylor RRT, Baltimore MD
  • Use of I-Neb® Insight™ for Training and Follow Up of Patients With Pulmonary Arterial Hypertension—Cheryl Nickerson, Cedar Grove NJ
  • The Use of Pleth Variability Index (PVI) to Detect Changes in Intrathoracic Pressure—Mitchell Goldstein MD, Loma Linda CA
  • Accuracy of a Novel Bioacoustic Sensor in Postoperative Patients—Mark Macknet MD, Loma Linda CA
  • Benzocaine Induced Methemoglobinemia After Tee—Mark Macknet MD, Loma Linda CA
  • Ventilatory Pattern Responses to Varying Compliance and Resistance in a Lung Model With Adaptive Support Ventilation—Michael Gentile RRT, Durham NC
  • Lab Evaluation of the INOmax DS in Backup Mode—John Newhart CRT, San Diego CA
  • Lung Diffusion Capacity for Nitric Oxide and Carbon Monoxide: Evaluation of a New Device—Werner Steinhaeusser, Hoechberg, Germany
  • Delivered O2 Concentration With an Oxygen Bleed-In Using the Emerson Coughassist In-Exsufflation Device: A Bench Study—Doug Aslin RRT, Seattle WA
  • Effects of Tidal Volume on Delivered O2 Concentrations With an Oxygen Bleed-In With the Emerson Coughassist MI-E Device: a Bench Study—Joel Ray RRT, Seattle WA
  • FDO2 of O2 Delivery Devices During Simulated Infant Breathing—Dave Crotwell RRT-NPS, Seattle WA

8:30 A.M.–12:10 P.M.
Special Challenges in Mechanical Ventilation
8:30 A.M.–9:10 A.M.
Critical Hypoxemia
Robert M Kacmarek PhD RRT FAARC
Boston MA

This presentation describes the ventilator modes and ancillary techniques that have been used to increase arterial oxygenation in patients with severe hypoxemic acute respiratory failure—including high PEEP, recruitment maneuvers, prone positioning, inhaled nitric oxide, and aerosolized vasodilators. It briefly reviews the evidence base supporting each and provides a practical approach for managing patients in whom supporting oxygenation is the primary problem.

9:15 A.M.–9:55 A.M.
Dangerously High Airway Pressures
Richard D Branson MSc RRT FAARC, Cincinnati OH
In previous decades numerous ventilatory modes and approaches were introduced in attempts to minimize peak airway pressure. This presentation briefly reviews the various airway pressures that can be monitored and the evidence relating them to ventilator-associated lung injury. It then describes current modes and approaches used to control airway pressures, including pressure modes of conventional ventilation, airway pressure release ventilation, and high-frequency ventilation. Based on review of the existing evidence, it concludes with recommendations for managing patients in whom high airway pressures are thought to be an important problem.

Experience the night life.

10:00 A.M.–10:40 A.M.
Patient-Ventilator Dys-synchrony
Dean R Hess PhD RRT FAARC, Boston MA
Patient-ventilator dys-synchrony occurs when gas delivery from the ventilator does not match the neural output of the patient’s respiratory center. Dys-synchrony is especially common in patients with COPD but is also a problem with low-tidal-volume lung-protective ventilation and in other settings as well. This presentation reviews the causes and clinical manifestations of this problem; reviews the methods available for dealing with it, including proportional assist ventilation and neurally adjusted ventilatory assist; and offers a practical approach for assessment and management.

10:45 A.M.–11:25 A.M.
Managing Acidosis during Mechanical Ventilation
Richard M Kallet MS RRT FAARC
San Francisco CA

After a brief review of acid-base physiology and the types of acidosis encountered in the ICU, this presentation deals with how to induce permissive hypercapnia, along with how and when to use bicarbonate and other interventions for managing acidosis in mechanically ventilated patients.

