Respiratory Services in Hospital Set-up
A. THERAPEUTIC SERVICES:
- Via aerosol face mask set-up
Via aerosol tracheostomy mask set-up
Patient in ventilator
The Respiratory Therapist explains the procedure to the patient and set-up the nebulizer. Before and after the procedure, auscultation of patient’s chest is being done and patient’s respiratory rate and pulse rate is acquired. Likewise, the patient’s condition is documented.
2) Chest Physiotherapy
In addition to aerosol therapy, chest percussion (CPT) is added to the procedure, if ordered by the physician, to improve the mobilization of retained secretions along the patient’s airways. This procedure can be done manual or utilize a device for “shaking” the secretions (G5 Vibracare).
3) Incentive Spirometry
MSA Respiratory Therapist make routine rounds to coach a patient on effective way of using the Incentive Spirometer – checking and recording the changes in inspiratory capacity of the patient.
MSA Respiratory Therapist set-ups the gadget, attached to the patient and make rounds every shift to check for obstructions (kinks, condensate), disconnections, and make sure that the level of water on the humidifiers and the working pressures of gas supplies (O2 and compressed air) is consistent with Physician’s order. Assessment on patient’s condition and record development is written in flowsheet.
5) Oxygen Therapy (Oxygen concentrator, APN, Venturi Set-Up )
MSA Respiratory Therapist visits the patient and check for proper function of APN (or Venturi) and make sure that the set-up is properly connected and no kinks. The RT also change tubings and refill water content of humidifier (for APN) / reservoir (for Venturi) if necessary. Assessment of patient’s condition while attached to the set-up is documented.
B. CRITICAL / EMERGENCY CARE
1) Tracheobronchial Suctioning / Bronchial Lavage
Suctioning of patient on mechanical ventilator are being done by MSA Respiratory Therapist during ventilator/patient rounds which is every two hours. Assessment of patient’s condition is documented.
2) CPR Participation
MSA Respiratory Therapist assists in the CPR. Ambubagging and external chest compression could be done to alternate with the NOD/physician on duty.
3) Mechanical Ventilation (Neonatal, Pediatrics, Adult)
Patient-ventilator management (“rounds”) every two hours, everyday while the patient is attached on the mechanical ventilator, are being done by MSA Respiratory Therapist. Patient-ventilator management includes:
- Assessment and monitoring of patient’s condition
Check for ventilator function (including alarm and tubing systems)
Refilling the humidifier if necessary
Ascultation of patient to know if suctioning is needed
Documentation of patient’s progress through : ventilator monitoring sheet and SOAP
Adjustment of the parameter settings per physician’s orders and troubleshooting when necessary
MSA standard procedure in changing ventilator circuit, for infection control, is every five (5) days for adult patients and every three (3) days for pediatric/infant patients.
4) Weaning Protocols
MSA Respiratory Therapist implements weaning program and method ordered by the physician. Patient’s vital signs are checked during the procedure as well as the physical condition and breath sounds. Communication with patient during weaning sessions is important. All pertinent patient data is documented and the nurse-on-duty or physician are notified on the out-come after each sessions.
5) Pulse Oximetry
The patient attached to pulse oximeter is visited by MSA Respiratory Therapist every shift to check if equipment is functioning properly and do troubleshooting when necessary. Assessment of patient’s condition is documented.
C. DIAGNOSTIC SERVICES
1) Blood Gas Analysis
The extraction of specimen and its processing shall be done by MSA Respiratory Therapist. The result is prepared and submitted to the Pulmonologist In-Charge for interpretation.
2) Pulmonary Function Test
MSA Respiratory Therapist explains the procedure and coaches the patients to obtain accurate test results. The result is prepared and submitted to the Pulmonologist In-Charge for interpretation.
3) Cardiac Monitoring
MSA Respiratory Therapist sets-up the equipment and attach it to the patient. The RT visits the patient to check for disconnections, wear-and-tear of the electrodes, and perform basic troubleshooting of the machine when necessary. Assessment of patient’s condition is documented.
4) Peak Expiratory Flow Rate Determination
Coaching the patient during the performance of the procedure and recording of result in the flowsheet are being done by MSA Respiratory Therpist.
5) Spontaneous Breathing Parameter Determination
MSA Respiratory Therapist assist the patient in doing the procedure and document result.
Setting up, attaching equipment to patient’s tubing and recording of result are the responsibilities of MSA Respiratory Therapist.
D. EDUCATION SERVICES
1) Patient and Family Education
All pulmonary procedures to be done are explained to the patient and relative prior to its performance. Full details on how procedure will be done, why it should be done and the benefits the patient can get from the procedure are conveyed in order to get their full participation.
2) In-Service Training
Orientations and lectures for physicians, nurses, etc. regarding pulmonary services provided by MSA and related topics such as new modalities in pulmonary services and equipment could be conducted per request.
MSA installs complete line of high modality pulmonary equipment as well as supplies necessary for the operation of an effective Respiratory Department. Maintenance and up-keep of all the respiratory equipment are done by MSA bio-medical engineers regularly to ensure that equipments are operating under optimal condition according to international standard.
MSA ensures delivery of quality cardiopulmonary services to the patients of its partner hospitals which is at par with the leading hospitals in the Philippines.