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9780323018135

Egan's Fundamentals of Respiratory Care

by
  • ISBN13:

    9780323018135

  • ISBN10:

    0323018130

  • Edition: 8th
  • Format: Hardcover
  • Copyright: 2003-06-11
  • Publisher: Mosby
  • View Upgraded Edition

Note: Supplemental materials are not guaranteed with Rental or Used book purchases.

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Supplemental Materials

What is included with this book?

Summary

This comprehensive, student-focused textbook provides the fundamental knowledge that respiratory care students need as they enter the health care field. For more than 30 years, instructors have relied on Egan's for the most accurate, timely information on pathophysiology, assessment, and treatment of neonatal, pediatric, and adult diseases of the chest. Fundamental concepts are addressed in easy-to-follow discussions on respiratory anatomy and physiology, patient assessment, basic therapeutics, and acute and critical care. The 8th edition continues this book's gold-standard tradition with a brand new, full-color design and thoroughly updated content, including new chapters on neonatal and pediatric disorders and noninvasive positive pressure ventilation. It also features new and expanded coverage on smoking cessation, hemodynamic monitoring, stress testing, polysomnography, and more. Instructor resources are available to qualified adopters; contact your sales representative for more information. Short, critical-thinking vignettes in each chapter, called Mini Clinis, raise questions and expose students to possible problems they may encounter during actual patient care. Rule of Thumb icons in each chapter highlight rules, formula, and key points that help readers learn concepts important to clinical practice. Excerpts of Clinical Practice Guidelines (CPGs), developed by the American Association for Respiratory Care (AARC), give important information regarding indications/contraindications, hazards and complications, assessment of need, assessment of outcome, and monitoring to familiarize readers with using CPGs in the practice setting. Learning Objectives tell readers what is important about each chapter, often paralleling the three areas tested on the NBRC exam: recall, analysis, and application. Therapist-Driven Protocols (TDPs) - decision trees developed by hospitals - help RTs assess a patient, initiate care, and evaluate outcomes. Key terms tell readers what terms will be learned by studying the chapter. Key Point Summaries highlight key content at the end of each chapter in a bulleted section. Current issues related to assessment and treatment of chest diseases are covered, including neonatal, pediatric, and adult diseases of the chest. New chapters on neonatal & pediatric disorders and noninvasive positive pressure ventilation (NIPPV) provide essential information on these important areas. All chapters have been reviewed and rewritten to reflect changes in the field and the most up-to-date material to prepare students for careers as RTs in today's health-care environment, including: an added discussion on smoking cessation (Chapter 44), polysomnography (Chapter 27), and arterial blood gas sampling (Chapter 16). Full color throughout makes the text more reader-friendly and drawing out special features. New illustrations highlight and clarify important concepts discussed the text.

Table of Contents

SECTION I Foundations of Respiratory Care
1(134)
Quality and Evidence-Based Respiratory Care
3(18)
Elements of a Hospital-Based Respiratory Care Program: Roles Supporting Quality Care
4(4)
Medical Direction
4(1)
Respiratory Therapists
4(1)
Respiratory Therapists' Designations and Credentials
5(2)
Professionalism
7(1)
Technical Direction
7(1)
Methods for Enhancing Quality Respiratory Care
8(7)
Respiratory Care Protocols
8(5)
Monitoring Quality Respiratory Care
13(2)
Peer Review Organizations
15(1)
New Patient Care Delivery Models and Quality of Respiratory Care
15(3)
Hospital Restructuring and Redesign
15(1)
Patient-Focused Care
16(1)
Protocols
16(1)
Disease Management
17(1)
Evidence-Based Medicine
18(3)
Patient Safety, Communication, and Recordkeeping
21(20)
Safety Considerations
22(6)
Patient Movement and Ambulation
2(22)
Electrical Safety
24(3)
Fire Hazards
27(1)
Communication
28(6)
Health Communication
29(1)
Factors Affecting Communication
30(1)
Effective Health Communication
30(1)
Improving Communication Skills
31(2)
Conflict and Conflict Resolution
33(1)
Recordkeeping
34(7)
Components of a Traditional Medical Record
34(1)
Legal Aspects of Recordkeeping
35(2)
Practical Aspects of Recordkeeping
37(1)
The Problem-Oriented Medical Record
37(4)
Principles of Infection Control
41(28)
Spread of Infection
42(3)
Source
42(1)
Host
43(1)
Transmission Route
43(2)
Spread of Infection to the Lungs
45(1)
Infection Control Strategies
45(1)
Decreasing Host Susceptibility
45(1)
Eliminating the Source of Pathogens
45(1)
Interrupting Routes of Transmission
46(1)
Equipment Processing
46(5)
Cleaning
46(1)
Disinfection
47(2)
Sterilization
49(2)
Equipment Handling Procedures
51(5)
Maintenance of In-Use Equipment
51(3)
Processing Reusable Equipment
54(1)
Disposable Equipment
54(2)
Fluids and Medications Precautions
56(1)
Barrier Measures and Isolation Precautions
56(8)
General Barrier Measures
56(4)
Isolation Precautions
60(4)
Surveillance
64(5)
Equipment Processing Quality Control
64(1)
Sampling of In-Use Equipment
