AARC Congress 2022

November 9–12, 2022
New Orleans, LA

Day 3 — Friday, Nov. 11

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8:30 a.m.–9:00 a.m. | Track: General

Flag Folding Ceremony

Joe Buhain, EdD, RRT, NREMT B, FAARC
Wadie Williams, MS, RRT, FAARC
Harry Roman, MA, RRT, FAARC
Michael de Peralta, MBA-HCM, RRT

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Joe BuhainWadie WilliamsHarry RomanMichael Peralta

An AARC tradition like no other, attend the AARC Flag Folding Ceremony and celebrate the rich tradition of the U.S. Military and Armed Forces. RT veterans and active-duty respiratory therapists conduct a moving ceremony as we recognize those who serve, those who have served, and those we have lost.

9:00 a.m.–11:30 a.m. | Track: General

Open Forum — Editor’s Choice

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TBA

Researchers present the result of their work using a short PowerPoint presentation, followed by questions from the attendees.

Supported by an unrestricted educational grant from

9:10 a.m.–9:45 a.m. | Track: Sleep | CRCE: 0.58

Sleep and COVID Update 2022

Lutana Haan, EdD, RRT

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Lutana Haan

The body of evidence of the relationship between COVID and sleep continues to grow, and this interactive discussion will review some of the emerging research on this subject. It will focus on the effect for the individual, health and wellbeing, and our society.

9:10 a.m.–9:45 a.m. | Track: Adult Acute Care | CRCE: 0.58

PRO/CON: Setting PEEP by the PEEP FIO2 Table — Proven Effectiveness

PRO: Neil MacIntyre, MD, FAARC
CON: Eddy Fan, MD, PhD

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Neil MacIntyreEddy Fan

Setting PEEP remains one of the most contentious aspects of mechanical ventilation. PEEP has been titrated by shunt, fall in cardiac output, PaO2, SpO2, and compliance. Development of the PEEP/FIO2 tables for the ARDSnetwork were based on expert opinion. Join this spirited debate to hear from two experts in mechanical ventilation debate the best way to set PEEP.

9:10 a.m.–10:30 a.m. | Track: Ambulatory & Post-Acute Care

Symposium

The Discharge Process and the Respiratory Therapist

9:10 a.m.–9:45 a.m. | CRCE: 0.58

Gaps in Effective Discharge Planning

Timothy Buckley, MSc, RRT, FAARC

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Timothy Buckley

This session will discuss the discharge process from the perspective of the respiratory therapist. Identification of the gaps that exist in this process will be followed by a discussion of those processes that are essential to create an effective discharge plan. Recommendations to help eliminate these gaps will be made.

9:55 a.m.–10:30 a.m. | CRCE: 0.58

Discharge Planning for the Transition to Subacute and Home Care

Vrati Doshi, MSc, RRT

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Vrati Doshi

Many complex respiratory patients are discharged to an LTACH or SNF before going home. This increased level of care and support increasingly requires the expertise of respiratory therapists to be successful. The speaker will highlight the type of patient that benefits from subacute care and the role played by respiratory therapists. Further, the speaker will discuss the planning process involved in transition to home from the subacute, again highlighting best practices across the country.

9:10 a.m.–9:45 a.m. | Track: Neonatal/Pediatrics | CRCE: 0.58

What’s New in Noninvasive Respiratory Support for Pediatric Asthma!

Andrew Miller, MSc, RRT, RRT-ACCS, RRT-NPS, FAARC

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Andrew Miller

Asthma is a common reason for hospital admission and is one of the leading causes of pediatric ICU admission. Patients are often treated with noninvasive interventions such as heliox, high-flow nasal cannula and noninvasive ventilation. This lecture will discuss the pathophysiology of critical pediatric asthma, the physiologic rationale for noninvasive respiratory support, and review the evidence for noninvasive interventions in critical pediatric asthma. The how, why, and when for each modality will be discussed.