11:30 A.M.–12:10 P.M.
Discontinuing Ventilatory Support
Jonathon D Truwit MD, Charlottesville VA
One of the goals of mechanical ventilation is to minimize its duration in order to avoid complications, reduce patient discomfort, and decrease costs. Knowing when a patient can safely be liberated from ventilatory support and how to accomplish this most effectively, remain important challenges for clinicians in the ICU. This presentation summarizes current evidence on the effects of different modes and approaches on the duration of mechanical ventilation, describes the present role of “weaning parameters” in this process, and reviews current recommendations for discontinuing ventilatory support.

Good Management = Good People—Part 2

Supported by an unrestricted educational grant from IKARIA
1:00 P.M.–2:55 P.M.
Clinicians present the results of their scientific studies. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand on the information presented.

  • Disaster Preparedness Among Hospital Respiratory Care Practitioners—Sigita Gsell, Watertown MA
  • Employee Councils in the Respiratory Care Department—Shelly Brown RRT-NPS, Little Rock AR
  • Disaster Preparedness – “Will You Come to Work?”– an Employee Survey—Ben Downs RRT-NPS, Little Rock AR
  • Current Practices for Respiratory Care in the ICU: A Regional Survey in Beijing, China—Jie Li, Beijing, China
  • Respiratory Care Practitioner: Code Blue Process Coordinator for an Academic University Medical Center—Kelly Jean Thompson-Lumen, Victorville CA
  • Intensive Care Unit Nurses’ Knowledge, Nursing Performance, and Stress About Delirium—Hee Jung Suh MSN, Seoul, South Korea
  • Evaluation of an Automatic Stop Order Procotol for Respiratory Care Medication Therapy—Elizabeth Bearden RRT, Houston TX
  • Improving Healthcare One Policy at a Time: Utilizing Evidence-Based Practice to Support Optimal Policy Revisions—Suzanne Iniguez RRT, Houston TX
  • Development of a 72 Hour Assessment Program to Facilitate Non-Concurrent Therapy—Beth Green MA MBA, Houston TX
  • Implementing a Web-Based Managerial Audit Tool—Elsie M Collado-Koman MBA-HCM, San Diego CA
  • Measuring Missed Treatments in Relation to Productivity—Gina Giles-Oas, San Diego CA
  • Multi-Site Staffing Model—Carol Mihailuk, San Diego CA
  • Literature Search Results: PubMed and Google Scholar in Comparison to Cochrane Evidence-Based Systematic Reviews—Michael F Anders PhD RRT, Little Rock AR
  • The Role of a Servant-Leader Model for Management of Respiratory Care Departments—Ken Thigpen, Jackson MS
  • Instructional Effectiveness of Disaster Preparedness and Response Training Focused on Respiratory Therapy Programs in Florida: A Pilot Program—Melanie McDonough MSHS RRT, Orlando FL
  • Assessing RN and RCP Initiation and Use of an Unfamiliar Ventilator for Possible Emergency Surge Capacity Use—Frank M Freihaut, Omaha NE

9:05 A.M.–9:55 A.M.
Of Science and Snake-Oil: A Clinician’s Guide to Interpreting the Scientific Literature
Richard M Kallet MS RRT FAARC
San Francisco CA

Everyone working in respiratory care needs to be able to critically evaluate the rapidly expanding literature in this field. This presentation, targeted primarily at clinicians without formal training in scientific methodology, provides an approach to reading a scientific paper. Included are a discussion of probability and random variation and why it is important to know about these things, basic principles of study design, levels of scientific evidence, and a selection of actual examples from the respiratory care literature showing how poor research design has fostered myths about therapies later proven to be ineffective.

9:20 A.M.–11:45 A.M.
Innovative Perspectives in Skilled Nursing Facilities
9:20 A.M.–10:05 A.M.
Establishing a Medical Fee System Based on Patient Time on Ventilator
Charles Bangley RRT, Greenville NC
This lecture will feature the experiences in Vermont with Medicaid, define the unique issues with SNF payments, and review the outcomes and long-term plan for this service.

Win a prize.

10:10 A.M.–10:55 A.M.
Better Continuum of Care
Gretchen May-Fendo MDiv RRT AE-C
Norwalk CT

The speaker will present a clinical pathway intended to decrease length of stay in the acute care arena and provide a better continuum of care to a skilled nursing facility.