65(1)
Microbiological Identification
65(4)
Ethical and Legal Implications of Practice
69(16)
Philosophical Foundation of Ethics
70(1)
Ethical Dilemmas of Practice
70(1)
Codes of Ethics
71(1)
Ethical Theories and Principles
72(4)
Autonomy
72(1)
Veracity
72(1)
Nonmaleficence
73(1)
Beneficence
74(1)
Confidentiality
74(1)
Justice
75(1)
Role Duty
75(1)
Ethical Viewpoints and Decision Making
76(2)
Formalism
76(1)
Consequentialism
76(1)
Mixed Approaches
76(1)
Virtue Ethics
76(1)
Intuitionism
77(1)
Comprehensive Decision-Making Models
77(1)
Legal Issues Affecting Respiratory Care
78(3)
Systems of Law
78(2)
Medical Supervision
80(1)
Interaction of Ethics and the Law
81(1)
Healthcare and Change
82(3)
Physical Principles of Respiratory Care
85(28)
States of Matter
86(3)
Internal Energy of Matter
86(1)
Internal Energy and Temperature
86(1)
Heat and the First Law of Thermodynamics
87(1)
Heat Transfer
88(1)
Change of State
89(13)
Liquid-Solid Phase Changes (Melting and Freezing)
89(1)
Properties of Liquids
90(3)
Liquid-Vapor Phase Changes
93(4)
Properties of Gases
97(5)
Gas Behavior Under Changing Conditions
102(3)
Gas Laws
102(1)
Effect of Water Vapor
102(2)
Properties of Gases at Extremes of Temperature and Pressure
104(1)
Critical Temperature and Pressure
104(1)
Fluid Dynamics
105(8)
Pressures in Flowing Fluids
105(1)
Patterns of Flow
106(1)
Flow, Velocity, and Cross-Sectional Area
107(1)
The Bernoulli Effect
108(1)
Fluid Entrainment
109(1)
Fluids and the Coanda Effect
110(3)
Computer Applications in Respiratory Care
113(22)
How Computers Work
114(5)
Hardware
114(3)
Software
117(2)
How Computers Communicate
119(1)
Computer Networks
119(1)
Computer Applications in Respiratory Care
120(12)
Information Management
120(2)
Clinical Applications
122(4)
Integrated Approaches
126(2)
Using the Internet
128(4)
Nontechnical Issues Related to Computers
132(3)
Confidentiality
132(1)
Technical Skills
132(1)
Software Errors and Risk of Patient Harm
132(1)
Lay Access to Medical Information
132(3)
SECTION II Applied Anatomy and Physiology
135(172)
The Respiratory System
137(50)
The Genetic Framework
139(1)
Development of the Respiratory System
140(2)
Transition From Uterine to Extrauterine Life
142(3)
Placental Circulation
142(1)
Fetal Circulation
143(1)
Cardiopulmonary Events at Birth
144(1)
Postnatal Lung Development
145(6)
Head and Upper Airway
145(1)
Conducting Airways and Peripheral Airway Growth
146(1)
Alveolar and Vascular Growth
147(1)
Lymphatic Circulatory System
147(1)
Nervous Pathways and the Control of Breathing
148(1)
Metabolic and Ventilatory Requirements
148(1)
Chest Wall Development and Lung Volumes
149(1)
Compliance, Airway Resistance, and Pressure-Volume Relationships
149(2)
The Respiratory System in the Adult
151(13)
The Thorax
151(1)
Gross Structure and Function
152(12)
Innervation of the Lung and Thoracic Masculature
164(2)
Somatic Innervation
164(1)
Autonomic Innervation
164(2)
Vascular Supply
166(2)
Pulmonary Circulation
166(1)
Bronchial Circulation
167(1)
Lymphatics
167(1)
Anatomy of the Respiratory Tract
168(16)
Upper Respiratory Tract
168(6)
Lower Respiratory Tract
174(10)
Other Functions of the Lung
184(3)
The Cardiovascular System
187(20)
Functional Anatomy
188(8)
The Heart
188(5)
The Vascular System
193(3)
Control of the Cardiovascular System
196(6)
Regulation of Peripheral Vasculature
196(1)
Regulation of Cardiac Output
196(3)
Cardiovascular Control Mechanisms
199(3)
Events of the Cardiac Cycle
202(5)
Ventilation
207(22)
Mechanics of Ventilation
208(9)
Pressure Differences During Breathing
208(1)
Forces Opposing Inflation of the Lung
209(8)
Mechanics of Exhalation
217(1)
Work of Breathing
218(2)
Mechanical
218(2)
Metabolic
220(1)
Distribution of Ventilation
220(4)
Regional Factors
221(1)
Local Factors
222(2)
Efficiency and Effectiveness of Ventilation
224(5)
Efficiency
224(2)
Clinical Significance
226(1)
Effectiveness
226(3)
Gas Exchange and Transport
229(26)
Diffusion
230(5)
Whole-Body Diffusion Gradients
230(1)
Determinants of Alveolar Gas Tensions
230(2)
Mechanism of Diffusion
232(2)
Systemic Diffusion Gradients
234(1)
Normal Variations From Ideal Gas Exchange
235(1)
Anatomical Shunts
235(1)
Regional Inequalities in Ventilation and Perfusion
235(1)
Oxygen Transport
236(8)
Physically Dissolved Oxygen
236(1)
Chemically Combined Oxygen (Oxyhemoglobin)
237(1)
Total Oxygen Content of the Blood
238(2)
Normal Loading and Unloading of Oxygen (Arteriovenous Differences)
240(1)
Factors Affecting Oxygen Loading and Unloading
241(2)
Measurement of Hemoglobin Affinity for Oxygen
243(1)
Carbon Dioxide Transport
244(3)
Transport Mechanisms
244(1)
Carbon Dioxide Dissociation Curve
245(2)
Abnormalities of Gas Exchange and Transport
247(8)
Impaired Oxygen Delivery
247(5)
Impaired Carbon Dioxide Removal
252(3)
Solutions, Body Fluids, and Electrolytes
255(16)
Solutions
256(5)
Definition of a Solution
256(1)
Concentration of Solutions
256(1)
Osmotic Pressure of Solutions
256(2)
Quantifying Solute Content and Activity
258(1)
Calculating Solute Content
259(1)
Quantitative Classification of Solutions
260(1)
Electrolytic Activity and Acid-Base Balance
261(2)
Characteristics of Acids, Bases, and Salts
261(1)
Designation of Acidity and Alkalinity
262(1)
Body Fluids and Electrolytes
263(8)
Fluids
263(3)
Electrolytes
266(5)
Acid-Base Balance
271(26)
Hydrogen Ion Regulation in Body Fluids
272(4)
Strong and Weak Acids and Bases: Equilibrium Constants
273(1)
Buffer Solution Characteristics
