Heritage: The Story of St. Mary's Hospital, 1880-1980
By Leo G. Bryne and Sister Alberta Cammack, C.S.J
Chapter III Contemporary St. Mary's
In the last twenty years, Respiratory Therapy has been one of the fastest growing and expanding areas of professional care. Today an individual with a respiratory problem can be offered an increased quality of life due to continual research and advances in this field.
The beginning of respiratory care usually starts in the Pulmonary Function Laboratory where physiological monitoring is done with tests that measure breathing capacity, total lung capacity, tolerance to exercise, and blood-gas analysis. These tests, which evaluate breathing capacity and efficiency of ventilation, indicate severity and the chronicity or acuteness of disease. Bronchoscopy procedures also aid in diagnosis. These are performed by a physician who inserts a fiberoptic tube instrument with a light source down the airways. By means of this procedure, irregularities can be seen and are able to be photographed and the involved portions of the lungs washed and biopsied to secure Clinical Laboratory specimens. With the bronchoscope, immediate emergency procedures can also be performed to remove foreign objects which are plugging the airways.
The Respiratory Department, besides functioning in its own area, also serves throughout the hospital. In critical care units, the therapist evaluates patients and administers treatment. He checks the continuous ventilation machines every hour, twenty-four hours a day. He is alert to possibilities of machine malfunctions and to changes in the patient which indicate a need for adjustments in treatment or emergency action.
Besides the machines used in critical care, continuous ventilation is also provided where needed in other nursing units, together with other breathing equipment which respond to voluntary breathing efforts and supply regulated oxygen with the proper temperature, humidity, and medications. The Respiratory Therapists are responsible for oxygen therapy, aerosol treatments and chest physiotherapy. Patients with Chronic Obstructive Pulmonary Disease (COPD) with acute acerbations are treated with low-flow oxygen which gets past the obstruction, with aerosol bronchodilators, and chest percussion to remove the thick airway secretions.
In the Emergency Room or other parts of the hospital, Cardio-Pulmonary Resuscitation (CPR) is usually carried out by a Respiratory Therapist working in conjunction with the emergency staff or cardiac arrest personnel who administer compression while the Respiratory Therapist maintains an open airway and administers ventilation by means of an inflated bag which he squeezes by hand. When the patient is moved from the Emergency Room, the Respiratory Therapist assists with the transfer, continuing ventilation until the patient is stabilized.
In the Burn Unit, patients receive ventilatory support with oxygen to overcome hypoxia and carbon dioxide poisoning associated with toxic fumes.
From the early days of the administration of oxygen by nursing personnel, to the present development of complex mechanical devices, the duration of years has been short. There has been a greatly increased demand for services and the emergence of a group of specialty practitioners to bridge the gap between knowledge and the delivery of care.
Continue with Chapter III: Contemporary St. Mary's Nuclear Medicine