Respiratory Care 2009

8:30 am – 11:40 am

RESPIRATORY CARE Journal Symposium: What You Should Know About the Journal and Its Role as a Peer-Reviewed Journal

8:30 am – 9:00 am

What Is Peer Review and Why Should I Care?

Robert L Chatburn RRT-NPS FAARC, Cleveland OH

This presentation will provide an overview of the concept of peer review and a description of the different types of scientific and professional publications. It will explain why practitioners (not just researchers and educators) need to understand what peer review is and how it works in this current era of universal Internet access.

9:05 am – 9:35 am

How Respiratory Care Works

Dean R Hess PhD RRT FAARC, Boston MA

To facilitate clear communication among authors, reviewers, and editorial staff, this presentation reviews how manuscripts are submitted, reviewed, revised, and processed for publication. Included in this discussion will be tips on how to maximize the likelihood that your manuscript will be accepted for publication.

9:40 am – 10:10 am

The Impact Factor and Other Assessments of the Quality of Both Journals and Individual Articles

Richard D Branson MS RRT FAARC, Cincinnati OH

How is quality of research papers and the journals in which they appear measured? This presentation describes and critiques the available indices, including the much-discussed Impact Factor, pointing out strengths and weaknesses of each.

10:15 am – 10:55 am

Soapboxes and Expert Opinions: Editorials and Letters to the Editor

Charles G Durbin Jr MD FAARC, Charlottesville VA

This presentation defines and describes these two important features of peer-reviewed journals and explains how they differ from other types of articles. How are editorial topics and authors selected, and how should they be read and interpreted? What topics are appropriate for a letter to the editor, and what are the dos and don’ts for prospective letter writers?

11:00 am – 11:40 am

Book Reviews: Why, What, Who, and How?

David J Pierson MD FAARC, Seattle WA

Why do journals review books? What makes a good book review? Who is qualified to review a book for RESPIRATORY CARE, and how are the books selected? This presentation addresses these topics and provides practical guidance for both authors and readers of book reviews in the journal.

8:30 am – 9:15 am

Pulmonary Complications of Illicit Drug Use

Andrew Luks MD, Seattle WA

This presentation reviews the physiologic and pathologic effects of heroin, cocaine, and other illicit drugs on respiration and the lungs. Topics will include respiratory depression, acute pulmonary edema, crack lung, Ritalin lung, talc granulomatosis, and the infectious complications of illicit drug abuse.

8:30 am – 9:25 am

Update on the Obesity-Hypoventilation Syndrome

Mark A Powers MD, Durham NC

The obesity-hypoventilation syndrome is a specific, severe subset of sleep-disordered breathing presenting important management challenges and carrying a poor prognosis. This presentation reviews the pathophysiology, diagnosis, and management of this important and increasingly prevalent disorder.

8:30 am – 9:35 am

Five Things I Learned This Year About…Part III

Jump start each Congress day with a concentrated briefing on what’s new and important! These high-yield sessions will highlight key developments in the field, for thought leaders, researchers, and educators as well as for clinicians who work “in the trenches” of respiratory care. Each presentation, focused on a specific subject or practice area, will be given by a recognized expert in that area, who will list and summarize what he considers to be the most important developments and issues to have emerged during the last 12 to 18 months.

8:30 am – 9:00 am

Five Things I Learned This Year about Sleep-Disordered Breathing

Sairam Parthasarathy MD, Tucson AZ

This presentation brings the attendee up-to-date on key aspects of this rapidly evolving field, based on research results and other developments over the last 18 months.

9:05 am – 9:35 am

Five Things I Learned This Year about Pulmonary Diagnostics

Susan B Blonshine RRT RPFT AE-C FAARC, Mason MI

This presentation brings the attendee up-to-date on key aspects of this rapidly evolving field, based on research results and other developments over the last 18 months.

8:30 am – 10:10 am

Respiratory Home Care: Moving Forward

8:30 am – 9:00 am

The Role of Protocols in Respiratory Home Care

Patrick J Dunne MEd RRT FAARC, Fullerton CA

The use of protocol-directed care is well established in the hospital setting. This presentation will discuss the advantages of using a protocol approach to providing long-term oxygen therapy and other types of home care.

9:05 am – 9:35 am

The Economics of High-Tech Ambulatory LTOT Technology

Louis M Kaufman RRT-NPS FAARC, Olney MD

High-tech ambulatory LTOT technology is a novel approach that is growing in popularity. This presentation will review the various systems currently available along with the advantages and limitations of each.

9:40 am – 10:10 am

How Will the New Medicare Pulmonary Rehabilitation Benefit Impact Respiratory Home Care?