273(1)
Bicarbonate and Nonbicarbonate Buffer Systems
273(1)
pH of a Buffer System: Henderson-Hasselbalch Equation
274(2)
Physiological Roles of Bicarbonate and Nonbicarbonate Buffer Systems
276(1)
Acid Excretion
277(2)
Lungs
277(1)
Kidneys
277(2)
Acid-Base Disturbances
279(3)
Normal Acid-Base Balance
281(1)
Primary Respiratory Disturbances
281(1)
Primary Metabolic (Nonrespiratory) Disturbances
281(1)
Compensation: Restoring pH to Normal
281(1)
Clinical Acid-Base States
282(15)
Systematic Acid-Base Classification
282(2)
Respiratory Acidosis
284(2)
Respiratory Alkalosis
286(2)
Metabolic Acidosis
288(2)
Metabolic Alkalosis
290(3)
Metabolic Acid-Base Indicators
293(1)
Mixed Acid-Base States
294(3)
Regulation of Breathing
297(10)
Medullary Respiratory Center
298(1)
Dorsal Respiratory Groups
298(1)
Ventral Respiratory Groups
299(1)
Inspiratory Ramp Signal
299(1)
Pontine Respiratory Centers
299(1)
Apneustic Center
299(1)
Pneumotaxic Center
299(1)
Reflex Control of Breathing
300(1)
The Hering-Breuer Inflation Reflex
300(1)
Deflation Reflex
300(1)
Head's Paradoxical Reflex
300(1)
Irritant Receptors
300(1)
J Receptors
300(1)
Peripheral Proprioceptors
300(1)
Muscle Spindles
300(1)
Chemical Control of Breathing
301(3)
Central Chemoreceptors
301(1)
Peripheral Chemorrecptors
302(1)
Control of Breathing During Chronic Hypercania
303(1)
Ventilatory Response to Exercise
304(1)
Abnormal Breathing Patterns
304(1)
Effect of Carbon Dioxide on Cerebral Blood Flow
305(2)
SECTION III Assessment of Respiratory Disorders
307(142)
Bedside Assessment of the Patient
309(26)
Interviewing the Patient and Taking a Medical History
310(5)
Principles of Interviewing
310(2)
Common Cardiopulmonary Symptoms
312(3)
Format for the Medical History
315(1)
Physical Examination
315(20)
General Appearance
315(1)
Level of Consciousness
316(1)
Vital Signs
317(3)
Examination of the Head and Neck
320(1)
Examination of the Thorax and Lungs
321(9)
Cardiac Examination
330(2)
Abdominal Examination
332(1)
Examination of the Extremities
332(3)
Electrocardiogram and Laboratory Test Assessment
335(20)
The Electrocardiogram
336(11)
Basic Principles of Electrophysiology
336(1)
The Conduction System
336(2)
Basic ECG Waves
338(2)
Interpreting the ECG
340(7)
Interpreting Clinical Laboratory Tests
347(8)
Complete Blood Count
347(2)
Blood Chemistry Tests
349(2)
Microbiology Tests
351(4)
Analysis and Monitoring of Gas Exchange
355(36)
Analysis Versus Monitoring
356(1)
Invasive Versus Noninvasive Procedures
356(1)
Measuring FIO2
356(2)
Instrumentation
356(1)
Procedure
357(1)
Problem-Solving and Troubleshooting
357(1)
Sampling and Analyzing Blood Gases
358(14)
Sampling
358(7)
Analyzing
365(7)
Blood Gas Monitoring
372(5)
Transcutaneous
372(3)
Intraarterial (In Vivo)
375(1)
On Demand (Ex Vivo)
376(1)
Oximetry
377(6)
Hemoximetry
377(2)
Pulse Oximetry
379(4)
Capnometry and Capnography
383(8)
Instrumentation
383(2)
Interpretation
385(1)
Procedure
386(1)
Problem-Solving and Troubleshooting
387(4)
Pulmonary Function Testing
391(36)
Pulmonary Function Testing
392(3)
Purposes
392(1)
Organization
393(1)
Equipment
393(1)
Infection Control
394(1)
Principles of Measurement
395(16)
Lung Volumes and Capacities
395(8)
Pulmonary Mechanics: Spirometry
403(5)
Diffusing Capacity
408(3)
Interpretation of Test Reults
411(16)
Pathophysiological Patterns
411(12)
Interpretation of the Pulmonary Function Report
423(4)
A Synopsis of Thoracic Imaging
427(22)
Overview of the Plain Chest Radiograph
428(1)
Overview of the Normal Anatomy Seen on the Chest Radiograph
429(1)
Technical Adequacy of a Radiograph
429(2)
The Pleura
431(4)
Hydrothorax
431(2)
Pneumothorax
433(1)
Abnormal Air Collection in the Thorax: Common Etiologies
434(1)
Lung Parenchyma
435(8)
Assesing Lung Volume
437(2)
Catheters, Lines, and Tubes
439(3)
Solitary Pulmonary Nodule
442(1)
The Mediastinum
443(6)
SECTION IV Synopsis of Cardiopulmonary Disease
449(176)
Pulmonary Infections
451(18)
Classification
452(1)
Pathogenesis
452(2)
Microbiology
454(1)
Clinical Manifestations
455(1)
Chest Radiograph
456(1)
Risk Factors for Mortality and Assessing the Need for Hospitalization
456(3)
Diagnostic Studies
459(3)
Community-Acquired Pneumonia
459(2)
Nosocomial Pneumonia
461(1)
Therapy
462(3)
Prevention
465(4)
Obstructive Lung Disease: COPD, Asthma, and Related Diseases
469(22)
Chronic Obstructive Pulmonary Disease
470(8)
Overview and Definitions
470(1)
Epidemiology
470(1)
Risk Factors and Pathophysiology
471(1)
Clinical Signs and Symptoms
472(1)
Management
473(5)
Asthma
478(9)
Definition
478(1)
Epidemiology
479(1)
Etiology and Pathogenesis
479(1)
Clinical Presentation and Diagnosis
479(2)
Management
481(1)
Objective Measurement and Monitoring
481(1)
Pharmacotherapy
482(3)
Emergency Department and Hospital Management
485(1)
Immunotherapy
485(1)
Environmental Control
485(1)
Patient Education
486(1)
Special Considerations in Asthama Management
486(1)
Bronchiectasis
487(4)
Clinical Presentation
487(1)
Evaluation
488(1)
Management
488(3)
Interstitial Lung Disease
491(12)
Classification of ILD
492(1)
Pathophysiology
492(1)
Clinical Signs and Symptoms of ILD
492(5)
Physical Examination
493(1)
Radiographic Features
493(2)
Physiological Features
495(2)
Specific Types of ILD
497(3)
Occupational
497(1)
Drug Related
498(1)
Connective Tissue Disease
498(1)
Allergic, or Hypersensitivity Responses
499(1)
Idiopathic and Unclassified Disease
499(1)
Treatment Issues
500(3)
Medical Treatment
500(1)
Oxygen Therapy
500(1)
Avoiding Exposure
