Mar 28, 2024  
Fall 2014 Catalog 
    
Fall 2014 Catalog [ARCHIVED CATALOG]

RC 240 - Respiratory Care Review Seminar


Credit Hours: 3

The purpose of this course is to help prepare the student for the Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT) exams. Successful completion of this course requires the student to pass the CRT self-assessment exam, as well as the RRT writren and clinical simulation self-assessment exams.

Course Outcomes
The following objectives reflect the National Board for Respiratory Care (NBRC) Summary Content Outline for Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT) Examinations.

Patient Data Evaluation and Recommendations


Upon completion of this course, the student will be able to:

  • Review Existing Data in the Patient Record including:
    • patient history;
    • physical examination relative to the cardiopulmonary system;
    • lab data;
    • pulmonary function results;
    • blood gas results;
    • imaging studies;
    • monitoring data; and
    • maternal and paternal/neonatal history and data.
  • Collect and Evaluate Additional Pertinent Clinical Information
    • assess patient’s overall cardiopulmonary status by inspection determine;
      • general appearance;
      • cough, amount and character of sputum; and
      • transillumination of chest, Apgar score, gestational age.
    • assess patient’s overall cardiopulonary status by palpation to determine;
      • heart rate, rhythm, and force; and
      • asymmetrical chest movements, tactile fremitus, crepitus, tenderness, secretions in the airway, tracheal deviation.
    • assess patient’s overall cardiopulmonary status by auscultation to determine presence of;
      • breath sounds;
      • heart sounds and rhythms; and
      • blood pressure.
    • interview patient to determine;
      • level of consciousness/sedation, orientation to time, place and person, emotional state, ability to cooperate, level of pain;
      • presence of dyspnea and/or orthopnea, work of breathing, sputum production, exercise tolerance and activities of daily living;
      • social history; and
      • advance directives.
    • assess patient’s learning needs;
    • review chest radiograph to determine;
      • quality of imaging;
      • position of endotracheal or tracheostomy tube;
      • presence of or change in pneumothorax or subcutaneous emphysema, othere extrapulmonary air, consolidation and/or atelectasis, pulmonary infiltrates;
      • position of chest tube(s), nasogastric and/or feeding tube, pulmonary artery catheter, pacemaker, and other catheters;
      • presence and position of foreign bodies; and
      • position of or change in hemidiaphragms, hyperinflation, pleural fluid, pulmonary edema, mediastinal shift, patency and size of major airways.
    • perform procedures including;
      • 12-lead ECG;
      • pulse osimetry, capnography;
      • tidal volume, minute volume, peak flow, vital capacity;
      • bedside spirometry;
      • arterial sampling – percutaneous or line;
      • blood gas/hemoximetry analysis;
      • lung mechanics;
      • ventilator pressure-volume and flow-volume loops;
      • apnea monitoring;
      • overnight pulse oximetry;
      • tracheal tube cuff pressure and/or volume;
      • tracheal intubation;
      • pulmonary function laboratory studies; and
      • auto-PEEP detection.
    • interpret procedure results including;
      • transcutaneous O2/CO2 monitoring;
      • pulse oximetry, capnography;
      • tidal volume, minute volume, peak flow, vital capacity;
      • bedside spirometry;
      • blood gas/hemoximetry analysis;
      • lung mechanics;
      • apnea monitoring;
      • overnight pulse oximetry;
      • tracheal tube cuff pressure and/or volume;
      • pulmonary function laboratory studies;
      • ventilator pressure-volume and flow-volume loops; and
      • auto-PEEP.
  • Recommend Procedures to Obtain Additional Data Including:
    • radiographic and other imaging studies;
    • lung mechanics; and
    • blood gas analysis, pulse oximetry, transcutaneous O2/CO2 monitoring.

