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Tuesday, December 9

AARC ANNUAL BUSINESS MEETING
8:30 am – 9:20 am • Rooms N245-251
David C Shelledy PhD RRT, AARC President/Presiding
The official Annual Meeting of your professional association. The 2004 AARC Officers, Board of Directors, and House of Delegates officers are installed. Reports from the AARC leadership are presented. The meeting concludes with the installation and address of the 2004 President, Janet M Boehm MS RRT.

Tracks: Professional, General
30th DONALD F EGAN SCIENTIFIC LECTURE
9:30 am – 10:20 am • Rooms N245-251
Janet M Boehm MS RRT, 2004 AARC President/Chairing
Supported by an unrestricted educational grant from Masimo
This lecture provides an overview of in-depth information about dynamic aspects of pulmonary physiology, pulmonary medicine, or clinical respiratory care. The lectureship is extended to a recognized world-class participant in the area of interest—one who is involved in investigation, clinician, or academician.

Gordon D Rubenfeld MD MSc
University of Washington School of Medicine
Seattle WA

Translating Clinical Research into Clinical Practice
The therapist at the bedside knows the most about certain very important things, and is the one who will be primarily responsible for implementation of current and future guidelines for mechanical ventilation. Herein lies both the natural leadership position for therapists in the future and their security as a profession.

PURITAN BENNETT SPUTUM BOWL™ PRELIMINARIES
8:00 am – 6:00 pm • Room 253
Jim Fenstermaker RRT, Placentia CA/Chairing
Teams from the AARC state affiliates compete in the preliminary competitions. The top four teams will advance to the Finals on Wednesday evening, Dec. 10.

Tracks: Pediatrics, Diagnostics
PEDIATRIC ASSESSMENT
10:30 am – 11:20 am • Rooms N255, 257

Making Tests Fun for the Pediatric Patient
Carolyn Kercsmar MD, Case Western Reserve University, Cleveland OH
Pediatrics is a very different population than adult care, yet many therapists are cross training to cover more diverse areas. This lecture prepares RCPs to provide appropriate care for the little patients.

Tracks: Management, Education
USING SIMULATORS IN CLINICAL PRACTICE
10:30 am – 12:00 noon • Room N252

10:30 am – 11:20 am
Can the Use of Simulators Improve Clinical Practice?
Keith Littlewood MD, University of Virginia Health Science Center, Charlottesville VA
The Institute of Medicine identified anesthesiology as a model for improving patient safety. One of the reasons for this praise was the use of simulators in preparing practitioners for uncommon but potentially lethal events. Patient simulators have been used successfully to model common and uncommon situations for many years in healthcare training. Does use of these expensive devices actually improve performance in clinical practice?

EDUCATION SECTION MEMBERSHIP MEETING
11:20 am – 12:00 noon • Room N252
Susan P Pilbeam MS RRT FAARC/Chairing
Whether or not you are a member of the Education Section, you are welcome to attend. Your participation can make a difference in the future of your area of interest in the profession.

Tracks: Home Care, Diagnostics
YEAR IN REVIEW: THE LATEST IN...
10:30 am – 11:20 am • Room N254

Polysomnography: The Last 12 Months
Suzanne Bollig RRT RPSGT, Hayes Medical Center, Hayes KS
A systematic overview of significant or noteworthy events in the area of polysomnography.

Tracks: Subacute Care, Management
PROFESSOR'S ROUNDS IN RESPIRATORY CARE
10:30 am – 11:20 am • Rooms N245-251

Management of ARDS
Professor: Stuart M Lowson MB MS, University of Virginia Health Sciences Center, Charlottesville VA
Presenter: Charles G Durbin Jr MD FAARC, University of Virginia Health Sciences Center, Charlottesville VA
Acutely ill patients with severe respiratory failure are becoming more common problems in the ICU world-wide. The incidence of ARDS, seemingly on the decline, is now increasing due to increasing motor vehicle crashes and the emergence of SARS and other new infectious pathogens. Standards of mechanical ventilation including lung protective ventilation have possibly improved the outcome from ARDS in general but have inhibited innovations in treatment. There are some who believe that while low tidal volume ventilation is an advance, the optimum ventilation strategies for patients with severe ARDS is still unknown. While there is some objective data to suggest the superiority of high frequency ventilation in adults, this therapy can be considered state of the art in neonatal respiratory distress syndrome. Dr. Lowson, an active investigator in the use of oscillation in adults, also pioneered the clinical use of nebulized prostacycline for treatment of the pulmonary hypertension seen in ARDS. As an active clinician, and supporter of the respiratory care team management of clinically ill patients, he will describe management decisions for use of these innovative therapies in a patient with severe respiratory failure following multiple trauma. How and when to initiate these unconventional techniques will be described. The emerging role of steroid therapy and use of vasopressin will also be discussed. Audience participation will be encouraged and a lively discussion is guaranteed.