500(2)
Pulmonary Rehabilitation and Exercise Therapy
502(1)
Vaccinations
502(1)
Transplantation
502(1)
Pleural Diseases
503(18)
The Pleural Space
504(1)
Overview and Definitions
504(1)
Pleural Effusions
505(6)
Transudative
505(2)
Exudative
507(2)
Physiological Importance
509(1)
Diagnostic Tests
509(2)
Pneumothorax
511(10)
Traumatic
511(1)
Spontaneous
512(1)
Complications
513(1)
Diagnosis
514(1)
Therapy
514(2)
Bronchopleural Fistula
516(1)
Pleurodesis
517(4)
Pulmonary Vascular Disease
521(16)
Venous Thromboembolic Disease
522(9)
Pathogenesis
522(1)
Pathology
523(1)
Pathophysiology
523(1)
Clinical Features
524(1)
Diagnostic Modalities
525(2)
Treatment
527(4)
Primary Pulmonary Hypertension
531(6)
Pathogenesis
531(1)
Epidemiology and Clinical Findings
531(1)
Diagnosis
532(1)
Management of Pulmonary Hypertension
532(5)
Acute Lung Injury, Pulmonary Edema, and Multiple System Organ Failure
537(20)
Epidemiology
538(1)
ARDS Risk Factors
539(1)
Pathophysiology
539(5)
Normal Physiology
539(1)
Pulmonary Blood Flow
539(1)
The Lung Interstitium
540(1)
Liquid and Solute Transport in the Lungs
540(1)
Pulmonary Edema
541(2)
Gas Exchange and Lung Mechanics During ARDS
543(1)
The Role of Organ-Organ Interactions in the Pathogenesis of ARDS and MODS
543(1)
Histopathology and Clinical Correlates of ARDS
544(2)
Exudative Phase (1 to 3 Days)
544(1)
Fibroproliferative Phase (3 to 7 Days)
544(1)
Differentiating Hydrostatic From Nonhydrostatic Pulmonary Edema in the Clinical Setting
545(1)
Therapeutic Approach to ARDS
546(11)
Supportive Care of Patients with ARDS and MODS
546(1)
Hemodynamics and Fluid Management During ARDS
546(2)
Mechanical Ventilation During ARDS
548(2)
Innovative Ventilation Strategies for ARDS
550(3)
Pharmacologic Therapies for ARDS
553(4)
Lung Neoplasms
557(14)
Etiology
558(1)
Pathogenesis and Pathology
559(5)
Clinical Manifestations
560(2)
Radiographic Manifestations
562(1)
Solitary Pulmonary Nodule
563(1)
Diagnosis
564(2)
Staging
564(1)
Screening
565(1)
Treatment
566(5)
Non-Small Cell Lung Cancer
566(2)
Prevention
568(3)
Neuromuscular and Other Diseases of the Chest Wall
571(16)
General Principles Relating to Neuromuscular Weakness of the Ventilatory Muscles
572(3)
Clinical Signs and Symptoms
573(1)
Pathophysiology and Pulmonary Function Testing
573(1)
Monitoring and Assessing Patients for Respiratory Insufficiency
574(1)
Management of Respiratory Muscle Weakness
574(1)
Specific Neuromuscular Diseases
575(7)
Disorders of the Muscle (Myopathic Disease)
575(1)
Disorders of the Neuromuscular Junction
576(2)
Disorders of the Nerves
578(1)
Disorders of the Spinal Cord
579(2)
Disorders of the Brain
581(1)
Disorders of the Thoracic Cage
582(5)
Kyphoscoliosis
582(1)
Fail Chest
583(1)
Ankylosis Spondylitis
583(4)
Disorders of Sleep
587(18)
Definitions
589(1)
Pathophysiology
589(2)
Obstructive Sleep Apnea
589(1)
Central Sleep Apnea
590(1)
Overlap Syndrome
590(1)
Clinical Features
591(1)
Laboratory Testing
591(2)
Treatment
593(7)
Behavioral Interventions and Risk Counseling
593(1)
Positional Therapy
594(1)
Medical Interventions
594(5)
Surgical Interventions
599(1)
Conclusions
600(5)
Neonatal and Pediatric Respiratory Disorders
605(20)
Neonatal Respiratory Disorders
606(10)
Lung Parenchymal Disease
606(5)
Control of Breathing
611(1)
Pulmonary Vascular Disease
612(1)
Congenital Abnormalities Affecting Respiration
613(1)
Congenital Heart Disease
614(2)
Pediatric Respiratory Disorders
616(9)
Sudden Infant Death Syndrome
616(1)
Gastroesophageal Reflux Disease
617(1)
Bronchilolitis
617(2)
Group
619(1)
Epiglottitis
619(1)
Cystic Fibrosis
620(5)
SECTION V Basic Therapeutics
625(286)
Airway Pharmacology
627(26)
Principles of Pharmacology
628(2)
The Drug Administration Phase
628(1)
The Pharmacokinetic Phase
628(1)
The Pharmacodynamic Phase
629(1)
Airway Receptors and Neural Control of the Lung
629(1)
Adrenergic Bronchodilators
630(4)
Indications for Use
630(1)
Mode of Action and Effects
630(1)
Adrenergic Bronchodilator Agents
631(2)
Adverse Effects
633(1)
Assessment of Bronchodilator Therapy
634(1)
Anticholinergic Bronchodilators
634(3)
Indications for Use
635(1)
Mode of Action
635(1)
Adverse Effects
636(1)
Assessment
637(1)
Mucus-Controlling Agents
637(3)
Acetylcysteine
637(1)
Dornase Alfa
638(1)
Other Mucoactive Agents
639
Assessment of Mucoactive Drug Therapy
369(271)
Inhaled Corticosteroids
640(1)
Indications and Purposes
640(1)
Mode of Action
640(1)
Adverse Effects
640(1)
Assessment of Drug Therapy
640(1)
Nonsteroidal Antiasthma Drugs
641(4)
Indications for Use
642(1)
Mode of Action
643(1)
Adverse Effects
644(1)
Assessment of Drug Therapy
644(1)
Aerosolized Antiinfective Agents
645(8)
Pentamidine Isethionate
645(1)
Ribavirin
646(1)
Inhaled Tobramycin
646(1)
Inhaled Zanamivir
647(1)
Inhaled Antifungal Therapy
648(5)
Airway Management
653(52)
Suctioning
654(7)
Endotracheal Suctioning
655(4)
Nasotracheal Suctioning
659(2)
Sputum Sampling
661(1)
Establishing an Artificial Airway
661(15)
Clinical Practice Guideline
661(1)
Routes
661(3)
Airway Tubes
664(3)
Procedures
667(9)
Airway Trauma Associated With Tracheal Tubes
676(3)
Laryngeal Lesions
677(1)
Tracheal Lesions
677(1)
Prevention
678(1)
Airway Maintenance
679(9)
Securing the Airway and Confirming Placement
679(1)
Providing for Patient Communication
679(2)
Ensuring Adequate Humidification
681(1)
Minimizing Nosocomial Infections
681(1)
Facilitating Secretion Clearance
681(1)
Providing Cuff Care
681(3)
Care of the Tracheostomy and Tube