Equipment Application and Cleanliness

Upon completion of this course, the student will be able to:

  • Select, Assemble, Use, and Troubleshoot Equipment Including:
    • oxygen administration devices;
    • CPAP devices;
    • humidifiers;
    • pneumatic aerosol generator;
    • resuscitation devices;
    • ventilators;
    • artificial airways;
    • suctioning devices;
    • gas delivery, metering, and clinical analyzing devices;
    • point-of-care blood gas analyzers;
    • patient breathing circuits;
    • aerosol (mist) tents;
    • incentive breathing devices;
    • percussors and vibrators;
    • high Frequency Chest Wall Oscillation (HFCWO);
    • positive expiratory pressure (PEP) devices;
    • vibratory PEP;
    • He/O2 therapeutic gas;
    • manometers;
    • respirometers;
    • ECG machines;
    • arterial catheters;
    • vacuum systems;
    • oximetry monitoring devices;
    • metered dose inhalers (MDI), MDI spacers;
    • dry powder inhalers;
    • spirometry screening equipment for bedside;
    • speaking tubes and valves;
    • CO, He, O2, and specialty gas analyzers; and
    • bronchoscopes.
  • Insure Infection Control:
    • Assure selected equipment cleanliness; and
    • Assure proper handling of biohazardous materials.
  • Perform Quality Control Procedures For:
    • blood gas analyzers, co-oximeters, and sampling devices;
    • oxygen analyzers;
    • pulmonary function equipment;
    • mechanical ventilators;
    • gas metering devices;
    • noninvasive monitors; and
    • record and monitor QC data using accepted statistical methods.

