Page 13 - Christiana Care Focus

“Respiratory therapists are an essential part of a life-saving team.” John Emberger, BS, RRT-AACS, FAARC, CPHQ
Christiana Care’s respiratory therapists work in critical care units to manage life support for patients who’ve experienced a traumatic injury or have a life-threatening respiratory condition.
“Much of our work is about putting yourself in the place of the pa- tient, who may have just gone from being able to walk, talk and eat on their own to depending on others for all of their needs,” said Mark Staples, RRT, a respiratory therapist at Christiana Care since 2004.
| Acute Medicine
“They wake up in the ICU frightened and often unable to breathe on their own following surgery or trauma,” said Staples. “We are at their side to reassure them and to help them get back to breathing
Ion their own as soon as possible.”
n the ICU, respiratory therapists are part of a team that includes speech language pathologists who assess the patient’s ability to swallow and nurses who guard against the pressure ulcers that can come with a ventilator, a life-
sustaining medical device that provides oxygen when when patients are unable to breathe on their own.
One of the team’s roles is to protect patients from ventilator- associated events (VAEs), potential complications that come with life support.
“By serving together, we can help patients move past the critical stage and toward their best health,” said Maureen Seckel, APRN, ACNS-BC, CCNS, CCRN, FCCM, AMSL, quality and safety clinical nurse specialist and sepsis coordinator.
Respiratory therapist Michelle Bair, RRT, led a team to prevent the conditions that trigger VAEs. The team developed specialized educational materials for every caregiver with best practices including ventilator settings and patient positioning.
“Implementing new protocols requires an all-hands-on-deck approach,” said Kathleen Bonis, RRT-NPS, clinical manager of Respiratory Care. “We don’t do it alone.”
In an especially successful protocol, caregivers elevate the head of a patient on a ventilator to lower the risk that bacteria in the digestive tract can escape into the lungs, where it may cause a life-threatening infection.
Piloted in the neurological and surgical intensive care units, where the protocol has almost eliminated VAEs, it has been expanded systemwide.
Liberation from life support
In the ICU, part of anticipating patients’ needs is identifying the earliest time they can be safely removed from a ventilator, a process called “liberation.”
Liberation means the patient can breathe without a machine, marking a major milestone in recovery.
The team huddles before beginning the liberation protocol to ensure they have the right caregivers, equipment and process ready, including backup plans if something doesn’t go as expected.
These protocols to prevent complications and liberate patients from ventilation were developed by respiratory therapists who advanced their careers at Christiana Care.
“Once patients are back breathing on their own, they’re happier because they’re one step closer to normalcy,” said respiratory therapistStaples. CONTINUED
FOCUS • SUMMER 2019 11