9:10 a.m.–11:15 a.m. | Track: Student

Symposium

Symposium for New Professionals

9:10 a.m.–9:45 a.m. | CRCE: 0.00

What It Means to be a Professional

Dana Evans, MHA, RRT, RRT-NPS, FACHE

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Dana Evans

This presentation will focus on preparing the respiratory care student to transition into professional life as a respiratory therapist. The presenter will discuss demonstrating professionalism in student environments (clinical rotations, professional meetings, etc.), applying and interviewing for a job, and maintaining professionalism after graduation.

9:55 a.m.–10:30 a.m. | CRCE: 0.00

Success on the Therapist Multiple Choice Examination

Bill Galvin, MSEd, RRT, AE-C, FAARC

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Bill Galvin

The presentation will address the factors that make for success in the examination process. It will cover preparatory issues and what you will experience onsite as well as test-taking strategies and techniques. Emphasis will be placed on the NBRC Therapist Multiple-Choice Examination (TMC).

10:40 a.m.–11:15 a.m. | CRCE: 0.00

Success on the Clinical Simulation Examination

Bill Galvin, MSEd, RRT, AE-C, FAARC

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Bill Galvin

This presentation will serve as a sequel to the previous one and will address the factors that make for success on the Clinical Simulation Examination. It will cover such issues as exam content, structure, and unique strategies for progressing through a branching logic type of exam. It will also highlight recent changes in policy.

9:55 a.m.–10:30 a.m. | Track: Sleep | CRCE: 0.58

OSA Therapies: Beyond CPAP

Jessica Schweller, MS, RRT, RRT-SDS, APRN-CNP

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Jessica Schweller

Therapy for OSA primarily revolves around PAP therapy. Given the recent events with equipment availability, other strategies for management are being used more frequently. This discussion will include other treatment options for a patient with sleep disordered breathing including oral appliance, nasal appliance, positional, neuromuscular stimulation, surgical, and medical therapies.

9:55 a.m.–10:30 a.m. | Track: Adult Acute Care | CRCE: 0.58

Changes in the New VAP/VAE Guidelines — What’s in What’s Out

Rich Branson, MSc, RRT, FAARC

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Richard Branson

Ventilator associated pneumonia and ventilator associated events remain important issues in respiratory care. The guidelines for prevention of VAP/VAE and non-ventilator associated pneumonia are living documents that are updated every few years. While delayed by COVID, new guidelines based on recent publications have recently been published. Changes to oral care, subglottic secretion drainage and use of probiotics are forthcoming. This talk will review the new guidelines and describe what’s in and what’s out.

9:55 a.m.–10:30 a.m. | Track: Neonatal/Pediatrics | CRCE: 0.58

Lung and Diaphragm Protective Ventilation in Children

Robinder Khemani, MD, MsCI

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Robinder Khemani

The importance of lung protective ventilation in adults and children has been well described. Unfortunately, lung protective strategies can have an impact on diaphragm contractility and the incidence of Ventilator Induced Diaphragm Dysfunction (VIDD). Ideally, ventilation strategies should focus on balancing protection of both the lung and diaphragm. This presentation will review the evidence related to VIDD and an integrated lung and diaphragm protective approach to mechanical ventilation.

10:00 a.m.–1:30 p.m. | Track: General

Exhibit Hall Open

10:40 a.m.–11:15 a.m. | Track: Sleep | CRCE: 0.58

Sleep Disordered Breathing Testing: The Right Test for the Right Person

Amanda Roby, PhD, RRT, RRT-SDS, RPSGT

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Amanda Roby

Confusion often exists as to which type of sleep testing is most appropriate to be used for a specific clinical situation. In-laboratory polysomnography, home sleep apnea testing, multiple sleep latency testing, actigraphy, and personal device monitors will be discussed in this session. A case-based approach will be used to help develop recommendations for the right test for the right person.

10:40 a.m.–11:15 a.m. | Track: Adult Acute Care | CRCE: 0.58

Hypoxic, Hyperoxic, and Normoxic States

Michael Lipnick, MD

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Michael Lipnick

How hypoxic is too hypoxic? Is hyperoxia something RTs should be concerned about? Is normoxia always best? This session will cover important concepts that relate to oxygen delivery and blood oxygen levels that are physiologically and clinically important.

