Is the content of textbooks on the evaluation of a patient in respiratory distress adequate?

Abstract:

BACKGROUND:The ability to rapidly and precisely evaluate patients in respiratory distress is essential. Due to limited opportunities for formal instruction during training, textbooks are the main educational source to teach junior physicians how to interpret the signs of respiratory distress. The quality of the textbook content relevant to respiratory distress is unknown. OBJECTIVE:To examine the content on the evaluation of a patient in respiratory distress in a representative sample of textbooks and Internet resources. METHODS:Two physicians individually reviewed the most recent edition of 21 standard textbooks from a variety of specialties. Smartphone applications, UptoDate, and MD Consult were examined. Each physician reviewed the source for 14 different signs. For each sign, the reviewers determined 3 parameters: a mention of the sign, its pathophysiology, and its detection. The reviews were compared for discrepancies, and a third reviewer resolved them. RESULTS:The normal respiratory rate was mentioned in 10 (48%) of textbooks, and ranged between 10 and 22 breaths/min. Each sign was mentioned by a mean of 45 ± 26% of the textbooks. The pathophysiology of the signs was described by a mean of 33 ± 30% of the textbooks. The most and least commonly mentioned inspection signs were cyanosis and retraction of suprasternal notch, respectively. They were mentioned in 20 (95%) and 4 (19%) textbooks, respectively. The most and least commonly mentioned palpation signs were thoracoabdominal asynchrony or paradox and tracheal tug, respectively. They were mentioned in 17 (81%) and 4 (19%) textbooks, and their pathophysiology was described in 15 (71%) and 4 (19%) textbooks, respectively. The reviewers also found inconsistency in the descriptions of the meaning of scalene muscle contraction and thoracoabdominal asynchrony and paradox. CONCLUSIONS:The content of the reviewed textbooks on the evaluation of respiratory distress is inconsistent and deficient.

journal_name

Respir Care

journal_title

Respiratory care

authors

Tulaimat A,Patel A,Shah B,Littleton SW

doi

10.4187/respcare.01112

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

404-12

issue

3

eissn

0020-1324

issn

1943-3654

pii

rc01112r2tulaimat

journal_volume

57

pub_type

杂志文章
  • The ventilator liberation process: update on technique, timing, and termination of tracheostomy.

    abstract::Tracheostomy is one of the most commonly performed procedures in the ICU. Despite the frequency of the procedure, there remains controversy regarding selection of patients who should undergo tracheostomy, the optimal technique, timing of placement and decannulation, as well as impact on outcome associated with the pr...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.01914

    authors: Bittner EA,Schmidt UH

    更新日期:2012-10-01 00:00:00

  • Human relations skills of respriatory therapy supervisors.

    abstract::The most critical factor in effective supervision is the supervisor's skill in human relations. A standardized test, the Supervisory Inventory of Human Relations, was administered to 39 credentialed respiratory therapists who were responsible for the work performance of at least two other individuals. It was found tha...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Conine TA,Rueckl RG

    更新日期:1978-07-01 00:00:00

  • Nintedanib: a novel therapeutic approach for idiopathic pulmonary fibrosis.

    abstract::Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic lung disease with no clear etiology and few therapeutic options. Growth factors that act as mediators in the development of this disease might be important therapeutic targets. Nintedanib is a triple-tyrosine kinase inhibitor and a potent antagoni...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.03023

    authors: Dimitroulis IA

    更新日期:2014-09-01 00:00:00

  • Development of a Web-Based Tool Built From Pharmacy Claims Data to Assess Adherence to Respiratory Medications in Primary Care.

    abstract:BACKGROUND:Medication adherence in asthma and COPD is notoriously low. To intervene effectively, family physicians need to assess adherence accurately, which is a challenging endeavor. In collaboration family physicians and individuals with asthma or COPD, we aimed to explore the barriers and facilitators of assessing ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07328

    authors: Yousif A,Peláez S,Lemière C,Forget A,Dalal C,Turcotte MK,Beauchesne MF,Blais L

    更新日期:2020-09-01 00:00:00

  • Cough Augmentation Techniques in the Critically Ill: A Canadian National Survey.

    abstract:BACKGROUND:Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficien...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.04775

    authors: Rose L,Adhikari NK,Poon J,Leasa D,McKim DA,CANuVENT Group.

