Dean Hess, PhD, RRT, FAARC is Assistant Director of Respiratory Care, Massachusetts General Hospital, and Associate Professor of Anesthesia, Harvard Medical School, Boston, MA. He has over 35 years of experience in respiratory care, including clinical, research, teaching, and administrative responsibilities. Since January, 2008, Dean Hess has been Editor-in-Chief of RESPIRATORY CARE, the official science journal of the American Association for Respiratory Care. He is on the Editorial Boards of the Journal of Aerosol Medicine, International Anesthesiology Clinics, and Critical Care Alert. His research interests include aerosol delivery techniques, adult mechanical ventilation, and critical care monitoring. He is a Fellow of the American Association for Respiratory Care, the American College of Chest Physicians, and the Society of Critical Care Medicine. He has published over 200 papers and 7 books. His books have been translated to several from English to several foreign languages. He has had a high level of professional activity, including committee appointments with the American Association for Respiratory Care, the American College of Chest Physicians, the American Thoracic Society, the Society of Critical Care Medicine, and 2 years as President of the National Board for Respiratory Care. He has lectured extensively throughout the United States, as well as in Europe, Southeast Asia, Africa, and South America.

 

Shelley C. Mishoe, PhD, RRT, FAARC, received a PhD in Adult Education from the University of Georgia, Athens, MEd in Education from Augusta State University, and BS in Respiratory Therapy from SUNY Upstate Medical University. At the present time, she is Associate Provost for Academic Strategic Initiatives, Professor of Respiratory Therapy, and Interim Director of the Center for Patient and Family Centered Care at Medical College of Georgia, Georgia’s Health Sciences University. She has held faculty positions at Chang Gung University in Taiwan, Capella University, Medical College of Georgia, and SUNY Upstate Medical University. Mishoe is Director, Quality Enhancement Plan (QEP) for reaffirmation by SACSCOC since 2009; CoA Rep, Commission on Accreditation for Allied Health Professions (CAAHEP) since 2007; a Member of the Georgia Hospital Association; a member of the Editorial Board for RESPIRATORY CARE since 1994, and is a 2009-2010 Fellow of the American Council on Education (ACE) Fellows Program. Mishoe has a high level of professional activity, including past leadership appointments with Commission for Accreditation in Respiratory Care (CoARC), Committee for Accreditation in Respiratory Care (CoARC), Southern Association of Allied Health Deans at Academic Health Centers, Healthcare Education Accreditation Services Corporation, Association of Schools of Allied Health Professions, Lambda Beta National Honor Society, Southern Association of Allied Health Deans at AHC, House of Delegates - American Association for Respiratory Care, Committee for AARC House of Delegates Strategic Planning, Georgia Delegate to the AARC House of Delegates, and Georgia Society for Respiratory Care.

 

Neil MacIntyre, MD is a native of Southern California but received his medical degree and internal medicine training at Cornell University in New York City. After three years of service as a US Navy flight surgeon at the Naval Aerospace Medical Research Lab in Pensacola FL, he returned to California for a pulmonary disease fellowship at the University of California, San Francisco. He was then recruited to the faculty at Duke University where he has spent the remainder of his career. At the present time, he is a Professor of Medicine (with tenure), Clinical Chief of the Pulmonary/Critical Care Division, and Medical Director of Respiratory Care Services. His research interests range from clinical pulmonary physiology to large scale randomized trials in COPD and acute respiratory failure. Currently he is on the Steering Committee of two large NIH multicenter trials: the Long Term Oxygen Trial (LOTT), and the Acute Respiratory Distress Syndrome Network (ARDSnet). To date he has over 200 peer reviewed articles and reviews, is the editor/co-editor of eight books, and is on the editorial board of five important journals. He is the past president of the American Lung Association of North Carolina, the National Association of Medical Directors of Respiratory Care, and the current Vice-Chair of the American Respiratory Care Foundation. Important honors include Alpha Omega Alpha, The Surgeon Generals Award for Aviation Medicine, the Forrest Bird Award for lifetime scientific achievement, and the Jimmy Young Medal from the American Association for Respiratory Care. He is listed both in “Best Doctors in America” and “Who’s Who in the World”.