11:00 A.M.–11:45 A.M.
Living with Chronic Illness
Gretchen May-Fendo MDiv RRT AE-C
The speaker will discuss the profound impact of living with a chronic illness and how the literature supports the use of spirituality as an important adjunct to health and the effect it has on a patient’s ability to live well with chronic illness. The lecture will also include the ways RTs can help to support this.

10:30 A.M.–12:05 P.M.
Air Transport Issues
10:30 A.M.–11:15 A.M.
Competing in a Non-Competitive Environment
Patrick Dowd RRT-NPS EMT
The presentation will explain the implementation, scheduling and training methodology of a busy air-medical program undergoing role enhancement and the interdisciplinary conflicts that frequently occur and techniques used for resolution.

11:20 A.M.–12:05 P.M.
Who’s in the Air?
Patrick Dowd RRT-NPS EMT
The presentation will discuss the national trends of air-medical crew configuration with a primary focus on which programs are utilizing respiratory therapists and how to enhance the opportunities and responsibilities during transport.

10:50 A.M.–11:35 A.M.
Pharmacotherapy for Tobacco Use and Dependence
Michael Anders PhD RRT, Little Rock AR
The presentation will address the indications, contraindications, advantages, and disadvantages for alternative pharmacotherapies in the treatment of tobacco use and dependency. Additionally, it will address the interactions, dosing regimes, and patient education issues related to alternative pharmacotherapies.

10:50 A.M.–12:50 P.M.
Topics in Respiratory Department Management
10:50 A.M.–11:20 A.M.
Have You Seen My Tanks Lately? Contract Cylinder Management in a Large Urban Hospital
St Louis MO

This presentation will outline the difficulties our respiratory care services department had in tracking thousands of medical gas cylinders through 6,000,000 square feet of hospital buildings and the negative financial impact the “loss” of many of these cylinders was having on the hospitals. We will share our experiences with the accountabilities put in place and the successes we have realized in improved customer satisfaction.

11:25 A.M.–12:15 P.M.
Respiratory Care Technician Development: Empowering Therapists To Work to Their Highest Potential
Tiyonda Valentine-Cook BS RRT, St Louis MO
This presentation will detail the development and implementation of our professional development program for registered respiratory therapists. The program was designed to encourage therapists to become more involved and contribute to both the department and profession. The program was approved and implemented by 7 out of 12 respiratory departments in the BJC Healthcare System with the goal of improving employee recruitment and retention. The speaker will discuss the challenges encountered while developing a standardized program that allows individual hospitals to retain their individuality. We will also discuss the impact on therapist job satisfaction and job performance.

12:20 P.M.–12:50 P.M.
Development and Implementation of a Shared Governance Program in Respiratory Care
Diana Bail RRT, St Louis MO
Our shared governance program engages front-line staff in the identification, analysis, and improvement of departmental challenges. Therapists are encouraged to practice effective problem-solving techniques and develop workable resolutions to the issues that have been identified. This shared governance model empowers staff and improves overall departmental quality. It also provides the opportunity to further develop staff toward leadership positions within the department by expanding their understanding of group dynamics and decision-making processes.

Earn 10.2 CRCE credits at the Asthma Educator Certification Prep Course prior to the Congress.

1:00 P.M.–1:45 P.M.
Chronic Care Models for COPD
Jacquelyn McClure RRT FAARC
Melbourne FL

Advanced chronic obstructive pulmonary disease, like so many chronic illnesses, afflicts one person but affects entire families. Most people with advanced lung disease have episodes of crisis, such as lung infections and shortness of breath, and then periods when nothing seems to happen. However, over time, symptoms worsen. This presentation will share information on care models with successful outcome data and reinforce the GOLD Guidelines.

1:00 P.M.–2:35 P.M.
Using Toyota Production System Methodology for Quality Management
1:00 P.M.–1:45 P.M.
An Introduction to Toyota Management Methods: Theory and Tools
Michael Westley, Seattle WA
This session will describe how the TPS improves quality by eliminating defects, provide an overview of TPS process management, and provide tools for improving processes.