Mary K Hart RRT, Dallas TX

The new Medicare coverage for pulmonary rehabilitation is scheduled for implementation in 2010. This presentation will discuss the opportunities the development of new pulmonary rehabilitation programs will present for respiratory home care providers.

8:30 am – 10:20 am

Neonatal ICU: How Small Can the Technology Go?

8:30 am – 9:30 am

Ethical Considerations from the Delivery Room Through the Neonatal ICU

Jonathan Fanaroff MD JD, Cleveland OH

Technology advances for the very-low-birth-weight (VLBW) infant continue at an astonishing rate. But what are the limits? How small can the technology get? What are the outcomes from VLBW infants? What happens when the outcome projections are not good? When is enough, enough? What if the staff and families disagree? These ethically charged issues will be discussed by one of the key leaders in the field.

9:35 am – 10:20 am

Unconventional Noninvasive Ventilation Strategies for the Neonate

Robert M DiBlasi RRT-NPS, Seattle WA

New information regarding the limitations of intubation, mechanical ventilation, and nasal CPAP for infants with lung disease will be reviewed. This presentation will overview the most recent technology and research that embraces noninvasive approaches to infants with acute respiratory disease, including noninvasive, high-frequency ventilation.

8:30 am – 10:45 am

Current Topics in Sleep Medicine

8:30 am – 9:00 am

Sleep Deprivation and Performance

Peter C Gay MD, Rochester MN

This lecture will focus on the continuum of physiological and psychological problems that develop when a person becomes increasingly sleep deprived. Available options for improving poor sleep hygiene will be discussed.

9:05 am – 9:35 am

Adherence to Positive Airway Pressure

Paul A Selecky MD FAARC, Newport Beach CA

This presentation will explore the issues associated with ensuring patient compliance with positive airway pressure recommendations. Interface options and patient education will be briefly discussed.

9:40 am – 10:10 am

Bi-Level Titration

Peter C Gay MD

This presentation will cover the current issues in titration of bi-level PAP and its advantage and disadvantage in treating sleep disordered breathing.

10:15 am – 10:45 am

To Split or Not To Split

Sairam Parthasarathy MD, Tucson AZ

This presentation will provide expert opinion on determining split-night sleep study criteria and performing sleep positive airway pressure titrations with confidence.

8:30 am – 11:20 am

AARC Leadership Institute

8:30 am – 9:00 am

Management Mythbusters

Kenneth Thigpen RRT FAARC, Jackson MS

Presenter will reveal some of the realities that come with assuming leadership roles, such as “strapping a target on your back,” always being “on call,” making unpopular decisions, sharing tough messages, and so forth.

9:05 am – 9:35 am

What They Still Don’t Teach You in Respiratory School

Garry W Kauffman MPA RRT FAARC, Lancaster PA

The presenter will share some “war stories” learned in the trenches as well as lessons learned for alternative approaches, some of which may seem counterintuitive at first glance.

9:40 am – 10:10 am

Building a High-Performing Team

Scott Reistad RRT CPFT, Denver CO

CEOs, COOs, CFOs, and CNOs tend to speak and understand a different language than most clinicians. The presenter will share the importance of building compelling business cases as an effective means for garnering their attention and support.

10:15 am – 10:45 am

Interviewing Strategies with the Team in Mind

Kenneth Thigpen RRT FAARC

The presenter will share the basic qualities that help attract and retain quality people and describe the environmental characteristics that create the unity needed to sustain quality and accomplish desired goals.

10:50 am – 11:20 am

Dealing with Difficult People

Scott Reistad RRT CPFT

Difficult people do exist at work. Difficult people come in every variety and no workplace is without them. The presenter will share some basic strategies for dealing with common disciplinary issues and overcoming the problems they create.

9:30 am – 10:10 am

Asthma Awareness Education Program: One School District’s Success Story

Diane Rhodes BBA RRT AE-C, San Antonio TX

This presentation will explain how a RT-sponsored asthma education program was able to meet the needs of an independent school district. The program’s framework addressed the four components of asthma control (awareness, medication, environment, and education) in a way to educate the district’s staff, students, parents, general community, and administrators on improving the quality of life of children with asthma, with the goals of increasing attendance, improving performance, improving physical activity, and social engagement for students and staff. In 2008 this program received a special achievement award.

9:30 am – 10:25 am

Clinical Application of Dead Space Fraction Measurements

Mark S Siobal RRT, San Francisco CA

A review of the clinical usefulness of serial dead space measurements as an indicator of the severity of lung injury, over-distension during PEEP titration, a predictor of weaning success from mechanical ventilation, and as a diagnostic indicator of pulmonary embolus.