 

William F. Galvin is an Assistant Professor for the School of Allied Health Professions, Program Director for the Respiratory Care Program and a member of the teaching and administrative faculty for the TIPS (Teacher Improvement Project System) Program at Gwynedd-MercyCollege. He has been a respiratory therapist for over 35 years and been on faculty at GMC since December of 1981 where he first served as Director of Clinical Education for two years before becoming the Director of the Respiratory Care Program in 1983. He holds an administrative and teaching faculty position for the TIPS Program (Teacher Improvement Project System), a national program designed to prepare practicing health care professionals to assume roles as clinical and classroom teachers. Additionally, he teaches in the Center for Life Long Learning and in the Bachelors of Health Science Degree Program. He earned his Bachelor’s degree in political science from La SalleCollege and his Master’s degree in Education (with a concentration in Health) from St. Joseph’s University. He is a registered and certified respiratory therapist, certified pulmonary function technologist and certified asthma educator. He has significant publishing experience. He has provided numerous article reviews, abstracts, and contributing chapters for such publishing companies as; Springhouse Corporation, Delmar/ Cengage Learning, FA Davis, CV Mosby, Williams and Wilkins, W B Saunders/ Elsevier, and Jones and Bartlett Learning. He has presented at the local, state and national level on topics such as communication skills, wellness, health promotion, disease prevention, patient education, interviewing and assessment skills, programmatic and regional accreditation, outcome assessment, recruitment and retention, and a variety of student survival topics and concepts related to the art of teaching and learning.