1:50 P.M.–2:35 P.M.
Putting Toyota Production System Methodology To Work
Robert Hase MS RRT-NPS, Seattle WA
The speaker will discuss practical application of TPS methodology and tools for respiratory care to process issues, plus case studies of actual process improvement activities using TPS methodology.

1:00 P.M.–2:40 P.M.
Secondary Causes of Pulmonary Hypertension
1:00 P.M.–1:30 P.M.
Pulmonary Hypertension Post Cardiac Surgery
Ian J Welsby MD, Durham NC
This lecture will discuss the incidence of post cardiac surgery pulmonary hypertension: the cause, the signs, and treatment.

1:35 P.M.–2:05 P.M.
Pulmonary Hypertension in Sleep Apnea
Nicholas M Hill MD FACCP, Boston MA
This presentation will present the investigation of the effect of sleep-stage changes on pulmonary circulation patients with obstructive sleep apnea syndrome and whether the treatment of OSAS has an effect on pulmonary hypertension.

2:10 P.M.–2:40 P.M.
Pulmonary Hypertension in COPD
Nicholas M Hill MD FACCP
The presentation will review the investigation and therapeutic recommendations for pulmonary hypertension as it is observed in patients with advanced COPD.

1:00 P.M.–2:40 P.M.
Optimizing Lung Procurement
1:00 P.M.–1:30 P.M.
Optimizing Lung Procurement
John Keller RRT, Little Rock AR
The respiratory therapist’s role is expanding at the bedside of the organ donor. An aggressive and pro-active coordination of diagnostic and therapeutic modalities has increased lung procurement. This presentation will include discussion of apnea testing, bronchoscopy, mechanical ventilation, airway clearance and blood gas analysis. Also discussed will be the factors affecting the University of Arkansas for Medical Sciences’ history of lung procurement, which involved no lungs being recovered prior to 2005, 14 in 2005, and 25 in 2006.

Mingle with peers from around the world.

1:35 P.M.–2:05 P.M.
Organ Donation from a Professional and Personal Perspective
Rena Barker RRT AE-C, Little Rock AR
After 15 years as a respiratory therapist in a growing organ donation and transplant center, this process became even more relevant after a family member became a liver transplant recipient. Three years later, a respiratory therapist was performing an apnea test on my grandchild. Discussions will include facing sensitive issues with family and using personal experience to be a more compassionate respiratory therapist.

2:10 P.M.–2:40 P.M.
Lung Transplantation: The Procedure
Ian J Welsby MD, Durham NC
Bad parts out. Good parts in!

1:00 P.M.–2:40 P.M.
Utilizing Protocols in Long-Term Care Facilities
1:00 P.M.–1:30 P.M.
Implementing Respiratory Protocols in the Long-Term Acute Care Hospital Setting
Kristin Kachnoskie RRT, Phoenixville PA
A how-to guide describing how to implement protocols in long-term care, from gaining “buy in” from medical providers and staff to implementation and monitoring.

1:35 P.M.–2:05 P.M.
Reducing Length of Stay Using Respiratory Protocols
Kristin Kachnoskie RRT
The lecture will focus on the benefits of using protocols to guide ventilator weaning, oxygen titration, and bronchodilator use as related to length of stay in the LTAC facility. The positive impact on patients and on the facility as a whole will be discussed.

2:10 P.M.–2:40 P.M.
Weaning Protocols and the LTAC Patient: Do They Really Work?
Kristin Kachnoskie RRT
The lecture will discuss the weaning protocols and whether weaning parameters have demonstrated any value. The pros and cons of various weaning methods in the LTAC setting will be discussed.

2:45 P.M..
Long Term Care Section Meeting
Maria M Wooldridge RRT/Chairing
Whether or not you are a member of the Long Term Care Section, you are welcome to attend. Your participation can make a difference in the future of your area of interest in the profession.