10:40 a.m.–11:15 a.m. | Track: Neonatal/Pediatrics | CRCE: 0.58

Pediatric HFOV: The End of the Road

Martin Kneyber, MD, PhD, FCCM

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Martin Kneyber

High-frequency oscillatory ventilation (HFOV) is frequently used in children suffering from acute severe lung injury. From a theoretical perspective, HFOV appears to be a suitable mode for lung-protective ventilation (LPV), and its use has, therefore, been recommended by the Pediatric Mechanical Ventilation Consensus Conference (PEMVECC) and the Pediatric Acute Lung Injury Consensus Conference (PALICC). This lecture will discuss in detail the pediatric and adult data on HFOV and how the current use of HFOV relates to setting the oscillator in an optimal fashion. In particular, setting frequency and finding the optimal mean airway pressure will be discussed by reviewing experimental and pre-clinical studies. A physiologic approach to HFOV is going to be presented, discussing the rationales for this physiology driven approach. First pediatric clinical data on the physiology driven approach will be discussed. The attendees will gain insight into a different, personalized setting and titration of HFOV.

10:40 a.m.–12:00 p.m. | Track: Clinical Practice

Symposium

Community Engagement and the Respiratory Therapist

10:40 a.m.–11:15 a.m. | CRCE: 0.58

The Roadmap for Community Engagement: The Role of the Respiratory Therapist

Linda Nozart, MPH, BSRC, RRT, AE-C

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Linda Nozart

The Chronic Care Model and Health Belief Model can be used in underserved populations to improve respiratory disease management. This discussion will focus on key strategies for forming professional partnerships, networking with community-based organizations, and collaborating to create bi-directional referral systems. One such application will discuss the use of Uber in the neighborhoods of North Brooklyn, NY.

11:25 a.m.–12:00 p.m. | CRCE: 0.58

“Lyfting” Up Persons in Appalachia

Brady Scott, PhD, RRT, FAARC

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TBA

Chronic disease management goals can be met in rural populations, but strategies used to address rural health challenges differ from those used for urban populations. Get a Lyft to the beautiful mountain region of Central Appalachia, specifically Eastern Kentucky, to see how respiratory health disparities are being addressed in a rural population.

11:25 a.m.–12:00 p.m. | Track: Sleep | CRCE: 0.58

Sleep Deprivation in Me and My Patient: What is It and What Can I Do about It

Brian Carlin, MD

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Brian Carlin

Sleep deprivation is prevalent in both patients and care providers. The deleterious effects of sleep deprivation are many. This discussion will center around sleep deprivation in hospitalized patients as well as those for health care providers (e.g., respiratory therapists). Strategies for the early recognition of sleep deprivation and techniques for prevention will be discussed.

11:25 a.m.–12:00 p.m. | Track: Adult Acute Care | CRCE: 0.58

Ventilating the Morbidly Obese: From the OR to the ICU

Danny Theodore, MD

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Danny Theodore

This lecture will discuss the complex issue of mechanical ventilation for the morbidly obese. Airway and ventilator management, including PEEP titration by imaging and esophageal manometry, will be discussed.

11:25 a.m.–12:00 p.m. | Track: Neonatal/Pediatrics | CRCE: 0.58

Dare To Be Different: Non-Conventional Mechanical Ventilation in Neo Peds Care

Emilee Lamorena, MS, RRT, RRT-NPS

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Emilee Lamorena

Conventional mechanical ventilation is still a cornerstone of therapy in many ICUs. However, there are also many other non-conventional forms of mechanical ventilation that have been developed and proposed to help mitigate the risk of ventilator-induced lung injury, while improving hemodynamics and gas exchange in our patients. With so many new technological and medical advances in neonatal/pediatric respiratory care, we have been using and sharing information over the past few years about the benefits and management strategies of these other modes. This presentation will review some popular non-conventional modes of ventilation, and make recommendations for their use in neonatal/pediatric critical care.