Tracks: Continuous Care, Home Care, Management
THE INs AND OUTCOMES OF MANAGING CHRONIC RESPIRATORY DISEASE
10:30 am – 11:45 am • Room N256

10:30 am – 11:05 am
Improving Adherence to Therapy at Home
Ellen Becker PhD RRT-NPS AE-C, Long Island University, Brooklyn NY
Prescribed therapies do not benefit our pediatric clients unless families can integrate these interventions into their daily routines. Therapists need to assess each family to determine the family’s risks for adherence to therapy and tailor their teaching plan accordingly. This presentation covers common adherence risks across all developmental pediatric age groups.

11:10 am – 11:45 am
Developing and Measuring Outcomes of an Asthma and COPD Case Management Program
Joe Dwan MS RRT, Kaiser Permanente Northwest Region, Beavercreek OR
This presentation describes the planning, training and support required to start a case management program. Outcome measurement categories will be reviewed with options for measuring each category and how to perform the measurement. Also covered will be how to use outcome measures to gain support and expand your program.

CONTINUOUS CARE/REHABILITATION SECTION MEMBERSHIP MEETING
11:45 am – 12:15 pm • Room N256
Mary K Hart RRT/Chairing
Whether or not you are a member of the Continuous Care/Rehabilitation Section, you are welcome to attend. Your participation can make a difference in the future of your area of interest in the profession.

Tracks: Continuous Care, Management, Education
ASTHMA EDUCATORS AND REIMBURSEMENT
10:30 am – 11:55 am • Rooms N259, 261

10:30 am – 10:55 am
U.S. Training Programs and Medicare Reimbursement
Carlos Camargo MD DrPH, Massachusetts General Hospital, Boston MA

11:00 am – 11:25 am
State and Local Reimbursement Strategies
Shawn McCormick RRT AE-C, Zoey LP, San Antonio TX

11:30 am – 11:55 am
RTs as Asthma Educators
Shawn R McCormick RRT AE-C
To ensure a leadership role in global disease management strategies, RTs must be encouraged to become entrepreneurs in patient education program development for asthma treatment in a variety of healthcare settings.

Tracks: Diagnostics, Management
MANAGEMENT ISSUES FOR THE PULMONARY DIAGNOSTIC SERVICE
10:30 am – 11:55 pm • Rooms N240-242

10:30 am – 10:55 am
Diagnostic Uniform Reporting Manual: Easy Steps to Implementation
Susan Blonshine RRT RPFT FAARC, TechEd Consultants, Mason MI
This presentation will provide an in-depth understanding of the recently published Diagnostics URM as a tool for evaluating productivity and providing benchmark data in the diagnostic area as well as provide steps to integrate the information into policy and procedures.

11:00 am – 11:25 am
Documentation and Risk Management in Diagnostics
Vickie L Ganey MBA RRT RPFT RN LNC, Halifax South Boston Community Hospital, South Boston VA
After this presentation the audience will understand the importance of documentation to risk management in respiratory care settings. Outcomes and documentation in diagnostic testing are integrally related. The implications of the proposed JCAHO 2004 requirement for pharmacist review of administered medications and its implications to the pulmonary function practitioner will be discussed.

11:30 am – 11:55 am
Diagnostic Coding: The Mysteries Unveiled
Carl Mottram RRT RPFT FAARC, Mayo Clinic, Rochester MN
This presentation will provide an understanding of the application of current coding strategies for diagnostic testing and the audience will take home resource information to stay on top of evolving coding changes.

Tracks: General
AND NOW, A WORD FROM OUR SPONSORS...
10:30 am – 11:45 am • Rooms N232, 234, 236
Manufacturers present their products in this 15-minute free-for-all format.

10:30 am – 10:45 am
An Alternative Measurement Method to Obtain CO2 Levels in Patients
Steffen O Klose, Linde Medical Sensors AG, Switzerland

10:45 am – 11:00 am
Lung Protective Ventilatory Strategies
Hamilton Medical

11:00 am – 11:15 am
Pulmonetics
Angela King RRT RPFT, Pulmonetic Systems

11:15 am – 11:30 am
Oscillator Mechanics and Application to Ventilator

11:30 am – 11:45 am
Passy-Muir Speaking Valve
Sandra Stawiasz RRT

EXHIBITS – THE BUYING SHOW!
11:00 am – 4:00 pm • North Hall
Presenting the famous AARC Exhibit Hall with the largest display in the world. Remember, this is The Buying Show and thus, the place for you to plan your purchases at special discounts.

Tracks: Home Care, Pediatric, Continuing Care, Acute Care
Open Forum #5—MEDICATIONS & NEBULIZERS
12:30 pm – 2:25 pm • Rooms N231, 233, 235
Presented by the Journal RESPIRATORY CARE
The results of scientific studies are presented. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand the information presented.