1:00 P.M.–3:10 P.M.
Identification, Assessment, and Stabilization of Infants and Children with Cardiac Disease
1:00 P.M.–1:40 P.M.
Clinical Presentations and Evaluation of Heart Disease in Children: Not as Complicated as You May Think?
Bradley A Kuch RRT-NPS, Pittsburgh PA
Advances in cardiology, intensive care, and surgical techniques have led to the survival of children with previously lethal cardiac disease (CD). These children often present to local community hospitals for initial resuscitation and stabilization before being transferred to pediatric tertiary care centers for definitive diagnostics and surgical or critical care intervention. For this reason, it has become increasingly more important for transport teams to understand pediatric CD and how it relates to their resuscitative efforts. These children pose a significant challenge to the transport team as they are younger, more severely ill, receive more interventions, and are at a higher risk of mortality than children from other diagnostic categories. The lecture introduces the transport therapist to various presentations of congenital and acquired heart disease in children. Particular emphasis will be placed on physical assessment and chest radiography.

Earn extra CRCE credits at the breakfast symposia.

1:45 P.M.–2:25 P.M.
Initial Stabilization and Transport of Infants and Children with Heart Disease
Kathryn Felmet MD, Pittsburgh PA
The lecture introduces the latest concepts in the management of children with congenital and/or acquired heart disease. Covered will be the indications and delivery of palliative interventions during the initial stabilization of patients with suspected heart disease. The use of prostaglandins (PGE 1), antiarrhythmic agents, inotropic support, and cardioversion will be discussed. The information presented will aid the respiratory therapist in understanding the proper treatment regimens used to reverse the clinical cascade of physiologic processes that lead to poor outcome in children with heart disease.

2:30 P.M.–3:10 P.M.
Transport Case Reviews: Pediatric and Neonatal Heart Disease
Bradley A Kuch RRT-NPS and
Kathryn Felmet MD

The lecture will present an assortment of neonatal and pediatric cardiac disease scenarios that occur in the interfacility transport setting. Each scenario will include a patient presentation, assessment, and a review of the indicated interventions. We intend to familiarize the respiratory therapist with the identification and treatment of common and not so common cardiac diagnoses in an interactive case review format.

1:00 P.M.–3:15 P.M.
Developing and Certifying Your Asthma Program
1:00 P.M.–1:30 P.M.
All of the Pieces: An Overview of the Process and Standards
Wichita KS

This presentation will look at the value of seeking certification for an asthma program and outline the process and the standards that must be met.

Disclosure of Faculty Conflict of Interest

The AARC remains strongly committed to providing the best available evidence-based clinical information to participants of this educational activity and requires an open disclosure of any potential conflict of interest identified by our faculty members.

It is not the intent of the AARC to eliminate all situations of potential conflict of interest, but rather to enable those who are working with the AARC to recognize situations that may be subject to question by others.

All disclosed conflicts of intesest are reviewed by the AARC Program Committee to ensure that such situations are properly evaluated and, if necessary, resolved.

The AARC educational standards pertaining to conflict of interest are intended to maintain the professional autonomy of the clinical experts inherent in promoting a balanced presentation of science.

Through our review process, all AARC CRCE activities are ensured of independent, objective, scientifically balanced presentations of information.

Disclosure of any or no relationships will be made available on-site during all educational activities.

1:35 P.M.–2:05 P.M.
Identifying Your Target Population and Performing a Needs Analysis
Timothy R Myers RRT-NPS FAARC
Cleveland OH

This presentation will describe how to determine who makes up the population served by the asthma program and how to gather data to determine the areas of greatest need to help plan the program contents and evaluation materials: how to identify the “players” and their roles as well as getting validation of the need from the community being served.

2:10 P.M.–2:40 P.M.
Hitting the Bull’s-Eye: Choosing, Measuring, and Analyzing Outcomes
Thomas J Kallstrom RRT FAARC, Irving TX
This presentation will identify resources for measuring the most important outcomes for an asthma education program and will address how to choose validated measures and track them for continuous quality improvement.