684(1)
Changing a Tracheostomy Tube
685(1)
Troubleshooting Airway Emergencies
685(3)
Extubation/Decannulation
688(4)
Assessing Patient Readiness for Extubation
688(1)
Procedures
689(3)
Alternative Airway Devices
692(3)
Laryngeal Mask Airway
692(1)
Double Lumen Airway
693(1)
Surgical Emergency Airways
694(1)
Bronchoscopy
695(10)
Rigid Tube Bronchoscopy
695(1)
Flexible Fiberoptic Bronchoscopy
695(10)
Emergency Life Support
705(32)
Causes and Prevention of Sudden Death
706(1)
Basic Life Support
706(16)
Determining Unresponsiveness
707(1)
Restoring the Airway
707(1)
Restoring Ventilation
708(3)
Restoring Circulation
711(3)
One-Versus Two-Rescuer Adult CPR
714(1)
Automated External Defibrillation
714(2)
Evaluating the Effectiveness of CPR
716(1)
Hazards and Complications
716(4)
Contraindications to CPR
720(1)
Health Concerns and CPR
720(1)
Dealing With an Obstructed Airway
720(2)
Advanced Cardiac Life Support
722(15)
Support for Oxygenation
722(1)
Airway Control
722(4)
Ventilation
726(1)
Bag-Valve Masks
726(1)
Restoring Cardiac Function
727(7)
Monitoring During Advanced Cardiac Life Support
734(1)
Postresuscitative Patient Care
734(1)
Respiratory Management
735(1)
Cardiovascular Management
735(2)
Humidity and Bland Aerosol Therapy
737(24)
Humidity Therapy
738(13)
Physiological Control of Heat and Moisture Exchange
738(1)
Indications for Humidification and Warming of Inspired Gases
738(2)
Equipment
740(8)
Problem Solving and Troubleshooting
748(3)
Bland Aerosol Therapy
751(5)
Sputum Induction
755(1)
Problem Solving and Troubleshooting
756(1)
Selecting the Appropriate Therapy
756(5)
Aerosol Drug Therapy
761(40)
Characteristics of Therapeutic Aerosols
762(4)
Output
762(1)
Particle Size
762(1)
Deposition
763(1)
Aging
764(2)
Hazards of Aerosol Therapy
766(1)
Infection
766(1)
Airway Reactivity
766(1)
Pulmonary and Systemic Effects
766(1)
Drug Reconcentration
766(1)
Aerosol Drug Delivery Systems
766(20)
Metered-Dose Inhalers
767(5)
Dry Powder Inhalers
772(3)
Pneumatic (Jet) Nebulizers
775(7)
Ultrasonic Nebulizers
782(1)
Hand-Bulb Atomizers
783(1)
New-Generation Nebulizers
783(2)
Advantages and Disadvantages
785(1)
Selecting an Aerosol Drug Delivery System
786(1)
Assessment-Based Bronchodilator Therapy Protocols
786(6)
Sample Protocol
786(1)
Assessing Patient Response
787(2)
Patient Education
789(3)
Special Considerations
792(4)
Continuous Nebulization for Refractory Bronchospasm
792(2)
Aerosol Administration to Intubated Patients
794(2)
Controlling Environmental Contamination
796(5)
Negative-Pressure Rooms
796(1)
Booths and Stations
796(1)
Personal Protective Equipment
797(4)
Storage and Delivery of Medical Gases
801(26)
Characteristics of Medical Gases
802(3)
Oxygen (O2)
802(1)
Air
803(1)
Carbon Dioxide (CO2)
804(1)
Helium (He)
804(1)
Nitrous Oxide (N2O)
804(1)
Nitric Oxide (NO)
804(1)
Storage of Medical Gases
805(8)
Gas Cylinders
805(6)
Bulk Oxygen
811(2)
Distribution and Regulation of Medical Gases
813(14)
Central Piping Systems
813(1)
Safety Indexed Connector Systems
814(3)
Regulating Gas Pressure and Flow
817(10)
Medical Gas Therapy
827(36)
Oxygen Therapy
828(24)
General Goals and Clinical Objectives
828(1)
Clinical Practice Guideline
829(1)
Assessing the Need for Oxygen Therapy
829(1)
Precautions and Hazards of Supplemental Oxygen
829(4)
Oxygen Delivery Systems: Design and Performance
833(17)
Selecting a Delivery Approach
850(1)
Protocol-Based Oxygen Therapy
851(1)
Hyperbaric Oxygen Therapy
852(3)
Physiological Effects
853(1)
Methods of Administration
853(1)
Indications
853(1)
Complications and Hazards
854(1)
Troubleshooting
855(1)
Other Medical Gas Therapies
855(8)
Nitric Oxide Therapy
855(3)
Helium Therapy
858(5)
Lung Expansion Therapy
863(20)
Causes and Types of Atelectasis
864(1)
Indications for Lung Expansion Therapy
864(1)
Clinical Signs of Atelectasis
865(1)
Lung Expansion Therapy
866(1)
Incentive Spirometry
866(4)
Physiological Basis of IS
866(2)
Indications for IS
868(1)
Contraindications for IS
868(1)
Hazards and Complications of IS
868(1)
Equipment
869(1)
Administering IS
869(1)
Intermittent Positive Pressure Breathing (IPPB)
870(7)
Definition and Physiological Principle
871(1)
Indications for IPPB
871(3)
Contraindications for IPPB
874(1)
Hazards and Complications of IPPB
874(1)
Administering IPPB
874(2)
Discontinuation and Follow-Up
876(1)
Monitoring and Troubleshooting
877(1)
Positive Airway Pressure (PAP) Therapy
877(4)
Definitions and Physiological Principle
878(1)
Indications for CPAP
878(1)
Contraindications for CPAP
878(1)
Hazards and Complications of CPAP
879(1)
Equipment
879(1)
Administering Intermittent CPAP
879(2)
Selecting an Approach
881(2)
Bronchial Hygiene Therapy
883(28)
Physiology of Airway Clearance
884(2)
Normal Clearance
884(1)
Abnormal Clearance
885(1)
Diseases Associated With Abnormal Clearance
886(1)
General Goals and Indications
886(1)
Bronchial Hygiene Therapy for Acute Conditions
887(1)
Bronchial Hygiene Therapy for Chronic Conditions
887(1)
Bronchial Hygiene Therapy to Prevent Retention of Secretions
887(1)
Determining the Need for Bronchial Hygiene Therapy
887(1)
Bronchial Hygiene Methods
888(18)
Postural Drainage Therapy
888(7)
Coughing and Related Expulsion Techniques
895(5)
PAP Adjuncts
900(3)
High-Frequency Compression/Oscillation
903(1)
High-Frequency Chest Wall Oscillation
903(1)
Mobilization and Exercise
904(1)
Selecting Bronchial Hygiene Techniques
905(1)
Section Factors
905(1)
Clearance Strategies for Specific Conditions
905(1)