• The Impact of Xopenex Substitution in Place of Albuterol—Thomas Serrano RRT, Whittier CA
• Comparison of Breath-Activated Jet Nebulizer (BAN) in ‘Continuous Delivery’ Mode with Other Continuous Delivery Nebulizers— Jolyon P Mitchell PhD, London, Ontario, Canada
• Albuterol Delivery During Noninvasive Ventilation—Matthew P Branconnier RRT, Boston MA
• Albuterol Emitted from a Metered Dose Inhaler: Effect of Priming and Tail-Off— Susan Lagambina RRT, Boston MA
• Albuterol Delivery by Tracheostomy Tube—Christopher M Piccuito RRT, Boston MA
• Albuterol Delivery Using the DHD Circuvent and the Airlife Valved Tee Adapter— Terrence O Brady RRT, Boston MA
• Laboratory Evaluation of New Generation Pneumatic Nebulizers—Dean R Hess PhD RRT FAARC, Boston MA
• Evaluation of Recovery Medication After Bronchial Provocation Testing—Franklyn Sandusky RRT, Cleveland OH
• Bacteria Growth in High-Efficiency Nebulizers for Single Patient Use—Betsy Robertson RRT, Cleveland OH
• In Vivo Effect of Particle Size on Lung Deposition of Two Drops of 99mTc-DTPA in a Macaque Model of Infant Mechanical Ventilation—James B Fink MS RRT FAARC, Mountain View CA
• Baby Don’t Cry: In Vitro Comparison of “Baby’s Breath” Aerosol Delivery Hood vs. Face Mask or Blow-By Using the “SAINT” Infant Upper Airway Model and “Aeroneb Go” vs T-Piece Nebulizer—Bert Kesser RRT, Orlando FL
• Is a Noseclip Necessary for Small Volume Nebulizer Treatments?—Michael McPeck RRT, Baldwin Park CA
• Can Aerosol Drug Delivery By SVN Be Predicted?—Michael McPeck RRT, Baldwin Park CA
• Validation of the Medicator® Plus “Aerosol Maximizer”: Comparison to a Commercial Reservoir-Type Delivery System and a Standard “Tee” System— Michael McPeck RRT, Baldwin Park CA
• Comparison in Rates of Breakthrough Treatments During a Conversion from Racemic Albuterol to Levalbuterol—Robert S Pikarsky BSRT, Syracuse NY
• 3-Day Azithromycin (AZM) vs. 5-Day Moxifloxacin (MOX) in Outpatients (OP) with AECB—Marcus Zervos MD, Royal Oak MI
• Evaluation of Three Small Volume Nebulizers for Use with Infant Ventilator Circuits—Kristin Smith RRT, Wilmington DE
• A Comparison of Maintenance Tiotropium and Salmeterol on Arterial Blood Gas Tensions In Patients with COPD—Nicholas Gross MD, Hines ILTracks: Home Care, Acute Care

Open Forum #6—OXYGEN: THERAPY & MONITORING
12:30 pm – 2:25 pm • Rooms N237, 239, 241
Presented by the Journal RESPIRATORY CARE
The results of scientific studies are presented. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand the information presented.

• Can the Vapotherm High Flow Nasal Cannula System Substitute for Non-Rebreathing Mask in Select Patients—Carl C Voss PhD RRT, Bethesda MD
• Reliability of Oxygenation Indices After Open Heart Surgeries—Mohamad El-Khatib PhD RRT, Beiruit, Lebanon
• A Comparison of Oxygen Concentrations During Oral and Nasal Breathing Via Low Flow and High Flow Nasal Cannula—Richard B Wettstein RRT, San Antonio TX
• Nasopharyngeal Oxygen Concentration in Normal Subjects Wearing Low Flow and High Flow Nasal Cannula—Richard B Wettstein RRT, San Antonio TX
• Oxygen Concentration During BiPAP, Effects of Oxygen Flow and System Leak—Eriko Miyoshi MD, Osaka, Japan
• Tertiary Backup Oxygen System—John Newhart CRT, San Diego CA
• A Comparison of Reflective and Transmission Oximetry in Patients with Poor Perfusion—Richard D Branson RRT FAARC, Cincinnati OH
• Comparison of an Adaptive Control Oxygen Blender with Manual Titration of Oxygen Therapy in an Oleic Acid Injured Piglet Model—Tom Blackson RRT, Wilmington DE
• An Evaluation of Forehead Reflectance Oximetry in Intraoperative Surgical Patients—Aman Mahajan MD, Los Angeles CA
• Comparison of the Masimo Pulse Oximeter Utilizing Various Probe Sites at Rest and with Exercise Against a Laboratory Oximeter Using Arterial Blood— Lori J Hanson RRT CPFT, Rochester MN
• VIASYS Hi-Ox80 Mask Does Not Provide Higher Oxygen Concentration When Compared to the Hudson Non-Rebreather Mask at 12 L/Min Flow During Ex-Vivo Ventilation—Lori Hinsch,Rochester MN
• Effects of Providing Oxygen Saturation Greater Than 90% to All Patients Having COPD and/or CO2 Retention—John W Earl RRT, White River Junction VT
• Delivery of High FIO2—John W Earl RRT, White River Junction VT
• Comparison of Vapotherm™ 2000i with A Bubble Humidifier for Humidifying Flow through an Infant Nasal Cannula—Brian K Walsh RRT-NPS RPFT Charlottesville VA

Tracks: General
AND NOW, A WORD FROM OUR SPONSORS...
1:00 pm – 1:45 pm • Rooms N232, 234, 236
Manufacturers present their products in this 15-minute free-for-all format.