11:25 a.m. -12:00 p.m. | Track: Ambulatory & Post-Acute Care | CRCE: 0.58

Remote Patient Monitoring by Respiratory Care: Implementing a Successful Program

Krystal Craddock, MSRC, RRT, CCM

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Krystal Craddock

As COVID-19 moved us into digital platforms for care, remote patient monitoring (RPM) has been a tool to help expand the care of our chronic pulmonary patients. In this lecture you will learn all it takes to implement an RPM program for chronic pulmonary diseases that can be monitored by RTs. The UC Davis Health Comprehensive COPD Clinic and COPD Case Management Program Coordinator will share highlights from building the first RPM program at UCD. She will discuss early considerations, key stakeholders needed, and foreseen barriers, as well as questions answered regarding billing aspects, access for patients, and patient outcomes.

12:00 p.m.–1:55 p.m. | Track: Education | CRCE: 1.50

Open Forum #8 — Education

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TBA

Researchers present the results of their work. Authors briefly present their findings and engage in an open discussion with the attendees.

Supported by an unrestricted educational grant from

12:00 p.m.–1:55 p.m. | Track: Diagnostics | CRCE: 1.50

Open Forum #9 — Pulmonary Function Testing and Equipment Evaluation

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TBA

Researchers present the results of their work. Authors briefly present their findings and engage in an open discussion with the attendees.

Supported by an unrestricted educational grant from

12:05 p.m.–12:35 p.m. | Track: General

Ambulatory & Post-Acute Care Section Meeting

Timothy Buckley, MSc, RRT, FAARC

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Timothy Buckley

Section members meet to determine their needs and priorities, as well as how to use AARC resources to accomplish them. All Congress attendees, including section non-members, are invited to attend and participate.

1:15 p.m.–1:45 p.m. | Track: General

Diagnostics Section Meeting

Ralph Stumbo, RRT, CPFT

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Ralph Stumbo

Section members meet to determine their needs and priorities, as well as how to use AARC resources to accomplish them. All Congress attendees, including section non-members, are invited to attend and participate.

1:15 p.m.–1:45 p.m. | Track: General

Sleep Section Meeting

Amanda Roby, PhD, RRT, RRT-SDS, RPSGT

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Amanda Roby

Section members meet to determine their needs and priorities, as well as how to use AARC resources to accomplish them. All Congress attendees, including section non-members, are invited to attend and participate.

1:15 p.m.–1:45 p.m. | Track: General

Neo/Peds Section Meeting

Emilee Lamorena, MS, RRT, RRT-NPS

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Emilee Lamorena

Section members meet to determine their needs and priorities, as well as how to use AARC resources to accomplish them. All Congress attendees, including section non-members, are invited to attend and participate.

2:00 p.m.–2:50 p.m. | Track: General, Adult Acute Care | CRCE: 0.83

2nd Robert M. Kacmarek Scientific Memorial Lecture

Complexities of Mechanical Ventilation: Toppling the Tower of Babel

Robert L. Chatburn, MHHS, RRT-NPS, FAARC

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Robert Chatburn

Mechanical ventilation is ubiquitous to intensive care from neonates to adults. The terminology surrounding mechanical ventilation is manufacturer-specific and jargon still prevails. To provide evidence-based mechanical ventilation, clinicians must be able to communicate regarding the operation of mechanical ventilation. Evidence-based treatment requires that the critical care team be lock step chapter and verse, yet ventilator complexities often place the team on different pages and sometimes in different books. This lecture will provide a method of teaching mechanical ventilation terminology and operation based on a set of principles and how we speak about mechanical ventilation in a consistent and meaningful way.

3:00 p.m.–3:35 p.m. | Track: Leadership & Management | CRCE: 0.58

Telehealth: Past, Present and Future

David Wheeler, MEd, RRT, RRT-NPS, FAARC

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David Wheeler

Access. This word has been both the driving force and inherent challenge of telehealth since its origin. Telehealth allows clinicians to scale delivery of health care services while simultaneously empowering patients in certain populations to receive the care they need, when they need it, eliminating disparities. Improved outcomes and increased access for all patient populations are some of the key objectives driving telehealth advancement. In this presentation, we will explore the past, present and future of telehealth services and what impact that will have on the respiratory care services moving forward.