Creating a Therapeutic Climate

Components of the Health History

Vital Signs

Techniques of Assessment

Physical Examination of the Lungs and Thorax

Assessment of Other Body Systems

Physiology of Gas Exchange

Assessment of Gas Exchange

Physiologic Mechanisms of Hypercapnia

Physiology of Acid–Base Balance

Definition of Acid and Base

Concept of pH

Buffer Solutions

Henderson-Hasselbalch Equation

Base Excess

Anion Gap

Strong Ion Difference

Regulation of pH

Erythrocytes and Acid–Base Control

Acid Production and Excretion

Acid–Base Disorders

Interpretive Strategies for Acid–Base Disorders

History of Arterial Blood Gas Analysis

Blood Gas Analyzers

Blood Gas Sampling

Quality Control

Pulse Oximetry

Capnography

Transcutaneous Blood Gas Monitoring

Respiratory Rate and Pattern

Cardiac Rate and Rhythm

Arterial Blood Pressure

Central Venous Pressure Monitoring

Pulmonary Artery Catheters

Clinical Use of Hemodynamic Measurements

Evaluation of Ventricular Function

Valvular Function

Coronary Artery Disease

Cardiac Conduction System

Serum Electrolytes

Serum Chemistries Associated with Renal Function

Serum Enzyme Activity

Cardiac Enzymes and Proteins

Miscellaneous Serum Chemistries

Coagulation Tests

Hematology

Laboratory Standards and Quality Control

Density and Contrast

The Normal Chest Radiograph

Abnormalities Seen on Chest Radiographs

Cross-Sectional Imaging Techniques

Goals of Pulmonary Function Testing

Spirometry

Lung Volumes and Capacities

Diffusing Capacity

Specialized Pulmonary Function Tests

Diagnostic Bronchoscopy

Therapeutic Bronchoscopy

Airway Stenting

Pleural Disease

Future Directions

Normal Sleep and Sleep Stages

Polysomnography Components

Scoring Criteria

Polysomnography Report

Effects of Nutrition on Respiratory Function

Nutrition Assessment

Calculation of Energy Requirements

Nutritional Support Guidelines

Normal Cardiopulmonary Response to Exercise

Incremental Exercise Testing

Interpreting the Results of Incremental Cardiopulmonary Exercise Testing

Timed Walk Tests

Indications for Cardiopulmonary Exercise Testing

Safety Issues

Chemical and Physical Properties of Therapeutic Gases

Therapeutic Gases in Respiratory Care

Storage and Distribution of Medical Gases

The Rationale for Supplemental Oxygen

Patient Conditions Commonly Warranting Oxygen Therapy

Limitations of Supplemental Oxygen

Complications and Hazards of Oxygen Therapy

Dosage Regulation and Administration Devices

Oxygen Administration Devices

Monitoring the Physiologic Effects of Oxygen

Clinical Application of Oxygen Therapy

Helium–Oxygen Therapy

Carbon Dioxide Therapy

Nitric Oxide Therapy

Humidity

Normal Heat and Moisture Exchange

Goals of Humidity Therapy

Devices Used for Humidification

Bland Aerosol Therapy

Device Selection for Humidity Therapy

Aerosol Drug Administration

Aerosol Generators

Aerosol Delivery During Mechanical Ventilation

Aerosol Delivery by Tracheostomy

Selection of an Aerosol Delivery Device

Normal Mechanisms of Mucociliary Transport

Sputum Collection

Airway Clearance

Lung Expansion Therapy

Oropharyngeal Airways

Nasopharyngeal Airways

History of Intubation

Selection and Training of Personnel

Indications for Endotracheal Intubation

The Difficult Airway: Assessment and Strategy

Endotracheal Intubation

Tracheostomy

Tracheostomy Tubes

Airway Cuff Concerns

Airway Clearance

Cardiopulmonary Resuscitation

Basic Life Support

Advanced Cardiovascular Life Support

Ethical Concerns

Basic Concepts

Input Power

Power Transmission and Conversion

Control System

Control Variables

Phase Variables

Modes of Ventilation

Targeting Scheme

Output

Effects of the Patient Circuit

Ventilator Alarm Systems

The Equation of Motion

Indications for Mechanical Ventilation

Complications of Mechanical Ventilation

Ventilator Settings

Monitoring the Mechanically Ventilated Patient

Choosing Ventilator Settings for Different Forms of Respiratory Failure

Ventilatory Support Involves Trade-Offs

Liberation from Mechanical Ventilation

Interfaces

Noninvasive Positive Pressure Ventilation

Continuous Positive Airway Pressure

Negative Pressure Ventilation, Rocking Beds, and Pneumobelts

Neonatal Assessment

Oxygen Therapy

Mechanical Ventilation

Manual Ventilation

Airway Management

Nasal Continuous Positive Airway Pressure

Noninvasive Positive Pressure Ventilation

Conventional Infant and Pediatric Ventilation

High-Frequency Ventilation

Adjuncts to Neonatal and Pediatric Mechanical Ventilation

Mechanisms of Functional Deterioration in Patients with Chronic Lung Disease

Program Structure

The Process of Pulmonary Rehabilitation

Outcomes from a Pulmonary Rehabilitation Program

Reimbursement Issues

Home Care Services

Goals of Home Care

The Medicare Program

Requirements for Home Medical Equipment Companies

The Respiratory Therapist as Home Care Provider

The Initial Home Visit

Bag Technique

Home Environment Evaluation

Long-Term Oxygen Therapy

Home Mechanical Ventilation

History

The Threat

Planning for Mass Casualty Respiratory Failure

Ventilator Performance Characteristics

Ventilators for Mass Casualty Respiratory Failure

Triage

The Demography of Aging

Aging Pulmonary Anatomy and Physiology

Geriatric Patient Assessment

Atypical Disease Presentation

Geriatric Pharmacotherapy

Communicating with Older Adults

Pulmonary Disease After Age 65 Years

Medical Information Management

Electronic Medical or Health Records

Appropriate Handling of Patient Information

Patient Safety

Safety Initiatives and Respiratory Care Applications

Forces Driving Disease Management

History and Evolution of Disease Management

Terms, Factors, and Concepts Associated with Disease Management

Goals of Disease Management

Basic Principles of Disease Management

Diseases Targeted for Disease Management Programs

Steps to Develop a Disease Management Program

Barriers and Opportunities

Respiratory Therapists as Disease Managers

Making the Case for Patient Education

Definition of Terms

Teaching and Learning Aspects of Patient Education

Indications and Goals in Patient Education

Process of Patient Education

Examples of Patient Education Programs

The Evolving Role of Respiratory Therapists as Decision Makers and Consultants

Introduction to Guidelines, Protocols, and Pathways

Outcomes Evaluation and Evidence: What Do the Data Show?