1:00 pm – 1:15 pm
VersaMed Ventilator

1:15 pm – 1:30 pm
Non-Invasive Interfaces
Fisher & Paykel

1:30 pm – 1:45 pm
Airway Clearance
Advance Respiratory

1:45 pm – 2:00 pm
Pulse Oximetry: New Developments
Massimo Corporation

2:00 pm
Tyco Healthcare/Nellcor Puritan Bennett Product Review
Dan Van Hise, Puritan Bennett
General overview of all of our products for both Nellcor and Puritan Bennett. Emphasis on key features and benefits for each product with time available for question and answers.

Tracks: Acute Care, Critical Care
NON-INVASIVE VENTILATION IN THE ACUTE CARE SETTING
1:00 pm – 2:55 pm • Rooms N255, 257

1:00 pm – 1:25 pm
May Non-Invasive Ventilation be an Alternative to Invasive Ventilation in COPD Patients with Acute Respiratory Failure?
Paolo Navalesi MD, Pulmonary Rehabilitation and Respiratory Intensive Care Unit, Pavia Italy
Although compared to standard treatment alone, non-invasive ventilation improves the outcome of COPD patients with mild to moderate acute respiratory failure, little is known about its use in more severe cases deemed to require ventilatory support. Is it effective and safe?

1:30 pm – 1:55 pm
Improving Patient Tolerance to Non-Invasive Ventilation
Robert M Kacmarek PhD RRT FAARC, Massachusetts General Hospital, Boston MA
Poor patient tolerance is one of the major causes of failure for non-invasive ventilation. This presentation is aimed at identifying problems and proposing solutions to decrease the occurrence of discomfort during non-invasive ventilation.

2:00 pm – 2:25 pm
Monitoring Patient-Ventilation Interaction during Non-Invasive Ventilation
Dean R Hess PhD RRT FAARC, Massachusetts General Hospital, Boston MA
Non-invasive ventilation has specific features that may peculiarly affect patient-ventilator interaction. What should we monitor to recognize and correct poor patient-ventilator interaction during non-invasive ventilation?

2:30 pm – 2:55 pm
Cough Assistance to Neuromuscular Patients Receiving Invasive and Non-Invasive Ventilation
Pamela Frigerio, Niguarda Ca’ Granda Hospital, Milano Italy
The lack of an effective cough may determine the need for intubation and affect the duration of mechanical ventilation in neuromuscular patients. Manual and mechanical forms of cough assistance may be used to overcome this problem. Are they really effective? And which is best?

Tracks: Professional, Management
KEEPING THE ENVIRONMENT SAFE
1:00 pm – 2:55 pm • Room N252

1:00 pm – 1:35 pm
Meeting New Standards in Patient Safety: The Practical Approach
Karen Stewart MS RRT, Charleston Area Medical Center, Charleston WV
This presentation should focus on the newest standards on patient safety and provide information on how to meet the standards. The speaker will provide examples on how to meet these newest standards.

1:40 pm – 2:15 pm
Using the Failure Mode Analysis Tool
Charlie G Brooks Jr MS RRT FAARC, University Medical Center, Nashville TN
This presentation is designed to demonstrate the FMEA tool and will demonstrate how the analysis will prevent medical errors and provide an example on how to complete a Failure Mode Effect Analysis.

2:20 pm – 2:55 pm
Medical Error Reporting and Respiratory Care
Ryan E Grueber RRT, University of Missouri, Columbia MO
According to the Institute of Medicine's 1999 report, medical errors contribute to or cause the death of 40,000 to 100,000 Americans every year. Accurately identifying medical errors and the circumstances surrounding them, is the first step to decreasing this number. This presentations discusses why respiratory therapy, as a part of the health care team, should report medical errors. The speaker will also demonstrate an electronic medical error reporting program.

Tracks: Management, Education, Acute Care
The Premier Symposium at the AARC Congress...

19th ANNUAL AARC NEW HORIZONS SYSMPOSIUM™
INTEGRATING EVIDENCE-BASED RESPIRATORY CARE INTO CLINICAL PRACTICE
1:00 pm - 5:00 pm • Rooms N249-251
Dean R Hess PhD RRT FAARC, Boston MA/Chairing

Evidence-based medicine entered into the lexicon of healthcare delivery late in the 20th century. As we enter the 21st century, evidence-based medicine has become a major principle directing clinical decision-making in medicine and is, increasingly, affecting respiratory care practice. This symposium will highlight respiratory care applications of evidence-based medicine and challenge the clinician to incorporate that into practice. Presentations will address applications of evidence-based medicine in technical and clinical aspects of respiratory care practice

1:00 pm – 1:25 pm
What is Evidence-Based Medicine and Why Should I Care?
Dean R Hess PhD RRT FAARC, Massachusetts General Hospital, Boston MA
Reviews evidence-based medicine, with examples specific to respiratory care practice and suggestions for appropriate use of evidence-based medicine.