9:30 am – 11:25 am

Respiratory Care Open Forum #13
Management: Nuts and Bolts To Do It Right—Part 2

Poster and oral presentations. Clinicians present the results of their scientific studies. Click Open Forum number for titles and authors presenting their findings.

9:30 am – 11:25 am

Respiratory Care Open Forum #14
Aerosols; Oxygen; Drugs and Medications–Part 2

Poster and oral presentations. Clinicians present the results of their scientific studies. Click Open Forum number for titles and authors presenting their findings.

9:45 am – 11:30 am

Transport Issues

9:45 am – 10:35 am

Crew Resources Management (CRM) for the Ground Transport RT

Matthew P Branconnier RRT EMT, Boston MA

This presentation will review the fundamentals of CRM. It will emphasize the importance of safety during critical care transports. Included will be advice on improving communication among crewmembers to improve personal safety. The risks, benefits and costs of implementing a CRM program will be discussed.

10:40 am – 11:30 am

Air Medical Transport: Still the Safest Way To Transport

Matthew P Branconnier RRT EMT

This presentation will cover information relating to the record number of air medical accidents in 2008, highlight the AARC representation during the July 2008 Safety Summit in Dallas, and recap our participation in the Helicopter Emergency Medical Services (HEMS) safety research project. A cause analysis study focused on HEMS-related accidents over the past 10 years will be summarized.

10:15 am – 11:05 am

Controversy in Respiratory Home Care

In-Home or Sleep-Center Testing for OSA: Is One Approach Better Than the Other?

Suzanne M Bollig BHS RRT RPSGT REEGT, Hays KS

Describes the basics of in-home testing for obstructive sleep apnea, its pros and cons, patient selection, and why its advocates favor this approach.

10:25 am – 11:10 am

Effects of Mechanical Ventilation and the Environment of the Neurodevelopment of the Infant

Jonathan Fanaroff MD JD, Cleveland OH

How do mechanical ventilation and other respiratory interventions affect the developing neonate? This presentation will identify the precursors and markers to long-term neurologic sequelae. How can the respiratory therapist make a difference in preventing neurologic injury? The answers will enable you to improve care of neonates in your neonatal unit.

10:30 am – 11:00 am

Clinical Applications of Bedside Ultrasound

Amy Bardin RRT, Phoenix AZ

Point-of-care ultrasound is a fast-growing bedside application to aid in invasive procedures as well as a quick-look diagnostic tool. This lecture will review the current clinical application of bedside ultrasound as it relates to hemodynamic monitoring and invasive placements.

10:30 am – 11:55 am

What Does This Graphics Screen Mean?

10:30 am – 11:10 am

Basics of Ventilation Graphics: Easy Steps to Success

John S Emberger RRT, Newark DE

Learners will understand easy steps to basic interpretation of ventilation graphics. Learners will see real-time loops and scalars (not just screen shots).

11:15 am – 11:55 am

Advanced Ventilation Graphics: Things You Will Not See Every Day

John S Emberger RRT

Learners will see cases with advanced ventilation graphics, including trigger asynchrony, severe airtrapping, over-distention, and volume asynchrony. Learners will see potential interventions to the cases.

11:10 am – 11:50 am

Inhaled Pulmonary Vasodilators

Mark S Siobal RRT, San Francisco CA

This presentation will be a review of pulmonary vasodilators commonly delivered by inhalation. Speaker will also discuss available delivery systems, the indications for use in specific disease states, as well as an overview of other potentila benefits resulting from use.

11:35 am – 12:00 noon

Surface and Air Transport Section Membership Meeting

Dawn Filippa RRT EMPT, Section Chair/Presiding

1:00 pm – 1:45 pm

Adult Acute Care Section Membership Meeting

Michael J Hewitt RRT-NPS FAARC, Section Chair/Presiding

1:00 pm – 1:45 pm

Sleep Section Membership Meeting
Sheri Tooley Peters RRT-NPS CPFT AE-C, Section Chair/Presiding

1:00 pm – 1:50 pm

Are We Dropping the Ball on Communication Handoffs?

Karen J Stewart MS RRT FAARC, Charleston WV

This presentation will address the issue of poor- and mis-communication in the workplace. It will explain how best to employ the Joint Commission National Safety Patient Goals regarding handoff communication. Examples and illustrations will be provided with trusted strategies to overcome this problem.