3:00 p.m.–3:35 p.m. | Track: Adult Acute Care | CRCE: 0.58

PRO/CON: Patient Ventilator Asynchrony Should be Avoided

Pro: Thomas Piraino, RRT, FCSRT, FAARC
Con: L. Felipe Damiani, PhD, MSc, PT

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Thomas PirainoL. Felipe Damiani

Patient ventilator asynchrony is common in the intensive care unit and has been shown to be associated with worse patient outcomes. Should it be avoided at all costs? Two experts will present data on both sides of the debate.

3:00 p.m.–5:05 p.m. | Track: Pulmonary Function

Symposium

Quality and the PFT Laboratory

3:00 p.m.–3:35 p.m. | CRCE: 0.58

Doing it Right … How to Prepare the PF Laboratory for Any Accreditation Review

Carl Mottram, BA, RRT, RPFT, FAARC

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Carl Mottram

This presentation will inform the attendees on the essential elements in meeting or exceeding an accrediting body expectation. It will review all aspects of setting up and completing quality control requirements. We will also review outcomes from other QA programs and their methods of implementing QC standards.

3:45 p.m.–4:20 p.m. | CRCE: 0.58

Getting Started: Understanding the Quality Control Alphabet Soup

Ellen Becker, PhD, RRT, RPFT, FAARC

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Ellen Becker

This discussion will review the requirements for quality control as it applies to the pulmonary function laboratory. The terms used in such quality control will be discussed, followed by case studies to review acceptable data. Techniques used for troubleshooting for unacceptable quality control results will be discussed.

4:30 p.m.–5:05 p.m. | CRCE: 0.58

Mechanical Quality Control Starter Steps

Ellen Moran, MS-RT, RRT, RPFT, AE-C

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Ellen Moran

The ATS/ERS Spirometry and DLCO standards require several mechanical quality control methods. This presentation describes how to perform the mechanical quality control steps of volume linearity, gas analyzer linearity, and DLCO syringe test. Expected results for each will be discussed.

3:00 p.m.–3:35 p.m. | Track: Ethics | CRCE: 0.58

Organ Donation after Circulatory Determination of Death

Kimberly McMahon, MD

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Kimberly McMahon

Advances in organ donation have occurred, and more donations are occurring after death by circulatory criteria. This presentation will discuss the history, evolution, and current regulations surrounding organ donation after determination of death by circulatory criteria. Participants will learn about the process of donor selection and preparation, as well as what occurs during and after the donation process. Special attention will be given to the role of the respiratory therapist in these cases, including how it differs from the role in organ donation by brain-dead donors. There will also be a discussion of ethical issues surrounding donation as well as the dead donor rule and the definition of death.

3:10 p.m.–5:05 p.m. | Track: Clinical Practice | CRCE: 1.50

Open Forum — Poster Walk Arounds #3

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TBA

Researchers present the results of their work. Authors briefly present their findings and engage in an open discussion with the attendees.

Supported by an unrestricted educational grant from

3:10 p.m.–5:05 p.m. | Track: Clinical Practice | CRCE: 1.50

Open Forum — Poster Walk Arounds #4

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TBA

Researchers present the results of their work. Authors briefly present their findings and engage in an open discussion with the attendees.

Supported by an unrestricted educational grant from

3:45 p.m.–4:20 p.m. | Track: Leadership & Management | CRCE: 0.58

RTs at the Tele-Critical Desk, Stronger Than We’ve Ever Been!

Corey Sillito MSRT, RRT, RRT-ACCS, RRT-NPS
Carrie Winberg MSHA, BSRT, RRT, RRT-ACCS, RRT-NPS

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Corey SillitoCarrie Winberg

After COVID and the emergent addition of RTs at the Tele-Critical Care desk, RRT value became front and center. Join these two innovative Tele-Critical Care leaders as they share how they created and “sold” physicians and executive leaders in permanently adding RTs to their team. Discover implementation strategies, monitoring success and marketing the value. They will share job descriptions, the business model and data collection tools.