1:30 pm – 1:55 pm
What is the Evidence for New Ventilator Modes?
Richard D Branson RRT FAARC, Cincinnati University Medical Center, Cincinnati OH
Addresses the current evidence to support the use of new ventilator modes. Includes such modes as dual-control, tube compensation, airway pressure-release ventilation, and proportional assist ventilation (and others as appropriate). Includes other features such as rise time adjustments and variable flow termination during pressure support. Which modes should we use? Do they make any difference? Are they cost effective?

2:00 pm – 2:25 pm
What is the Evidence That Respiratory Care Protocols Work?
James K Stoller MD MS FAARC, The Cleveland Clinic, Cleveland OH
Discusses the motivations for the use of protocols. Covers the evidence that respiratory care protocols work, including quality of care outcomes and fiscal outcomes.

2:30 pm – 2:55 pm
Evidence-Based Asthma Management
Thomas J Kallstrom RRT AE-C FAARC, Fairview Hospital, Cleveland OH
Discusses the current evidence for management of the patient with asthma, with specific emphasis on the role of the respira- tory therapist.Included are the role of inhaled medications (bronchodilators, steroids, and others), selection of aerosol delivery device (nebulizer, pressurized metered-dose inhaler, dry powder inhaler), gas therapy (heliox, anesthetics), patient education, and mechanical ventilation (invasive and noninvasive). Reviews the role of guidelines (NAEPP) in the management of asthma.

2:55 pm – 3:05 pm
Break

3:05 pm – 3:30 pm
Evidence-Based Inpatient Management of COPD
Scott Epstein MD, Tufts University Medical School, Boston MA
Care of patients with COPD remains a major focus of the practice of respiratory therapists. Presents the role of inhaled medications (bronchodilators, steroids), selection of aerosol delivery device (nebulizer, pressurized metered-dose inhaler, dry powder inhaler), gas therapy (oxygen, heliox), secretion clearance techniques (chest physiotherapy, mucolytics), surgical therapies and mechanical ventilation (invasive and noninvasive). Provides evidence to support these interventions will be provided. Discusses the role of guidelines (GOLD) in the management of COPD.

3:35 pm – 4:00 pm
Evidence-Based ARDS Management
Richard Kallet MS RRT FAARC, University of California at San Francisco General Hospital, San Francisco CA
Focuses on the mechanical ventilation of ARDS patients including selection of tidal volume, PEEP, mode (volume control, pressure control, new modes like APRV and HFO), and the role of recruitment maneuvers. Describes the role of prone positioning and pharmacological therapy (steroids, nitric oxide, and others).

4:05 pm – 4:30 pm
Evidence for Use of NPPV in Patients with Acute Respiratory Failure
Dean R Hess PhD RRT FAARC
Over the past 10 years, considerable evidence has evolved to support the use of noninvasive ventilation in appropriately selected patients. This presentation will include a discussion of patient selection for NPPV, equipment selection for NPPV, and monitoring the patient receiving NPPV. Also included will be issues such as aerosol delivery during NPPV and heliox therapy with NPPV.

4:35 pm – 5:00 pm
Evidence-Based Weaning from Mechanical Ventilation
Neil R MacIntyre MD FAARC, Duke University Medical Center, Durham NC
One of the most controversial aspects of mechanical ventilation relates to the liberation of patients from the ventilation. Discusses the issues related to identification of weaning readiness, the role of weaning parameters, the importance of a spontaneous breathing trial, the role of ventilator modes, causes of prolonged ventilator dependence, timing of tracheos-tomy, and the role of weaning protocols. Includes recently published guidelines for weaning from mechanical ventilation.

Tracks: Neonatal, Pediatrics
IT'S ALL SMALL STUFF: PEDIATRIC PULMONARY MEDICINE
1:00 pm – 3:25 pm • Rooms N240-242

1:00 pm – 1:45 pm
Long Term Effects of Pediatric Sedation
Paul Smith DO, Rainbow Babies and Childrens Hospital, Cleveland OH
This session will review risks and benefits of sedation for mechanical ventilation, compare different pharmacological agents and discuss the utility of non-pharmacological means for reducing patient agitation.

1:50 pm – 2:35 pm
Update on Asthma Pharmacology for the Pediatric Population
Robert Cohn MD, MetroHealth Medical Center, Cleveland OH
This speaker will review the pharmacology and current strategies for effective management of asthma. The current pharmacologic interventions and their relevance to the NIH/NAEPP Guidelines as they pertain to the pediatric population will also be discussed.

2:40 pm – 3:25 pm
Infant Pulmonary Function Studies: Diagnostic Medicine or Random Number Generation
Carolyn Kercsmar MD, Rainbow Babies and Childrens Hospital, Cleveland OH
This program will provide a general description of the system and results provided by infant pulmonary function tests. The speaker will address the issue of infant pulmonary function studies and their utility for diagnostic monitoring in pulmonary disease.