Protocol-Based Bronchial Hygiene
906(5)
SECTION VI Acute and Critical Care
911(278)
Respiratory Failure and the Need for Ventilatory Support
913(16)
Acute Hypoxemic Respiratory Failure (Type I)
914(3)
Ventilation/Perfusion Mismatch
914(1)
Shunt
915(1)
Alveolar Hypoventilation
915(1)
Diffusion Impairment
915(1)
Perfusion/Diffusion Impairment
916(1)
Decreased Inspired Oxygen
916(1)
Differentiating the Causes of Acute Hypoxemic Respiratory Failure
916(1)
Acute Hypercapnic Respiratory Failure (Type II)
917(2)
Decreased Ventilatory Drive
918(1)
Respiratory Muscle Fatigue or Failure
918(1)
Increased Work of Breathing
918(1)
Chronic Respiratory Failure: Type I and Type II
919(2)
Acute-on-Chronic Respiratory Failure
920(1)
Complications of Acute Respiratory Failure
920(1)
Indications for Ventilatory Support
921(1)
Parameters Indicating the Need for Ventilatory Support
921(1)
Hypoxemic Respiratory Failure
921(1)
Hypercapnic Respiratory Failure (Ventilatory Failure)
922(1)
Mechanisms of Hypercapnic Respiratory Failure
922(1)
Decreased Ventilatory Drive
922(1)
Respiratory Muscle Fatigue and Weakness
922(1)
Increased Work of Breathing
923(1)
Choosing a Ventilatory Support Strategy for Different Causes of Respiratory Failure
923(2)
Ventilatory Support in Hypoxemic Respiratory Failure
924(1)
Ventilatory Support in Hypercapnic Respiratory Failure (Ventilatory Failure)
925(1)
Special Considerations During Ventilatory Support
925(4)
Increased Intracranial Pressure
925(1)
Obstructive Lung Disease
925(4)
Mechanical Ventilators
929(34)
How Ventilators Work
930(18)
Input Power
930(1)
Power Transmission and Conversion
931(1)
Control System
931(4)
Phase Variables
935(13)
Output Waveforms
948(2)
Pressure
948(1)
Volume
949(1)
Flow
950(1)
Effects of Calibration Errors and the Patient Circuit
950(1)
Clinical Application of Modes
950(13)
Volume Control Versus Pressure Control
950(1)
Continuous Mandatory Ventilation (CMV)
951(4)
Intermittent Mandatory Ventilation (IMV)
955(3)
Continuous Spontaneous Ventilation (CSV)
958(5)
Physiology of Ventilatory Support
963(40)
Pressure and Pressure Gradients
964(4)
Airway, Alveolar, and Intrathoracic Pressure, Volume, and Flow During Spontaneous Ventilation
965(1)
Airway, Alveolar, and Intrathoracic Pressure, Volume, and Flow During Negative Pressure Mechanical Ventilation
966(2)
Airway, Alveolar, and Intrathoracic Pressure, Volume, and Flow During Positive Pressure Mechanical Ventilation
968(1)
Effects of Mechanical Ventilation on Oxygenation
968(3)
Increased Inspired Oxygen
968(1)
Alveolar Oxygen and the Alveolar Air Equation
968(1)
Arterial Oxygenation and Oxygen Content
968(2)
Decreased Shunt
970(1)
Increased Tissue Oxygen Delivery
970(1)
Effects of Mechanical Ventilation on Ventilation
971(2)
Increased Minute Ventilation
971(1)
Increased Alveolar Ventilation
971(1)
Decreased Ventilation/Perfusion Ratio
971(1)
Alveolar and Arterial Carbon Dioxide
972(1)
Changes in Acid-Base Balance
972(1)
Effects of Positive Pressure Mechanical Ventilation on Lung Mechanics
973(5)
Time Constants
973(1)
Increased Pressure
974(2)
Increased Lung Volume
976(1)
Decreased Work of Breathing
977(1)
Minimizing Adverse Pulmonary Effects of Positive Pressure Mechanical Ventilation
978(2)
Decreasing Pressure
978(1)
Positive End-Expiratory Pressure/Continuous Positive Airway Pressure
979(1)
Effects of Ventilatory Pattern
980(1)
Trigger Site and Work of Breathing
980(1)
Physiological Effects of Ventilatory Modes
980(6)
Volume-Controlled Modes
980(2)
Pressure-Controlled Modes
982(3)
Continuous Positive Airway Pressure
985(1)
Bilevel Continuous Positive Airway Pressure
985(1)
Automatic Tube Compensation
985(1)
Proportional Assist Ventilation
985(1)
Patient Positioning to Optimize Oxygenation and Ventilation
986(1)
Cardiovascular Effects of Positive Pressure Mechanical Ventilation
986(2)
Thoracic Pump and Venous Return During Spontaneous and Mechanical Ventilation
986(1)
Compensation in Healthy Persons
987(1)
Pulmonary Vascular Pressure, Blood Flow, and Pulmonary Vascular Resistance
987(1)
Right and Left Ventricular Function
987(1)
Endocardial Blood Flow
988(1)
Cardiac Output, Cardiac Index, and Systemic Blood Pressure
988(1)
Minimizing the Cardiovascular Effects of Positive Pressure Mechanical Ventilation
988(2)
Mean Pleural Pressure
988(1)
Decreasing the Mean Airway Pressure
989(1)
Fluid Management and Cardiac Output
989(1)
Pharmacological Maintenance of Cardiac Output and Blood Pressure
990(1)
Effects of Positive Pressure Mechanical Ventilation on Other Body Systems
990(4)
Increased Intracranial Pressure
990(1)
Effect on Renal Function
991(1)
Decreased Liver and Splanchnic Perfusion
992(1)
Decreased Gastrointestinal Function
992(1)
Effect on the Central Nervous System
993(1)
Complications of Mechanical Ventilation
994(5)
Negative Pressure Ventilation
994(1)
Positive Pressure Ventilation
994(1)
Complications Related to Pressure
995(1)
Complications Related to Volume Are the Result of Alveolar Overdistension
995(1)
Auto-Positive End-Expiratory Pressure
996(1)
Oxygen Toxicity
997(1)
Ventilator-Associated (Nosocomial) Pneumonia
997(2)
Aberrant Work of Breathing
999(1)
Ventilator Malfunction
999(4)
Initiating and Adjusting Ventilatory Support
1003(56)
Indications for Mechanical Ventilatory Support
1004(5)
Definitions
1004(1)
Disease States or Conditions Necessitating Mechanical Ventilation
1005(1)
Clinical Manifestations of Respiratory Failure
1005(1)
Physiologic Values Associated With the Need for Mechanical Ventilatory Support
