Respiratory Care

Respiratory failure, one of the most common conditions we treat, can be caused by many conditions such as asthma, emphysema, chronic obstructive pulmonary disease (COPD), complications of surgery, lung weakness created by an overdose of narcotics or sleeping pills, premature birth, or injuries in trauma. The condition may also result from extensive burns, muscular disease, neurological disease, profuse bleeding, drowning, heart failure, severe infection and/or extreme obesity. Often, a patient may need mechanical ventilation to help with breathing during respiratory failure.

Pneumonia is an infection that inflames the air sacs in one or both lungs and fills them with fluid and debris, causing coughing with phlegm or pus, fever, chills and difficulty breathing. Though it is often successfully treated, complications of pneumonia are possible and can be very dangerous, especially for patients who have underlying respiratory conditions. In the most severe cases, pneumonia can cause respiratory failure, making ventilator support necessary to facilitate breathing.

A ventilator is a machine that helps patients breathe. It might also be referred to as a respirator. The ventilator reduces the work of breathing and will facilitate the delivery of oxygen into the lungs. It also removes carbon dioxide from the lungs. The ventilator is needed until the patient is able to maintain the work of breathing without it. The closely monitored process of removing the patient from the ventilator for periods of time is known as “liberation.” It can sometimes take a week or longer to get you off the ventilator completely. We liberate our patients carefully following clinical guidelines and protocols in order to help prevent setbacks.

Respiratory therapists are highly skilled and educated in diseases affecting the lungs. They specialize in ventilator management and liberation, and help patients recover their lung strength after ventilation.

Occupational therapists (OT) perform therapy that encourages rehabilitation through the performance of activities required in daily life. Physical therapists (PT) perform therapy and exercise to promote mobility. Together, occupational therapists and physical therapists work to improve physical function.

Examples of therapy while patients are on mechanical ventilation:

• Range of motion (ROM) exercises that improve joint function.
• Sitting at the edge of bed (EOB) or in a chair.
• Sit-to-stand position exercises. These could include standing beside the bed or being placed on a tilt table.
• Practicing activities of daily living (ADLs). This might include bathing, dressing, shaving, or combing hair.
• Transfer training. This could include teaching the patient how to transfer safely from their bed to a chair.
• Energy conservation. This could include breathing and pacing techniques.
• Diaphragmatic breathing training and exercises.

Speech-language pathologists (SLP) specialize in communication, cognition and swallowing. The SLP collaborates with team members to ensure the patient’s cognitive needs are being met and utilizes special techniques to meet those needs.