Tracks: Professional, Acute Care, Home Care
EMERGING TECHNOLOGIES IN RESPIRATORY CARE
1:00 pm – 3:25 pm • Room N254

1:00 pm – 1:45 pm
New Treatment Options for the Nasal Cannula through High-Flow Therapy and the Importance of Humidity
Jonathan B Waugh PhD RRT RPFT, University of Alabama, Birmingham AL
A new generation of high-flow devices is expanding the scope of applications for oxygen devices like the nasal cannula. This may allow clinicians to more frequently end using mechanical ventilation, lower supplemental oxygen, diminish episodes of nocturnal asthma, and reduce humidifier transmission of pathogens. An overview of these new high-flow devices with clinical applications will be presented.

1:50 pm – 2:35 pm
Volumetric Capnography: A Step Beyond Conventional Time-Based Capnography
Michael A Gentile RRT, Duke University Medical Center, Durham NC
The lecture will provide a brief review of how conventional time-based Capnography can be used in critical care. Volumetric Capnography (breath-by-breath measurement of CO2 elimination) will then be described. Clinical applications of volumetric Capnography will be discussed including ventilation management and weaning.

2:40 pm – 3:25 pm
Telemedicine and Home Care
Todd Ringeisen RRT, All Childrens Hospital, St Petersburg FL
This presentation will explain the advantages and disadvantages of telemedicine in homecare. The speaker will examine various types of home care equipment that utilize telemedicine.

Tracks: Pediatrics, Critical Care, Continuous Care
A BREATH OF FRESH AIR IN THE INTENSIVE CARE UNIT
1:00 pm – 5:00 pm • Rooms N259, 261

1:00 pm – 1:45 pm
Spontaneous Breathing in the NICU & PICU
Melissa K Brown RRT-NPS, University of California Medical Center, San Diego CA
An evidence based look at the clinical value of spontaneous breathing in the NICU and PICU. What technical challenges will be encountered? What ventilator modes are available and what ventilator features are helpful to effectively allow spontaneous breathing in these patients? Speaker will detail how to identify patient-ventilator dysynchrony.

1:50 pm – 2:35 pm
Management of Status Asthmaticus: Art or Science
Carlos Camargo MD DrPH, Massachusetts General Hospital, Boston MA
Speaker will review the evidence on current strategies for effective management of status asthmaticus in the intensive care setting and will discuss the current pharmaco-logic interventions and therapy adjuncts (heliox, mechanical ventilation, etc.) that are utilized in status asthmaticus.

2:40 pm – 3:25 pm
Liberation from Mechanical Ventilation in the Pediatric Intensive Care Unit
Paul Smith DO, Rainbow Babies and Childrens Hospital, Cleveland OH
Discusses the use and advantages of weaning protocols in the pediatric intensive care unit. Reviews the evidence on pulmonary mechanics or tools that are effective in evaluating weaning or readiness for extubation in the pediatric population.

3:30 pm – 4:15 pm
Cardio-Respiratory Interactions of the Mechanically Ventilated Patient: The Heart-Lung Connection
Ira Cheifetz MD FAARC, Duke University Medical Center, Durham NC
The presentation will describe the physiologic principles involved in the interactions between the cardiac and respiratory systems. The lecture will offer suggestions for optimizing conventional and non-conventional ventilation based upon improved cardio-respiratory interactions.

4:20 pm – 5:00 pm
Overview of Pediatric Mechanical Ventilation
Ira Cheifetz MD FAARC
This presentation will include an overview of non-invasive and invasive ventilation of the pediatric patient. The speaker will cover an overview of the medical literature including non-invasive ventilation, respiratory mechanics, analysis, weaning and extubation.

Tracks: Home Care, Management
YOUR HOME CARE EMPLOYER ISN'T A PHILANTHROPIST
2:00 pm – 4:25 pm • Room N256

2:00 pm – 2:45 pm
Where the RT Paycheck Comes From
Vernon R Pertelle MBA RRT CCM, Apria Healthcare, Lake Forest CA
Challenges the Homecare Manager faces from EBIT-DA to allocation of income for operating expenses, inventory, payroll and benefits. Also discussed will be information from the American Association of Homecare Financial Survey statistics regarding number of visits per day per RT.

2:50 pm – 3:35 pm
Understanding Third Party Payers
Allan B Saposnick MS RRT FAARC, ABSCO Enterprises, Newton Square PA
Reimbursement for the products and supplies you provide from Medicare, Medicaid, Managed Care and Private Insurance. Describes eligibility, deductibles and co-pays, who pays premiums and fee schedules.

3:40 pm – 4:25 pm
Medicare Reimbursement of Oxygen, Nebulizers and Medications
Joseph S Lewarski RRT, Hytech Homecare, Mentor OH
Addresses documentation and testing as well as the use of CMS form 484. Covers criteria to be met, rules to be followed, and what the homecare RT may and may not perform.