3:45 p.m.–4:20 p.m. | Track: Adult Acute Care | CRCE: 0.58

The Interaction Between Mechanical Ventilation and Hemodynamics

Ira Cheifetz, MD, FAARC

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Ira Cheifetz

Respiratory therapists that manage mechanical ventilators need to have a keen understanding of physiologic interactions between the respiratory and cardiac system—and how it is altered when mechanical ventilation is initiated. This session reviews the complex interaction between mechanical ventilation and patient hemodynamics.

3:45 p.m.–4:20 p.m. | Track: Neonatal/Pediatrics | CRCE: 0.58

Critical Bronchiolitis in the PICU

Steven Shein, MD, FCCM

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Steven Shein

Bronchiolitis is a common reason for admission to the PICU, often resulting in the need for invasive or non-invasive respiratory support. Despite this, care varies broadly between centers. This presentation will discuss the implications of critical bronchiolitis as well as the current evidence for interventions and support.

3:45 p.m.–4:20 p.m. | Track: Adult Acute Care | CRCE: 0.58

Capturing a New Perspective on Pressure Injuries — Thermographic Imaging

Lexie Caraway, MBA, RRT, RRT-ACCS, AE-C

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Lexie Caraway

Pressure injuries are costly to hospitals and sadly our patients suffer the consequences of what can often be preventable. This lecture will discuss why respiratory therapists should be striving to add more value to their hospital’s pressure injury teams and why our expertise matters. Thermographic imaging is an added tool which can help provide better patient care as well as elevate the respiratory care profession.

4:30 p.m.–5:05 p.m. | Track: Leadership & Management | CRCE: 0.58

The Role of the Respiratory Therapist in Tele-ICU

Karsten Roberts, MSc, RRT, RRT-ACCS, FAARC

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TBA

Telemedicine is a practice of medicine in which health care providers use telecommunication technologies to deliver health care, diagnosis, and treatment to patients remotely. As the COVID-19 pandemic expanded throughout the world, innovative methods were required to involve respiratory therapists in the care of critically ill patients utilizing telemedicine services. This lecture will discuss the role that the respiratory therapist has in a tele-ICU environment.

4:30 p.m.–5:05 p.m. | Track: Adult Acute Care | CRCE: 0.58

Extracorporeal Carbon Dioxide Removal (ECCO2-R) for Hypercapnic Respiratory Failure

John Davies, MA, RRT, FAARC

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John Davies

Extracorporeal Carbon Dioxide Removal (ECCO2-R) has been described as a way to support patients who are hypercapnic. What is the evidence to support this practice? The session will discuss the concept of ECCO2-R and current evidence to support its use in patients in hypercapnic respiratory failure.

4:30 p.m.–5:05 p.m. | Track: Neonatal/Pediatrics | CRCE: 0.58

Aerosol Delivery in Children Receiving Ventilatory Support

Ariel Berlinski, MD, FAAP, FAARC

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Ariel Berlinski

The delivery of inhaled medications is vital to the care of many children who require mechanical ventilation. Ineffective or inefficient techniques result in decreased quality of care. The presenter will discuss the different aspects that affect drug delivery in children receiving invasive mechanical ventilation, including the integration of current data.

4:30 p.m.–5:05 p.m. | Track: Ethics | CRCE: 0.58

Ethical Discernment in a Time of Scarcity

David Wheeler, MEd, RRT, RRT-NPS, FAARC

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David Wheeler

We are living through an era we could not have anticipated in our wildest dreams. This discussion will focus on the ethical discernment necessary in the allocation of scarce medical resources, the moral distress that attends a pandemic and the ethical constraints of a polarized society. This discussion will highlight aspects of biomedical ethical thought. It will also explore a mental model of ethical action and discernment when confronted with the allocation of scarce medical resources, ethical decision-making and unheard-of circumstances, along with ways to counteract the effects of medical nihilism.

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