    更新日期:2016-10-01 00:00:00

  • Assessment of aspiration in patients with tracheostomies: comparison of the bedside colored dye assessment with videofluoroscopic examination.

    abstract:BACKGROUND:Aspiration is a serious clinical concern in patients with long-term artificial airways. The purpose of this study was to determine the reliability of a bedside colored dye assessment of aspiration in tracheostomized patients and to determine its comparability to a more sophisticated videofluoroscopic study. ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Peruzzi WT,Logemann JA,Currie D,Moen SG

    更新日期:2001-03-01 00:00:00

  • Use of a computerized respiratory care record system to study utilization of IPPB therapy.

    abstract::Increases in the utilization of respiratory therapy and the need to avoid its misuse have placed increasing management responsibilities on medical and technical supervisors of respiratory care services. To improve our managerial capabilities we designed a computerized respiratory care record system. Respiratory therap...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Chase CR,Merz BA,Shinozaki T,Greenwood SA,Deane RS

    更新日期:1983-03-01 00:00:00

  • The importance of nonelectrostatic materials in holding chambers for delivery of hydrofluoroalkane albuterol.

    abstract:INTRODUCTION:Electrostatic attraction of aerosolized particles to the inner walls of an aerosol holding chamber (HC) made from a nonconducting material can reduce medication delivery, particularly if there is a delay between actuation and inhalation. OBJECTIVE:Compare total emitted mass and fine-particle mass (mass of...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Rau JL,Coppolo DP,Nagel MW,Avvakoumova VI,Doyle CC,Wiersema KJ,Mitchell JP

    更新日期:2006-05-01 00:00:00

  • Documentation issues for mechanical ventilation in pressure-control modes.

    abstract::As hospitals begin to implement electronic medical records, the inadequacies of legacy paper charting systems will become more evident. One area of particular concern for respiratory therapists is the charting of mechanical ventilator settings. Our profession's lack of a standardized and generally accepted taxonomy fo...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Chatburn RL,Volsko TA

    更新日期:2010-12-01 00:00:00

  • Pulmonary hypertension in COPD.

    abstract::Pulmonary hypertension (PH) is a common consequence of COPD. It has been speculated that patients showing serious PH and vascular remodeling without severe airway obstruction might benefit from vasoactive treatment. There is no approved drug available for COPD-induced PH. Most trials assessing the efficacy of vasoacti...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02058

    authors: Held M,Jany BH

    更新日期:2013-08-01 00:00:00

  • Users' Experiences With Home Mechanical Ventilation: A Review of Qualitative Studies.

    abstract:BACKGROUND:Users of home mechanical ventilation encounter major psychological and physiologic challenges. To ensure well-functioning home mechanical ventilation, users' experiences of care and treatment are important knowledge to supplement clinical perspectives. This systematic review aimed to summarize current qualit...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.06855

    authors: Ørtenblad L,Carstensen K,Væggemose U,Løvschall C,Sprehn M,Küchen S,Nørregaard O,Jensen LG

    更新日期:2019-09-01 00:00:00

  • Practical problems with aerosol therapy in COPD.

    abstract::Inhaled aerosol drugs commonly used by patients with chronic obstructive pulmonary disease include short-acting and long-acting bronchodilators, as well as corticosteroids. These agents are available in a variety of inhaler devices, which include metered-dose inhalers (MDI), breath-actuated MDIs, nebulizers, and, curr...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Rau JL

    更新日期:2006-02-01 00:00:00

  • Asthma disease management and the respiratory therapist.

    abstract::The role of the respiratory therapist (RT) is expanding with the growing acceptance and use of the disease-management paradigm for managing chronic diseases. RTs are key members of the asthma disease-management team, in acute-care settings, patients' homes, out-patient clinics, emergency departments, and in the commun...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Kallstrom TJ,Myers TR

    更新日期:2008-06-01 00:00:00

  • Computerized adventitious respiratory sounds as outcome measures for respiratory therapy: a systematic review.