Tracks: Critical Care, Transport, Professional
CRITICAL CARE AIR TRANSPORT TEAMS 
(An Air Force Perspective)
3:00 pm – 3:55 pm • Rooms N255, 257

The U.S. Air Force Critical Care Air Transport Team (CCATT)
Major Deborah Milkowski MD, David Grant USAF Medical Center, Travis Air Force Base CA
This lecture will discuss transporting critically ill patients by air. The lecture will focus on the equipment and personnel that make the transport of critically ill patients feasible.

Tracks: Acute, Subacute, Professional
Open Forum #7—AIRWAYS, SUCTIONING, AND MUCH MORE
3:00 pm – 4:55 pm • Rooms N231, 233, 235
Presented by the Journal RESPIRATORY CARE
The results of scientific studies are presented. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand the information presented.

• Are Emergency Medical Technicians Predisposed to Administer Pejorative Ventilatory Strategies to Patients Intubated for Acute Severe Asthma?—Jeffrey M Haynes RRT RPFT, Nashua NH
• Expanded Role of the Respiratory Therapist in Bedside Percutaneous Dilatational Tracheostomy—Robert Jackson RRT, Tyler TX
• The Accuracy of Pressure Relief Valves Among Leading Neonatal Manual Resuscitators—Kurt Schroeder CRT, Indianapolis IN
• Evaluation of 16 Adult Disposable Manual Resuscitators—Nancy Marshall RRT, Park Ridge IL
• A Comparison of Total Patient Work of Breathing (TPWOB) Associated with Different Sizes of Endotracheal and Tracheostomy Tubes in a Lung Model—Jennifer L Boenisch CRT, San Antonio TX
• The Use of Propofol As a means of Sedation for Intubation in the Critically Ill Patient: Our Experience—Tate Bennett RRT, Durham NC
• Open Versus Closed Endotracheal Suctioning During ARDSnet Protocol—Maria P Caramez MD PhD, Boston MA
• Inline Suctioning During Mechanical Ventilation—Ashraf El Masry MD, Boston MA
• Effects of Decreasing Inspiratory Flow Rate and Use of a Smaller Adult Self-Inflating Bag During Simulated Basic Life Support Ventilation of a Cardiac Arrest Patient on Lung and Stomach Tidal Volumes—Melissa E Catino, Boston MA
• Comparative Evaluation of Two Endotracheal Tube Securing Methods—Douglas S Gardenshire MS RRT, Atlanta GA
• Mini-Bronchoalveolar Lavage Using the Combi-Cath Catheter System: Improved Outcome—Jeffrey Davis RRT, Cleveland OH
• Evaluation of the Hi Lo Evac Tube As an Adjunct Therapy in the Prevention of Ventilator Associated Pneumonia—John J Hill RRT, Browns Mills NJ
• An Evaluation of Delivered Oxygen Fractions in Four Self-Inflating Resuscitators—Timothy Cox RRT, Wilmington DE
• The Use of a Bronchiolitis Clinical Practice Guideline (CPG) and Outcomes to Identify Areas of Process Improvement in the Utilization of Inhaled Medication Administration—Debbie Forbush CRT, St George UT

Tracks: Home Care, Rehah, Pediatric
Open Forum #8—CPAP; HELIOX
3:00 pm – 4:55 pm • Rooms N237, 239, 241
Presented by the Journal RESPIRATORY CARE
The results of scientific studies are presented. Abstracts with a similar focus are clustered into a symposium to encourage discussions and interactions among investigators and observers; posters expand the information presented.

• Bench Test of the eVent Medical Inspiration Mechanical Ventilator with Heliox Mixtures—Melissa K Brown RRT-NPS, San Diego CA
• Bench Test of the Siemens SERVOi Mechanical Ventilator with Heliox Mixtures—Melissa K Brown RRT-NPS, San Diego CA
• Developing a Correction Factor to Determine the Set Tidal Volume When Using Helium Through a Dräger Dura 2 Ventilator—Diane Jereb RRT, Cleveland OH
• Effects of He/O2 Mixtures on the Performance of Siemens SERVO 300 and SERVOi Ventilators—Steven T Polston RRT, Louisville KY
• Laboratory Evaluation of C-Flex As an Adjunct to Continuous Positive Airway Pressure (CPAP)—Dean R Hess PhD RRT FAARC, Boston MA
• Heliox Delivery Using the Avea Ventilator—Christine D Perino RRT, Boston MA
• Pre-Hospital Use of Continuous Positive Airway Pressure for Saltwater Near-Drowning—David Pavlakovich RRT, Galveston TX
• Does Proactive Intervention Influence Compliance on Continuous Positive Airway Pressure Therapy (CPAP)?—Melanie Marshall, Bognor Regis, United Kingdom
• Accuracy of Volumes Delivered and Monitored by the Viasys Avea® Ventilator During Heliox Administration—Mark Rogers RRT, Loma Linda CA
• Control of Pressures and Oxygen Percentage by the Viasys Avea® Ventilator During Heliox Administration in Pressure Control Mode—Charles B Spearman MSEd RRT FAARC, Loma Linda CA
• Evaluation of Aerosol Generated By a Large Volume Heart Nebulizer Powered by Heliox—Kristin Smith RRT, Wilmington DE
• The Utilization of Blood Gas and Chest Radiography (CXR) Results vs Physical Assessment in Determining Placement on Continuous Positive Airway Pressure (CPAP) in the Treatment of Bronchiolitis Patients—Glenna McKinley RRT, Salt Lake City UT
• Skin Integrity During the Application of Continuous Positive Airway Pressure (CPAP) in the Treatment of Bronchiolitis—Glenna McKinley RRT, Salt Lake City UT
• The Utilization of Continuous Positive Airway Pressure (CPAP) in the Treatment of Bronchiolitis Patients—Glenna McKinley RRT, Salt Lake City UT
• Adaptive Servo Ventilation Improve Patients with Congestive Heart Failure and Cheyne-Stokes Respiration—Guo Xiheng, Beijing, PR China
• The Expression of Circulating sICAM-1, sVCAM-1 and IL-13 In OSAHS Patients Before and After CPAP Treatment—Guo Xiheng, Beijing, PR China
• The Utility of Albuterol Nebulized with Heliox during Acute Asthma Exacerbations—John P Kress MD, Chicago IL