1006(1)
Indications for Mechanical Ventilation
1006(2)
Goals of Mechanical Ventilatory Support
1008(1)
Ventilatory Management Strategies for Specific Disorders
1009(3)
Normal Pulmonary Mechanics
1009(1)
Acute Respiratory Distress Syndrome
1010(1)
Chronic Obstructive Pulmonary Disease
1010(1)
Acute Severe Asthma Exacerbation
1010(1)
Postoperative Ventilatory Support
1011(1)
Myocardial Ischemia and Congestive Heart Failure
1011(1)
Neuromuscular Disorders
1011(1)
Head Trauma
1011(1)
Unilateral Lung Disease
1012(1)
Bronchopleural Fistula
1012(1)
Ventilator Initiation
1012(3)
Negative Pressure Ventilation
1012(1)
Noninvasive Positive Pressure Ventilation
1013(1)
Establishment of the Airway
1013(1)
Pressure-Controlled Versus Volume-Controlled Ventilation
1013(1)
Full Ventilatory Support Versus Partial Ventilatory Support
1014(1)
Choice of a Ventilator
1015(1)
Initial Ventilator Settings
1015(20)
Choice of Mode
1015(6)
Tidal Volume and Rate
1021(2)
Trigger Sensitivity
1023(1)
Inspiratory Flow, Time, and I:E Ratio for Volume Ventilation
1024(5)
Oxygen Percentage
1029(1)
Positive End-Expiratory Pressure and Continuous Positive Airway Pressure
1030(1)
Pressure Support
1030(1)
Limits and Alarms
1031(1)
Humidification
1031(1)
Periodic Sighs
1032(3)
Adjusting Ventilatory Support
1035(2)
Patient-Ventilator Interaction
1035(2)
Oxygenation
1037(6)
Oxygen Concentration
1037(1)
Positive End-Expiratory Pressure and Continuous Positive Airway Pressure
1037(5)
Other Techniques for Improving Oxygenation
1042(1)
Ventilation
1043(16)
Adjusting Tidal Volume and Rate
1044(4)
Pressure-Support Ventilation and PaCO2
1048(1)
Pressure-Control Ventilation and PaCO2
1048(2)
High-Frequency Ventilation and PaCO2
1050(1)
Permissive Hypercapnia
1050(2)
Alternative Lung Protective Strategies for Acute Lung Injury and Acute Respiratory Distress Syndrome
1052(1)
Acid-Base Homeostasis
1053(6)
Noninvasive Positive Pressure Ventilation
1059(22)
Types of Noninvasive Ventilation
1060(1)
Goals of and Indications for Noninvasive Positive Pressure Ventilation
1061(2)
Acute Care Setting
1061(2)
Chronic Care Setting
1063(1)
Chronic Care Setting
1063(3)
Patient Selection and Exclusion Criteria for Noninvasive Positive Pressure Ventilation
1064(1)
Acute Care Setting
1064(1)
Predictors of Success During Noninvasive Positive Pressure Ventilation
1065(1)
Chronic Care Setting
1065(1)
Equipment Used in the Application of Noninvasive Positive Pressure Ventilation
1066(8)
Patient Interfaces
1066(4)
Ventilators Used for Noninvasive Positive Pressure Ventilation
1070(4)
Instituting and Managing Noninvasive Positive Pressure Ventilation
1074(2)
Initiation of Noninvasive Positive Pressure Ventilation
1074(1)
Noninvasive Ventilator Adjustments
1075(1)
Monitoring
1075(1)
Location
1076(1)
Weaning from NPPV
1076(1)
Complications of Noninvasive Positive Pressure Ventilation
1076(2)
Time and Cost Associated With Noninvasive Positive Pressure Ventilation
1078(3)
Monitoring and Management of the Patient in the Intensive Care Unit
1081(40)
Principles of Monitoring
1082(2)
Pathophysiology and Monitoring
1084(1)
Respiratory Monitoring
1084(16)
Gas Exchange
1084(6)
Monitoring Lung and Chest Wall Mechanics
1090(3)
Monitoring Breathing Effort and Patterns
1093(7)
Cardiac and Cardiovascular Monitoring
1100(9)
Electrocardiography
1104
Arterial Blood Pressure Monitoring
1007(100)
Central Venous-Right Atrial Pressure Monitoring
1107(1)
Pulmonary Arterial Pressure Monitoring
1107(2)
Neurological Monitoring
1109(3)
History
1109(1)
Neurological Examination
1109(2)
Intracranial Pressure Monitoring
1111(1)
Glasgow Coma Score
1112(1)
Monitoring Renal Function
1112(1)
Monitoring Liver Function
1112(1)
Nutritional Monitoring
1113(1)
Assessment of Nutritional Status
1113(1)
Functional Assessment
1113(1)
Metabolic Assessment
1113(1)
Estimating Nutritional Requirements
1114(1)
Global Monitoring Indices
1114(1)
Acute Physiology and Chronic Health Evaluation (APACHE)
1114(1)
Troubleshooting
1115(6)
Discontinuing Ventilatory Support
1121(34)
Definitions
1123(1)
Categories for Discontinuing Ventilatory Support
1123(1)
Reasons for Ventilatory Dependence
1123(2)
Ventilatory Workload, or Demand
1123(1)
Ventilatory Capacity
1124(1)
Discontinuing Ventilatory Support
1124(1)
Patient Evaluation
1125(5)
The Most Important Criterion
1125(1)
Weaning Indices
1126(1)
Ventilation
1127(1)
Oxygenation
1128(1)
Acid-Base Balance
1128(1)
Metabolic Factors
1129(1)
Renal Function and Electrolytes
1129(1)
Cardiovascular Function
1129(1)
Psychological Factors and Central Nervous System Assessment
1129(1)
Integrated Indices
1130(1)
Evaluation of the Airway
1130(1)
Preparing the Patient
1130(2)
Optimizing the Patient's Medical Condition
1130(1)
Patient's Psychological and Communication Needs
1131(1)
Methods
1132(7)
Rapid Ventilator Discontinuation
1132(1)
Patients Who Need Progressive Weaning of Ventilatory Support
1133(1)
Traditional T-Tube Trials
1133(1)
Continuous Positive Airway Pressure
1133(1)
Intermittent Mandatory Ventilation and Synchronized Intermittent Mandatory Ventilation
1134(1)
Pressure Support Ventilation
1134(2)
Intermittent Mandatory Ventilation/Synchronized Intermittent Mandatory Ventilation With Pressure Support Ventilation
1136(1)
Daily Spontaneous Breathing Trials
1136(3)
Newer Techniques
1139(4)
Mandatory Minute Volume Ventilation
1139(1)
Adaptive Support Ventilation
1140(1)
Computer-Based Weaning
1140(1)
Flow-By, Flow Triger, Tracheal Pressure Sensing