1:00 pm – 2:35 pm

Controversies in the Diagnosis and Management of VAP

1:00 pm – 1:45 pm

Should We Use an Invasive Approach for Diagnosing VAP?

Pro: Dean R Hess PhD RRT FAARC, Boston MA
Con: Marcos I Restrepo MD, San Antonio TX

This controversy centers on the fact that several diagnostic methods have shown important differences in sensitivity and specificity to diagnose VAP.

1:50 pm – 2:35 pm

Can We Have Zero VAP?

Pro: Ruben D Restrepo MD RRT FAARC, San Antonio TX
Con: Marcos I Restrepo MD

Several institutions have claimed “zero” VAP while others have only dramatically reduced its rate. What tells these institutions apart?

1:00 pm – 2:35 pm

Extracorporeal Life Support

1:00 pm – 1:45 pm

Cardiac Support: New Uses for an Old Technique

Brad A Kuch RRT-NPS, Pittsburgh PA

Once considered a contraindication for extracorporeal life support, pediatric cardiac disease has become one of its more common indications. Clinical indications, patient selection, and outcomes will be reviewed. Also discussed will be the future of extracorporeal circulatory support including ventricular assist devices and the Berlin Heart.

1:50 pm – 2:35 pm

Artificial Lungs: What Does the Future Hold?

Brad A Kuch RRT-NPS

Current ECMO configurations can cause blood trauma and hemolysis. A pumpless means to artificially ventilate and oxygenate the body over an extended period of time allowing the lungs to heal is an exciting proposal. The current literature will be presented along with a discussion of the future direction of artificial lungs as means to respiratory support.

1:00 pm - 2:55 pm

Respiratory Care Open Forum #15
Education: Advancing The Profession

Poster and oral presentations. Clinicians present the results of their scientific studies. Click Open Forum number for titles and authors presenting their findings.

1:00 pm - 2:55 pm

Respiratory Care Open Forum #16
Ventilation and Ventilators––Part 4

Poster and oral presentations. Clinicians present the results of their scientific studies. Click Open Forum number for titles and authors presenting their findings.

1:00 pm – 3:35 pm

Current Issues in Asthma Education

1:00 pm – 1:35 pm

Barriers to Asthma Education

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

Lists and describes the most common barriers to effective asthma education and explains how such barriers can be overcome.

1:40 pm – 2:15 pm

All That Wheezes Is Not Asthma: Mimics of Asthma

Timothy B Op’t Holt EdD RRT AE-C FAARC, Mobile AL

Reviews the mimics of asthma and describes how these mimics are differentiated from true asthma.

2:20 pm – 2:55 pm

Reimbursement for Asthma Education

Rhonda Vosmus RRT-NPS AE-C, Portland ME

Discusses the successes that certified asthma educators have had with respect to integrating systems for sustainability and reimbursement for asthma self management education programs.

3:00 pm – 3:35 pm

Telemedicine and Electronic Media for Asthma Education

Timothy B Op’t Holt EdD RRT AE-C FAARC

Presents methods used in asthma education that go beyond traditional face-to-face teaching. Discusses the effectiveness of these methods in comparison with traditional efforts.

1:00 pm – 4:15 pm

Perfecting Patient Care with Lean Thinking

1:00 pm – 1:45 pm

Introduction to Lean

Laura K Mahood MS SCT ASCP, Pittsburgh PA

The first module will discuss the current condition of health care – highly complex and filled with “waste” that interferes with the ability to meet the needs of patients. Health care workers do not intend for things to go wrong and are often subject to a culture of blame.

1:50 pm – 2:35 pm

The Rules in Use

Linda Vicaro MS, Pittsburgh PA

Three rules of designing work will be discussed—activities, pathways and connections—in addition to one rule of improvement. Health care examples for the application of each rule are incorporated and discussed in comparison to the “Ideal.”

2:40 pm – 3:25 pm

Value Stream Mapping

Laura K Mahood MS SCT ASCP

This presenter will define and provide “how-to” value of stream mapping. The participant will be presented with a hands-on exercise to help understand the use of stream mapping.

3:30 pm – 4:15 pm

Lean Problem-Solving Methods

Linda Vicaro MS

The module will incorporate a discussion of the differences between traditional thinking in problem-solving in comparison to lean thinking. Participants will have an opportunity to use an exercise to begin addressing an individual problem.

1:00 pm – 4:15 pm

Respiratory Therapy Management Issues

1:00 pm – 1:45 pm

Certification in the Management of COPD by The Joint Commission

David A Gourley MHA RRT FAARC, Pompton Plains NJ

This presentation will review The Joint Commission’s disease-specific certification in the management of COPD, describe the development of the COPD certification program, explain certification standard requirements, and describe the certification survey process.