    abstract:INTRODUCTION:There is a need to develop simple, noninvasive, and sensitive outcome measures for respiratory therapy. Adventitious respiratory sounds (ie, crackles and wheezes) can be objectively characterized with computerized respiratory sound analysis (CORSA) and have been shown to contribute for diagnosis purposes; ...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.02765

    authors: Marques A,Oliveira A,Jácome C

    更新日期:2014-05-01 00:00:00

  • Efficacy of Interventions to Improve Respiratory Function After Stroke.

    abstract:BACKGROUND:The aim of this study was to systematically review all current interventions that have been utilized to improve respiratory function and activity after stroke. METHODS:Specific searches were conducted. The experimental intervention had to be planned, structured, repetitive, purposive, and delivered with the...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.06000

    authors: Menezes KK,Nascimento LR,Avelino PR,Alvarenga MTM,Teixeira-Salmela LF

    更新日期:2018-07-01 00:00:00

  • Impact of Home Oxygen Therapy on the Level of Physical Activities in Daily Life in Subjects With COPD.

    abstract:BACKGROUND:Chronic hypoxemia in patients with COPD is a limiting factor that is associated with disease progression and significantly contributes to decreased physical activity. Although correction of hypoxemia results in physiological improvements, oxygen therapy may be related to social isolation and inactivity. Howe...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06206

    authors: Cani KC,Matte DL,Silva IJCS,Gulart AA,Karloh M,Mayer AF

    更新日期:2019-11-01 00:00:00

  • Testing airway management skills: interactive video courseware vs ACLS instructor.

    abstract:UNLABELLED:Lectures and demonstrations have been the teaching and testing strategies most often employed by the American Heart Association in Advanced Cardiac Life Support (ACLS) training. I compared the abilities of interactive videodisc (IVD) courseware and ACLS instructors to evaluate airway management skills. METH...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Rubens AJ

    更新日期:1991-08-01 00:00:00

  • Modification of an external low-pressure ventilator alarm to allow its remote use for isolated patients.

    abstract::The problem of patients in isolation becoming disconnected from their ventilator systems is a serious one, as the closed doors of an isolation room usually prevent hospital personnel outside the room from hearing or seeing standard ventilator alarms To overcome this potentially life-threatening problem, we modified a ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Morganstern MA,Karpel SK

    更新日期:1986-05-01 00:00:00

  • Impact of a radio frequency management information system on the process and timing of providing respiratory care services.

    abstract:BACKGROUND:Although radio frequency (RF) systems have proliferated and are designed to simplify care delivery in many clinical settings, little information is available on the impact of such RF systems on the delivery of patient care. Having used a hand-held-device-based management information system in our Respiratory...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Stoller JK,Kester L,Orens DK,McCarthy K

    更新日期:2002-08-01 00:00:00

  • Respiratory Therapist Endotracheal Intubation Practices.

    abstract:BACKGROUND:Endotracheal intubation is a common procedure performed by respiratory therapists (RTs). The purpose of this study was to describe current RT intubation practices in North Carolina through the use of a survey instrument. METHODS:A survey was developed by the authors using REDCap. The survey was sent via ema...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07338

    authors: Miller AG,Gentile MA,Coyle JP

    更新日期:2020-07-01 00:00:00

  • Sleep-disordered breathing may be under-recognized in patients who wean from prolonged mechanical ventilation.

    abstract:BACKGROUND:The prevalence of sleep-disordered breathing (SDB) in patients with prolonged mechanical ventilation (PMV) is unknown. The aim of this study was to assess the frequency of SDB in patients admitted to a long-term acute care (LTAC) hospital who weaned from PMV. METHODS:Retrospective chart review was conducte...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01260

    authors: Diaz-Abad M,Verceles AC,Brown JE,Scharf SM

    更新日期:2012-02-01 00:00:00

  • Pulmonary function testing and outcomes in subjects with heart failure listed for heart transplantation.

    abstract:BACKGROUND:Impaired spirometric parameters have been reported in patients with stage C heart failure and portend worse outcomes in these patients. The impact of spirometric parameters on outcomes in patients with stage D heart failure listed for heart transplantation is unknown. METHODS:We collected data on consecutiv...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03709

    authors: Georgiopoulou VV,Deka A,Li S,Niazi AA,Farooq K,Kalogeropoulos AP,Butler J,Alexopoulos D