Tracks: Diagnostics, Home Care
TESTING FOR SLEEP DISORDERS
3:00 pm – 4:55 pm • Room N252

3:00 pm – 3:35 pm
Limited Channel Sleep Studies
Cameron Harris RPSGT, Mayo Clinic, Rochester MN
Participants will hear how and under what circumstances these studies might be appropriately used and understand the limitations of unattended sleep studies.

3:40 pm – 4:15 pm
Test Your Sleep Event Recognition Skills
Russell Rozensky RRT RPGST, SUNY, Stony Brook NY
The presenter will instruct the audience as to the current guidelines used to mark respiratory events including definitions and case examples. Also included will be a discussion on EKG changes that are seen during polysomnograms and how to recognize the basic abnormalities that are commonly seen during polysomnograms.

4:20 pm – 4:55 pm
Electrode Application in Sleep Studies
Russell Rozensky RRT RPSGT
The presenter will instruct the audience on the International 10-20 system of electrode application of EEG leads used during polysomnograms. There will also be a discussion of proper placement of other electrodes used during polysomnograms. Also discussed will be the proper measuring techniques and methods of cleansing and applying electrodes.

Tracks: Management
GROWING YOUR OWN THERAPISTS
3:00 pm – 4:55 pm • Rooms N232, 234, 236

3:00 pm – 3:35 pm
A Managers Guide to Professional Development
Michelle L Murray RRT, Childrens Medical Center, Dallas TX
Using professional development tracts to develop and retain respiratory therapists while preparing for the future critical needs of our community will be discussed. These tracts have enabled us to instill a sense of professionalism in our staff, empowering employees to advance in their careers.

3:40 pm – 4:15 pm
Promoting the Role of Respiratory Therapists in the Nursing Crunch
Kay Martin RRT-NPS, Childrens Medical Center, Dallas TX
Children’s Medical Center of Dallas has taken advantage of the nursing shortage by extending the services of respiratory care across all areas of the hospital. This lecture will discuss the many opportunities to promote and expand the role of respiratory therapists to meet the expectations and needs of our hospital.

4:20 pm – 4:55 pm
A Practical Approach to Clinical Ladders
Michelle L Murray RRT
Developing and implementing a clinical ladder that allows the individual to recognize their own professional successes while providing meaningful reward and recognition will be discussed. This presentation will address the stumbling blocks managers face in implementing career ladders.

Tracks: Education
THINGS WE THINK WE'VE LEARNED ABOUT TEACHING STUDENTS AND PATIENTS
3:30 pm – 4:55 pm • Room N254

3:30 pm - 4:10 pm
How Can We Best Use Technology to Teach?
Keith B Hopper PhD RRT, Southern Polytechnic State University, Marietta GA
The presenter will describe when and how the use of technology will enhance learning.

4:15 pm - 4:55 pm
All You Really Need To Know about Teaching Can Be Learned in Las Vegas...Viva la Difference
William J Malley MS RRT CPFT, Western Pennsylvania Hospital, Pittsburgh PA
The presenter will describe how many of the techniques and methods used in Las Vegas to attract and engage people are similar to many basic principles of teaching. A major focus will be recognizing differences in people and learners.

Tracks: Subacute Care, Management
LUNG VOLUME REDUCTION SURGERY
4:00 pm – 4:50 pm • Rooms N240, 242

Lung Volume Reduction Surgery: Update from the NETT Study
Andrew L Ries MD MPH, University of California, San Diego CA
The presentation will give updated information and results from the NETT study.

Tracks: Pediatrics, Home Care, Continuing Care
SMOKING ISSUES
4:00 pm – 4:50 pm • Room N256

Smoking Issues in Pediatric Asthma
Robert Cohn MD, MetroHealth Medical Center, Cleveland OH
The speaker will address issues of smoking and second hand smoke in pediatric asthma and ways to support smoking cessation.

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