Consultation Skills for Healthcare Professionals

Respiratory Therapists as Healthcare Consultants

Transmission of Infection

Strategies for Infection Control

Regulatory Agencies

Cleaning, Disinfection, and Sterilization

Precautions

Healthcare-Associated Infections Related to Respiratory Care Equipment

Epidemiology

Pathophysiology

Pathogenesis

Risk Factors

Other Asthma Phenotypes

Disease Severity Classification

Assessing Control of Asthma

Objective Measurements

Pharmacologic Therapy

Aerosol Therapy

Adjunctive Treatments

Education

Burden of Chronic Obstructive Pulmonary Disease

Definitions and Staging of Disease

Etiology of Chronic Obstructive Pulmonary Disease

Pathophysiology of Chronic Obstructive Pulmonary Disease

Diagnosis and Clinical Course

Outpatient Care of Stable Chronic Obstructive Pulmonary Disease

Surgery

Overview of Management of Stable Chronic Obstructive Pulmonary Disease

Managing Exacerbations

Palliative and End-of-Life Care

Pathophysiology

Classification

Clinical Presentation and Diagnostic Evaluation

Pathology

Prognosis

Management

Associated Diseases

Pathophysiology

Epidemiology

Diagnosis

Management of Selected Pulmonary Vascular Diseases

Definition and Classification of Pneumonia

Diagnostic Workup

Bacterial Causes of Pneumonia

Anaerobic Bacterial Infection

Viral Causes of Pneumonia

Mycobacterial Causes of Pneumonia

Fungal Respiratory Infections

Actinomycosis and Nocardiosis

Community-Acquired Pneumonia

Healthcare-Associated Pneumonia and Hospital-Acquired Pneumonia

Pneumonia in Immunocompromised Patients Without HIV Infection

Pneumonia in Patients with HIV Infection

Pneumonia in Children

History

Pathogenesis

Diagnosis

Extrapulmonary Manifestations

Respiratory Manifestations

Major Respiratory Complications

Standard Therapy of Lung Disease

Definition

Incidence

Etiology

Clinical Manifestations

Pathobiology

The National Institutes of Health ARDS Network

Management

Outcomes

Preoperative Assessment and Management

Preoperative Testing

Intraoperative Risk Factors

Postoperative Respiratory Failure: Assessment and Management

Atelectasis

Pulmonary Emboli and Pulmonary Thromboembolic Disease

Pneumonia

Mechanical Ventilation

Definition

Cardiac Physiology

Determinants of Ventricular Function

Pathophysiology of Cardiac Failure

Pathophysiology of Pulmonary Edema

Heart–Lung Interactions

Clinical Aspects of Cardiac Failure

Measurement and Monitoring of Cardiac Function

Treatment Guidelines for Chronic Cardiac Failure

Treatment Guidelines for Acute Cardiac Failure

Acute Myocardial Infarction

Ventilatory Support of the Patient with Cardiac Failure

The Primary and Secondary Surveys

Thoracic Trauma

Airway and Breathing Injuries

Circulation Injuries

Injuries Encountered During the Secondary Survey

Head Trauma

Primary Survey Issues of Head Injury

Secondary Survey Issues of Head Injury

Treatment of Head Injuries

Burn Injury

Inhalation Injury

Management of Inhalation Injury

Overview

Pathophysiology of Neuromuscular Disease on Respiratory Function

Evaluation of Respiratory Function in Patients with Neuromuscular Disease

Upper Motor Neuron Disorders

Lower Motor Neuron Disorders

Disorders of the Peripheral Nerves

Disorders of the Neuromuscular Junction

Inherited Myopathies

Acquired Inflammatory Myopathies

Treatment of Neuromuscular Dysfunction

Descriptions and Common Terms

Obstructive Sleep Apnea

Complications of Obstructive Sleep Apnea

Diagnosis of Obstructive Sleep Apnea

Treatment of Obstructive Sleep Apnea

Mortality Associated with Obstructive Sleep Apnea

Classification

Epidemiology

Risk Factors and Etiology

Presentation

Solitary Pulmonary Nodule