2:45 P.M.–3:15 P.M.
Planning Individual Patient Plans
Bill Galvin MEd RRT CPFT AE-C FAARC Gwynedd Valley PA
This presentation will discuss building the individual patient teaching plan based on the individual’s needs and personal goals. The presentation will include the specific components (assess patients’ knowledge and areas to be stressed—symptom identification, MDI use, etc.) and when they should be introduced as well as how to do this when you have limited time for the teaching process.

1:00 P.M.–3:15 P.M.
Home Mechanical Ventilation Around the World
1:00 P.M.–1:30 P.M.
Home Medical Equipment in Brazil
Gustavo Ghion RRT, Brazil
Mr. Ghion will review the incidence of home mechanical ventilation in Brazil. He will discuss how home ventilation is paid for, who provides the care, the type of equipment used, and special challenges facing the delivery of home mechanical ventilation.

1:35 P.M.–2:05 P.M.
Home Mechanical Ventilation in India
Arvind Bohme MD, India
Dr. Bohme will review the incidence of home mechanical ventilation in India. He will discuss how home ventilation is paid for, who provides the care, the type of equipment used, and special challenges facing the delivery of home mechanical ventilation.

2:10 P.M.–2:40 P.M.
Home Mechanical Ventilation in Japan
Yuki Nakayama PhD RN, Japan
Dr. Nakayama will review the incidence of home mechanical ventilation in Japan. She will discuss how home ventilation is paid for, who provides the care, the type of equipment used, and special challenges facing the delivery of home care.

2:45 P.M.–3:15 P.M.
Home Mechanical Ventilation in the United States
Angela King RRT-NPS, United States
Mrs. King will review the incidence of home mechanical ventilation in the United States. She will discuss how home ventilation is paid for, who provides the care, the type of equipment used, and special challenges facing the delivery of home care.

1:00 P.M.–4:40 P.M.
Therapeutic Interventions for Sleep Apnea
1:00 P.M.–1:50 P.M.
Exploring Treatments for Complex Sleep Apnea
Daniel L Herold RPSGT, Rochester MN
The speaker will discuss the relationship between various forms of central apnea complex sleep-disordered breathing, the treatment of central forms of sleep apnea, and how to screen and diagnose the patient with complex breathing at night.

1:55 P.M.–2:45 P.M.
Treatment Options for Nocturnal Hypoventilation
Nilesh B Dave MD MPH, Dallas TX
This lecture will focus on treatment of patients with nocturnal hypoventilation that may be associated with underlying disease or primary hypoventilation. The speaker will talk about identification of nocturnal hypoventilation, titration, and management of patients with nocturnal hypoventilation.

2:50 P.M.–3:40 P.M.
The Impact of OSA on the Anesthesia Patient
Sharon Baer MBA RRT, Murrysville, PA
With the implementation of screening guidelines for all patients undergoing anesthesia and the recommendations by The Joint Commission to implement screening and treatment of sleep-disordered breathing within hospitals, the speaker will address how a program on obstructive sleep apnea was successfully implemented within his hospital system.

3:45 P.M.–4:40 P.M.
Role of Sleep Therapy in Bariatric Programs
Nilesh B Dave MD MPH, Dallas TX
This lecture will discuss the relationship between sleep disordered breathing and the bariatric patient. With growing awareness of bariatric surgery, this program will discuss the role of polysomnography and sleep therapy for a patient undergoing bariatric surgery.

2:40 P.M.–3:40 P.M.
Local Leader Multidisciplinary Safety Rounds in Critical Care
Local Leader Safety Rounds in Critical Care
Robert Hase MSc RRT-NPS, Seattle WA
This session will define local leader safety rounds, describe rationale for establishing multidisciplinary safety rounds in critical care environments, give examples of safety rounds process and results, and provide practical suggestions on how to institute multidisciplinary safety rounds.

2:45 P.M.–3:30 P.M.
Agencies Update
Toni Rodriguez EdD RRT–AARC President
Michael T Amato–ARCF Chair
David W Chang EdD RRT–CoARC Chair
Theodore Oslick MD–NBRC President

The leadership of AARC, ARCF, CoARC and the NBRC will discuss the latest professional, research, accreditation, and credentialing issues facing respiratory care.

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