    更新日期:2015-05-01 00:00:00

  • Clinical and physiological outcomes of a university-hospital pulmonary rehabilitation program.

    abstract::Pulmonary rehabilitation programs have resulted in improvements in quality of life, capacity for carrying out daily activities, and physical conditioning, as well as reduced hospitalization and cost of care. In our retrospective study, we reviewed the data of 75 patients who had participated in Loma Linda University M...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Bebout DE,Hodgkin JE,Zorn EG,Yee AR,Sammer EA

    更新日期:1983-11-01 00:00:00

  • Role of noninvasive positive-pressure ventilation in postextubation respiratory failure: a meta-analysis.

    abstract:BACKGROUND:There is a need for an intervention that prevents re-intubation in patients who have been weaned off mechanical ventilation. Noninvasive positive-pressure ventilation (NPPV) has been shown to facilitate weaning in mechanically ventilated patients. OBJECTIVES:To assess the effect of NPPV on re-intubation rat...

    journal_title:Respiratory care

    pub_type: 杂志文章,meta分析,评审

    doi:

    authors: Agarwal R,Aggarwal AN,Gupta D,Jindal SK

    更新日期:2007-11-01 00:00:00

  • Adjunct therapies during mechanical ventilation: airway clearance techniques, therapeutic aerosols, and gases.

    abstract::Mechanically ventilated patients in respiratory failure often require adjunct therapies to address special needs such as inhaled drug delivery to alleviate airway obstruction, treat pulmonary infection, or stabilize gas exchange, or therapies that enhance pulmonary hygiene. These therapies generally are supportive in ...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.02217

    authors: Kallet RH

    更新日期:2013-06-01 00:00:00

  • Prognostic value of plateau pressure below 30 cm H2O in septic subjects with acute respiratory failure.

    abstract:BACKGROUND:Ventilation with low tidal volume is recommended for patients with acute lung injury. Current guidelines suggest limiting plateau pressure (Pplat) to < 30 cm H2O for septic patients needing mechanical ventilation. The aim of this study was to determine whether Pplat within the first 24 h of ICU admission is ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03138

    authors: Chan MC,Tseng JS,Chiu JT,Hsu KH,Shih SJ,Yi CY,Wu CL,Kou YR

    更新日期:2015-01-01 00:00:00

  • Mucus, phlegm, and sputum in cystic fibrosis.

    abstract::Although some clinicians still believe that cystic fibrosis (CF) lung disease is largely due to hypersecretion of very viscous mucus, it has never been demonstrated that there is mucus hypersecretion in CF and it is clear that there is almost no intact mucin (the principal polymeric component of normal mucus) in CF sp...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/002013209790983269

    authors: Rubin BK

    更新日期:2009-06-01 00:00:00

  • Performance of Leak Compensation in All-Age ICU Ventilators During Volume-Targeted Neonatal Ventilation: A Lung Model Study.

    abstract:BACKGROUND:Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. ME...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.05012

    authors: Itagaki T,Bennett DJ,Chenelle CT,Fisher DF,Kacmarek RM

    更新日期:2017-01-01 00:00:00

  • The Risk and Related Factors for Readmission to an ICU Within 7 Days in Mechanically Ventilated Subjects--A Nationwide Population-Based Cohort Study.

    abstract:BACKGROUND:Readmission of mechanically ventilated patients to an ICU within 7 d reflects not only patient safety but also the quality of care of the ICU. This study aimed to investigate the risk and related factors for readmission to an ICU within 7 d in mechanically ventilated subjects. METHODS:A total of 658,452 mec...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03868

    authors: Chu CC,Liu CJ,Shih CM,Kung PT,Tsai YS,Tsai WC

    更新日期:2015-12-01 00:00:00

  • Inhaled Nitric Oxide: In Vitro Analysis of Continuous Flow Noninvasive Delivery via Nasal Cannula.

    abstract:BACKGROUND:Inhaled nitric oxide (NO) is most frequently delivered to mechanically ventilated patients in critical care, but it can also be administered noninvasively. The delivered dose and efficiency of continuous flow NO supplied through a nasal cannula has yet to be established. This study aimed to determine the inf...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07737

    authors: Pillay K,Chen JZ,Finlay WH,Martin AR

    更新日期:2021-02-01 00:00:00