Therapeutic Procedure Initiation And Modification

  • Maintain Records and Communicate Information:
    • record therapy and results using conventional terminology as required in the health care setting and/or by regulatory agencies;
    • verify computations and note erroneous data;
    • communicate information;
    • apply computer technology to;
      • document patient management; and
      • monitor workload assignments.
    • communicate results of therapy and alter therapy per protocol(s);
    • explain planned therapy and goals to patient in understandable terms to achieve optimal therapeutic outcome; and
    • counsel patient and family concerning smoking cessation and disease management education.
  • Maintain a Patent Airway Including the Care of Artificial Airways:
    • properly position patient;
    • insert oro- and nasoparyngeal airways;
    • perform endotracheal intubation;
    • identify tube placement by available means;
    • change trachestomy tubes;
    • maintain; and
      • proper cuff inflation; and
      • adequate humidification.
    • perform extubation procedure.
  • Remove Bronchopulmonary Secretions:
    • perform;
      • postural drainage and percussion and/or vibration;
      • nasotracheal suctioning; and
      • oropharyngeal suctioning.
    • suction artificial airways;
    • administer aerosol therapy, administer prescribed agents; and
    • instruct and encourage bronchopulmonary hygiene techniques.
  • Achieve Adequate Respiratory Support:
    • Instruct in;
      • proper breathing technique, encourage deep breathing, instruct and monitor techniques of incentive spirometry; and
      • inspiratory muscle training techniques.
    • Initiate and adjust;
      • IPPB Therapy;
      • continuous mechanical ventilation settings;
      • noninvasive ventilation;
      • elevated baseline pressure; and
      • combinations of ventilatory techniques.
    • select ventilator graphics;
    • administer;
      • aerosolized drugs; and
      • oxygen – on or off a ventilator.
    • initiate and modify weaning procedures;
    • position patient to minimize hypoxemia;
    • prevent procedure-associated hypoxemia; and
    • adhere to infection control policies and procedures.
  • Evaluate and Monitor Patient’s Objective and Subjective Responses to Respiratory Care:
    • recommend and review chest radiograph;
    • obtain a blood gas sample;
    • perform;
      • pulse oximetry;
      • blood gas and co-oximetry analysis;
      • capnography;
      • Interpret blood gas and co-oximetry results;
      • Observe changes in sputum characteristics;
      • Observe for signs of patient-ventilator dysynchrony;
      • Measure and record vita signs, monitor cardiac rhythm, evaluate fluid balance – intake and output;
      • Perform spirometry, determine vital capacity, measure pulmonary compliance and airways resistance, interpret airway graphics, measure peak flow;
      • Monitor mean airway pressure, adjust and check alarm systems, measure tidal volume, respiratory rate, airway pressures, I:E, and maximum inspiratory pressure;
      • Measure FIO2 and/or liter flow;
      • Monitor endotracheal or tracheostomy tube cuff pressure; and
      • Auscultate chest and interpret changes in breath sounds.
  • Independently Modify Therapeutic Procedures Based on the Patient’s Response:
    • terminate treatment based on patient’s response to therapy;
    • modify treatment techniques including;
      • IPPB;
      • Incentive breathing devices;
      • aerosol therapy;
      • oxygen therapy;
      • specialty gas;
      • bronchial hygiene therapy;
      • management of artificial aiways;
      • suctioning;
      • mechanical ventilation; and
      • procedures for weaning from mechanical ventilation.
  • Recommend Modifications in the ‘Respiratory Care Plan Based on the Patient’s Response:
    • recommend;
      • institution of bronchopulmonary hygiene procedures;
      • sedation and/or use of muscle relaxant(s);
      • insertion or change of artificial airway;
      • procedures for weaning from mechanical ventilation;
      • extubation; and
      • discontinuing treatment based on patient response.
    • recommend changes in;
      • patient position;
      • aerosol drug dosage or concentration; and
      •  FIO2 and oxygen flow.
    • recommend changes in mechanical ventilation to;
      • improve patient synchrony;
      • enhance oxygenation;
      • improve alveolar ventilation;
      • adjust I:E settings;
      • modify ventilator techniques;
      • adjust noninvasive positive pressure ventilation;
      • monitor and adjust alarm settings;
      • adjust ventilator settings based on ventilator graphics;
      • change type of ventilator, change patient breathing circuitry;
      • alter mechanical dead space;
      • modify ventilator settings to;
        • eliminate auto-PEEP; and
        • reduce plateau pressure.
    • recommend use of pharmacologic interventions including;
      • bronchodilators;
      • anti-inflammatory drugs;
      • mucolytics/proteolytics;
      • sedatives;
      • analgesics;
      • diuretics; and
      • surfactants.
  • Determine and Appropriateness of the Prescribed Respiratory Care Plan and Recommend Modification When Indicated:
    • analyze available data to determine pathophysiological state;
    • review;
      • planned therapy to establish therapeutic plan; and
      • interdisciplinary patient and family plan.
    • determined appropriateness of prescribed therapy and goals for identified pathophysiological state;
    • recommend changes in the therapeutic plan when indicated based on data;
    • perform respiratory care quality assurance;
    • develop outcomes of;
      • quality improvement programs; and
      • respiratory care protocols.
    • monitor outcomes of;
      • quality improvement programs; and
      • respiratory care protocols.
    • apply respiratory care protocols; and
    • conduct disease management education.
  • Initiate, Conduct, or Modify Respiratory Care Techniques in an Emergency Setting:
    • treat cardiopulmonary collapse according to;
      • BCLS;
      • ACLS;
      • Pediatric Advanced Life Support (PALS); and
      • Neonatal Resusciation Program (NRP).
    • treat tension pneumothorax;
    • participate in;
      • land/air patient transport outside the hospital;
      • intra-hospital patient transport; and
      • disaster management.
  • Act as an Assistant to the Physician Performing Special Respiratory Care Procedures Including:
    • Bronchoscopy;
    • Tracheostomy;
    • Cardioversion; and
    • Intubation.
  • Initiate and Conduct Pulmonary Rehabilitation and Home Care Within the Prescription:
    • explain planned therapy and goals to patient in understandable terms to achieve optimal therapeutic outcome;
    • educate patient and family in disease management;
    • counsel patient and family concerning smoking cessation; and
    • instruct patient and family to assure safety and infection control.


Prerequisites: Matriculation in the Respiratory Care Program or permission of the department. Successful completion of all previous Respiratory Care coursework. All Respiratory Care coursework must be taken in sequential order.
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