1141(1)
Automatic Tube Compensation
1141(1)
Volume Support and Volume-Assured Pressure Support
1141(1)
Proportional Assist Ventilation and Proportional Pressure Support
1141(1)
Noninvasive Positive Pressure Ventilation
1142(1)
Other Techniques for Facilitatating Weaning
1142(1)
Selecting an Approach
1143(2)
Monitoring the Patient During Weaning
1145(2)
Ventory Status
1145(1)
Oxygenation
1146(1)
Cardiovascular Status
1146(1)
Extubation
1147(2)
Effects of Artificial Airways Related to Weaning
1147(2)
Failure
1149(1)
Chronically Ventilator-Dependent Patients
1149(2)
Terminal Weaning
1151(4)
Neonatal and Pediatric Respiratory Care
1155(34)
Assessment of the Newborn
1156(7)
Maternal Factors
1156(1)
Fetal Assessment
1156(1)
Evaluation of the Newborn
1157(2)
Respiratory Assessment of the Infant
1159(4)
General Management of the Critically III Neonate
1163(1)
Temperature Regulation
1163(1)
Fluid and Electrolyte Balance
1164(1)
Nutrition
1164(1)
Infection Control
1164(1)
Basic Respiratory Care
1164(8)
Oxygen Therapy
1164(1)
Bronchial Hygiene Therapy
1165(1)
Humidity and Aerosol Therapy
1166(2)
Aerosol Drug Therapy
1168(1)
Airway Management
1168(3)
Neonatal Resuscitation
1171(1)
Continuous Positive Airway Pressure
1172(1)
Methods of Administration
1172(1)
Mechanical Ventilation
1173(10)
Basic Principles
1173(2)
Goals of Mechanical Ventilation
1175(4)
Assessment of Mechanical Ventilation
1179(1)
Weaning From Mechanical Ventilation
1180(1)
High-Frequency Ventilation
1181(2)
Complications of Mechanical Ventilation
1183(1)
Nitric Oxide
1183(1)
Extracorporeal Life Support (ECLS)
1184(5)
Neonatal-Pediatric Transport
1185(4)
SECTION VII Preventative and Long-Term Care
1189(98)
Patient Education and Health Promotion
1191(10)
Patient Education
1192(2)
Cognitive Domain
1192(1)
Affective Domain
1192(1)
Psychomotor Domain
1193(1)
Teaching Tips
1193(1)
Teaching Children Versus Adult Learners
1193(1)
Evaluation of Patient Education
1194(1)
The Teachable Moment
1194(1)
Practice Guidelines
1194(1)
Health Education
1194(3)
Health Promotion and Disease Prevention
1197(1)
Implication for RRTs
1198(1)
Healthcare Institutions
1199(1)
Work Site
1199(1)
Home
1199(1)
Community
1199(1)
Educational Institutions
1199(1)
Health Promotion, Disease Prevention, and Medical Care Costs
1199(2)
Nutritional Aspects of Health and Disease
1201(24)
Maintaining Health Through Good Nutrition
1202(4)
Dietary Guidelines
1202(1)
Macronutrients and Energy Requirements
1202(3)
Micronutrients and Dietary Supplements
1205(1)
Dietary Fiber
1206(1)
Fluid Intake
1206(1)
Antioxidants
1206(1)
Malnutrition
1206(2)
Protein-Energy Malnutrition
1206(1)
Micronutrient Malnutrition
1207(1)
Respiratory Consequences of Malnutrition
1207(1)
Nutritional Assessment
1208(7)
History and Physical Examination
1208(1)
Anthropometry
1209(1)
Clinical Laboratory Tests
1210(1)
Pulmonary Function Parameters
1211(1)
Total Caloric Requirements
1211(4)
General Aspects of Nutritional Support
1215(3)
Meeting Overall Energy Needs
1215(1)
Providing the Appropriate Combination of Substrates
1215(1)
Timing of Nutritional Support
1216(1)
Routes of Administration
1216(2)
Nutritional Support in Specific Circumstances
1218(7)
General Guidelines for Critically Ill Patients
1218(1)
Systemic Inflammatory Response Syndrome
1218(1)
Mechanical Ventilation
1219(1)
Chronic Obstructive Pulmonary Disease
1219(2)
Cystic Fibrosis
1221(4)
Cardiopulmonary Rehabilitation
1225(22)
Definitions and Goals
1226(1)
Historical Perspective
1226(1)
Scientific Bases
1227(4)
Physical Reconditioning
1227(2)
Psychosocial Support
1229(2)
Pulmonary Rehabilitation Programming
1231(16)
Program Goals and Objectives
1231(1)
Benefits and Potential Hazards
1231(2)
Patient Evaluation and Selection
1233(3)
Program Design
1236(4)
Program Implementation
1240(3)
Cost, Fees, and Reimbursement
1243(1)
Program Results
1244(3)
Respiratory Care in Alternative Settings
1247(40)
Recent Developments and Trends
1248(1)
Definitions and Goals
1249(1)
Subacute Care
1249(1)
Home Care
1250(1)
Standards
1250(1)
Governmental Laws and Regulations
1250(1)
Private Sector Accreditation
1250(1)
Traditional Acute Care Versus Postacute Care
1251(1)
Discharge Planning
1251(3)
Multidisciplinary Team
1251(2)
Site and Support Service Evaluation
1253(1)
Oxygen Therapy in Alternative Settings
1254(9)
The Oxygen Therapy Prescription
1254(3)
Supply Methods
1257(3)
Delivery Methods
1260(3)
Ventilatory Support in Alternative Settings
1263(10)
Patient Selection
1263(1)
Settings and Approaches
1263(1)
Standards and Guidelines
1264(1)
Special Challenges in Providing Home Ventilatory Support
1264(4)
Invasive Versus Noninvasive Ventilatory Support
1268(1)
Equipment
1268(3)
Evaluation and Follow-up
1271(2)
Other Modes of Postacute Respiratory Care
1273(4)
Bland Aerosol Therapy
1273(1)
Aerosol Drug Administration
1273(1)
Airway Care and Clearance Methods
1273(1)
Nasal CPAP
1274(3)
Apnea Monitoring
1277(1)
Patient Assessment and Documentation
1277(3)
Institutional Subacute and Long-Term Care
1277(3)
Home Care
1280(1)
Equipment Disinfection and Maintenance
1280(1)
Palliative Care
1281(6)
Appendix 1: Temperature Correction of Barometric Reading 1287(1)
Appendix 2: Factors to Convert Gas Volumes From ATPS to STPD 1288(1)
Appendix 3: Factors to Convert Gas Volumes From STPD to BTPS at Given Barometric Pressures 1289(1)
Appendix 4: Table of Normal Values 1290(3)
Glossary 1293

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