Diagnosis

Workup and Staging

Treatment

Prognosis

Prevention

Future Directions

Apnea of Prematurity

Respiratory Distress Syndrome

Bronchopulmonary Dysplasia and Chronic Lung Disease

Transient Tachypnea of the Newborn

Pneumonia in the Neonate

Meconium Aspiration Syndrome

Persistent Pulmonary Hypertension of the Newborn

Congenital Diaphragmatic Hernia

Air Leak Syndrome

Retinopathy of Prematurity

Bronchiolitis

Laryngotracheobronchitis

Epiglottitis

Design Factors

Statistical Issues

Study Types

Basic Physics

Gas Laws

Gas Mixtures and Partial Pressures

Humidity, Water Vapor, and Evaporation

Gases in Solution, Diffusion, and Osmosis

Conversion of Gas Volumes

Conservation of Energy

Flow of Gases and Other Fluids

Application of Physical Principles to Measurement and Physiology

Basic Chemistry

Inorganic Molecules

Organic Molecules

Fluid Balance

Metabolic Pathways

Bacteria

Viruses

Fungi

Parasites

Common Respiratory Infections

Sampling Methods

Microbiology Techniques

Antimicrobial Resistance

The Heart

Circulatory System

Gross Anatomy of the Respiratory System

Anatomy of the Thorax

Microanatomy of the Respiratory System

Functional Characteristics of the Respiratory System

Routes of Delivery

Principles of Pharmacotherapy

Pharmacologic Therapies

Drugs for Airway and Ventilator Management

Diuretics

Hemodynamic Control

Historical Events and Key Advances in Medical-Related Sciences

Evolution of Respiratory Care in the 20th and 21st Centuries

Historical Events That Signaled the Evolution of Respiratory Care

Milestones in the Organizations Within the Respiratory Care Profession: Beginning Years

Respiratory Care Science: Contemporary and Future

American Association for Respiratory Care

American Respiratory Care Foundation

National Board for Respiratory Care

Commission on Accreditation for Respiratory Care

National Association for Medical Direction of Respiratory Care

American College of Chest Physicians

American Thoracic Society

American Society of Anesthesiologists

Society of Critical Care Medicine

The Joint Commission

National Asthma Educator Certification Board

Association of Asthma Educators

American Academy of Sleep Medicine

Board of Registered Polysomnographic Technologists

Healthcare Trends

Traditional Roles of Respiratory Therapists

Nontraditional Roles for Respiratory Therapists

What Is Critical Thinking, and Why Is It Important for Respiratory Therapists?

The Essential Skills for Critical Thinking in Practice

Abilities and Characteristics of Critical Thinkers

Teaching Critical Thinking

Definition of Ethics

Foundations of Ethical Thinking

Ethical Versus Legal Behavior

Ethical Theories

Ethical Principles

Role of Professional Organizations in Ethics

Ethics Committees

Miscommunication: The Case for Effective Communication Skills

Basic Concepts of Communication

Principles and Assumptions

Communication Defined

Factors Affecting Communication

Barriers to Effective Communication

Basic Goals and Purpose of Communication

Effective Communication

Questioning Techniques

Basic Healthcare Delivery Functions

Stakeholders in Healthcare Reimbursement

The Respiratory Therapist’s Role: Balancing Cost and Care

Forces Influencing Healthcare Costs

Financing Healthcare: A Brief History and Overview

The Era of Managed Care

Reimbursement Methodologies

The Future of Healthcare Funding

Reimbursement and the Respiratory Therapist

What Is Evidence-Based Respiratory Care?

Hierarchy of Evidence

Evidence for a Diagnostic Test

Evidence for a Therapy

Meta-Analysis

Finding the Evidence

Narrative Reviews and Systematic Reviews

Clinical Practice Guidelines

Glossary

Index