Friday, July 16, 2010

Pathogens Associated with the Intensive Care Unit Environment – Considerations for the Respiratory Therapist

The August 1 2010 Article Review is by John Davies, MA RRT FAARC

PDF File Article Link Click Here

This program has been approved for 2.0 contact hours by the AARC

Ventilator-associated pneumonia (VAP) is the most common nosocomial pulmonary infection and accounts for a significant proportion of the 1.7 million infections and 99,000 associated deaths each year in American hospitals. Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) are of growing concern due to their ease of transmission via medical devices and hospital personnel. Other pathogens causing VAP include Staphylococcus aureus, Streptococcus pneumonia and Hemophilus influenzae, Pseudomonas aeruginosam, Acinetobacter species and Enterobacter species. A clear diagnosis of VAP requires a combination of findings from clinical signs, chest X-ray, and analysis of bronchial alveolar lavage. Although there are several natural defense systems against infection, these are often breached through the use of indwelling devices, such as catheters, and inadequately sterilized mechanical ventilation equipment, such as endotracheal tubes, ventilator circuits, humidifiers, medication nebulizers and suction catheters. Methods to prevent VAP include effective handwashing with antimicrobial preparations, education of hospital staff, thorough sterilization of equipment, and implementation of protocols such as the VAP bundle. Modified equipment is now available to limit the likelihood of infection.

Saturday, July 3, 2010

BTPS HFT Standard of Care in Your Hospital Setting

I'd like to have some input as to the Standards of Care in Your Hospital regarding "Heated" High Flow Oxygen Delivery. Currently where I work we do not have or use BTPS High Flow Oxygen and after reading the Clinical Foundations Article I am quite interested in pursuing this avenue and plan on speaking with our Director.

"Breathing cool, dry gases can produce deleterious effects in the respiratory tract and when delivered through an artificial airway, can maginfy the negative impact of ventilation."

"(BTPS) Body Temperature Pressure Saturated (HFT) High flow therpay delivers warm, humdified gas to the patient through a nasal cannula. BTPS gas can be beneficial, regardless of whether the the patient is receiving supplemental oxygen, although the mechanism is not yet fully understood"

Today I found new technology to deliver BTPS via nasal canula and ventilator see Vapore for details
Please make your comments below.

Online Discussion of Respiratory Care Article Reviews

The turn out for our July 1 RT Article Review was very dishearting. I arrived at 7pm ordered a sandwich and drink and waited until 730pm. No one arrived. I should know by now that only those very dedicated people to their profession would take the time to meet in a group to increase they awareness and share their expertise with their peers. To this end I will post the Monthly Article for review at http://RCPSAM.com and discussions of the article will be posted on this blog. At some future date I will set up a group conference line so those interested can share their thoughts on the Montly Articles.