1:50 pm – 2:35 pm

Perpetually Ready: The RT’s Role in Compliance with the National Patient Safety Goal

Darnetta Clinkscale MBA RRT, St Louis MO

This presentation will outline the role that respiratory therapists play in hospitals meeting 100% compliance with the National Patient Safety Goal. It will explain steps to take toward being perpetually ready and meeting the standards every day.

2:40 pm – 3:25 pm

Disruptive Behavior: A Threat to Patient Safety

David A Gourley MHA RRT FAARC

This presentation will define disruptive behavior and provide specific health care examples, explain the impact of disruptive behavior on patient safety, discuss The Joint Commission’s requirements regarding disruptive behavior, describe disruptive behavior between disciplines and within disciplines, and review Code of Conduct expectations for all clinicians.

3:30 pm – 4:15 pm

Shared Governance in Respiratory Care—A Model That Works

Darnetta Clinkscale MBA RRT

This presentation will define the Barnes-Jewish Hospital (BJH) Shared Governance Council model for respiratory care services, discuss steps that were taken to implement this model, share the benefits of creating the council at BJH, and describe how the council integrates and works with other departments and how the process impacts the care of our patients.

1:50 pm – 2:45 pm

Comorbidity Issues in Sleep-Disordered Breathing

Paul A Selecky MD FAARC, Newport Beach CA

This presentation will discuss multiple comorbidity issues that can contribute to and/or complicate sleep-disordered breathing. Topics will include the effects of drug use, Parkinson’s disease, central sleep apnea, as well as the immune system effects of sleep.

1:55 pm – 2:50 pm

Transcutaneous Monitoring of Gas Exchange: It’s Not Just for Kids Any More

Michael A Gentile RRT FAARC, Durham NC

Transcutaneous monitoring of PO2 and PCO2 is widely used in neonatology and pediatrics. In the past it has not been widely used in monitoring adult patients, particularly those in the ICU, because of studies suggesting poor correlation between arterial and transcutaneous values in unstable patients. Is this still the case? Or should transcutaneous PO2 and PCO2 monitoring replace arterial blood gases in many cases? This presentation reviews the relevant physiology and summarizes the evidence base pertaining to the substitution of transcutaneous for arterial measurements.

2:00 pm – 2:30 pm

Airway Pressure Release Ventilation: Theory & Practice

John S Emberger RRT, Newark DE

This presentation will review the current evidence for airway pressure release ventilation (APRV) and discuss potential uses as an alternative mode for mechanically ventilated patients. Discussion will also cover the pros and cons for use of APRV in place of conventional modes of ventilation.

2:40 pm – 3:20 pm

The Growing World of Vascular Access Management: What Every RT Should Know

Amy Bardin RRT, Phoenix AZ

This presentation will provide an overview of current vascular access management practices. Topics included will be insertion and maintenance of devices, incorporation of ultrasound as a primary tool to aide in catheter insertion, and review of patient and catheter selection criteria.

2:50 pm – 3:45 pm

Sleep-Disordered Breathing and Anesthesia

Brian W Carlin MD FAARC, Pittsburgh PA

This session will focus on the implications that sleep-disordered breathing poses for patients who are undergoing anesthesia. An action plan for the preoperative assessment for the presence of SDB will be discussed.

2:55 pm – 4:00 pm

Assessment of the Critically Ill Adult Patient

2:55 pm – 3:25 pm

Assessment of Gas Exchange

Jody Lester RRT, Nampa ID

This presentation will examine key methods and issues relating to gas exchange measurement and the value of these measurements in the management of the critically ill adult patient. Case studies will be used to demonstrate appropriate selection, evaluation and clinical application.

3:30 pm – 4:00 pm

Invasive and Noninvasive Assessment of Hemodynamics

Richard M Kallet MS RRT FAARC, San Francisco CA

This presentation will include a brief review of the systemic and pulmonary circulations and the factors that influence blood flow and pressures in those systems. In addition, the common invasive measurements and calculations used in hemodynamic assessment will be reviewed. Lastly, some noninvasive techniques of assessing hemodynamics will be compared to invasive techniques to illustrate the strengths and limitations of each.

3:25 pm – 4:05 pm

Becoming a Change Agent in Today’s Health Care Arena

Terry L Forrette MHS RRT, New Orleans LA

This presentation will discuss the role of respiratory therapists as change agents and how they can create a difference in the delivery of health care. Using the speaker’s personal experience from a national environmental campaign, the presentation will draw from the works of several well-known authors.