Course Descriptions

RTH 110 - Introduction to Respiratory Care

2 Credits, 2 Contact Hours
2 lecture periods 0 lab periods

Introduction to the field of respiratory care and to the skills for being a successful, confident college student. Includes study strategies, college resources, time management, life choices, respiratory care practice settings, elements of effective team dynamics, communication with diverse populations, and ethical decision making and professional responsibility.

Corequisite(s): RTH 156  
Information: Students mus meet all pre-admission requirements for the PCC Respiratory Therapy Program and receive final approval to register for this course. Please see a program advisor.
  

1. Identify and apply appropriate study strategies to successfully complete course assignments and exams.
2. Locate and use relevant in-person and online college resources.
3. Analyze and develop productive time management strategies.
4. Identify and prepare for life choices and goals.
5. Identify and describe the broad variety of Respiratory Therapy practice settings.  
6. Identify and describe skills necessary to function within inter-professional teams.  
7. Demonstrate the ability to communication effectively with diverse populations. 
8. Demonstrate competency in the application of ethical decision-making and professional responsibility.     

1. Study Strategies
   1. Textbook reading approach(es)
   2. Memory and concentration
   3. Attentive listening
   4. Organization of lecture/text material
   5. Note taking system(s)
   6. Test taking strategies
   7. Use of college resources
2. College Resources
   1. College catalog
   2. Schedule of classes
   3. Academic advising
   4. Counseling services
   5. Library
   6. PCC online resources
   7. MyPima
   8. Student handbook
   9. Academic Computer Commons
   10. Financial aid

1. Time Management
   1. Personal analysis
   2. Creating a realistic balance
   3. Procrastination
   4. Using calendars, schedules, to-do lists, etc.
2. Life Choices
   1. Goals - academic, career, personal
   2. Level of commitment and motivation
   3. Growth mindset - emotional, intellectual, and personal
3. Respiratory Care Practice Settings
   1. Acute-care
   2. Long-term care
   3. Home care
   4. Outpatient clinic settings
   5. Case management
   6. Public health and research
4. Elements of Effective High-Performance Team Dynamics
   1. Roles
   2. What to communicate
   3. How to communicate
5. Communicate Effectively with Diverse Populations
   1. Caring for the elderly in a multicultural society
   2. American Association of Respiratory Care (AARC) position statements on cultural diversity
   3. Cultural and ethnic considerations of respiratory practice
6. Ethical Decision Making and Professional Responsibility
   1. Making sound ethical decisions in practice
   2. American Association of Respiratory Care (AARC) statement of ethics and professional conduct  
   3. State licensure standards of practice and responsibilities  

RTH 112 - Respiratory Physiology

1. Relate anatomical structures of the respiratory and renal systems to their functions.
2. Discuss the processes of ventilation, the diffusion of pulmonary gases, and measurements made to determine the effectiveness of ventilation.
3. Explain the process of circulation and measurements made to determine the effectiveness of the heart as a pump.
4. Discuss oxygen and carbon dioxide transport, and analyze acid-base balance.
5. Describe how ventilation/perfusion relationships affect gas exchange.
6. Describe how ventilation is controlled.
7. Describe the effects of aging, exercise, and altitude on the cardiopulmonary system.
8. Apply anatomic and physiologic principles to common clinical situations.
9. Use graphs and nomograms in the description of physiology literature.

1. The Anatomy of the Respiratory System
   1. The upper airway
   2. The lower airways
   3. The sites of gas exchange
   4. Pulmonary vascular system
   5. The lymphatic system
   6. Neural control of the lungs
   7. The lungs, mediastinum, pleural membranes, and thorax
2. Ventilation and Diffusion of Pulmonary Gases
   1. Muscles of ventilation
   2. Pressure differences across the lungs
   3. Role of the diaphragm in ventilation
   4. Static characteristics of the lungs
   5. Dynamic characteristics of the lungs
   6. Ventilatory patterns
   7. Gas laws and equations
   8. Perfusion and diffusion limited gases
3. The Circulatory System
   1. Blood
   2. The heart
   3. The pulmonary and systemic vascular systems
   4. The cardiac cycle
   5. The distribution of pulmonary blood flow
   6. Determinants of cardiac output
4. Oxygen and Carbon Dioxide Transport
   1. Oxygen transport and studies
   2. Oxygen dissociation curve
   3. Tissue hypoxia, cyanosis, and polycythemia
   4. Carbon dioxide transport
   5. Acid-base balance
5. Control of Ventilation
   1. Ventilation – perfusion relationships
   2. The respiratory components of the medulla
   3. Monitoring systems that influence the respiratory components of the medulla
   4. Reflexes that influence ventilation
6. Renal Failure and Its Effects on the Cardiopulmonary System
   1. The kidneys
   2. Urine
   3. Regulation of the electrolyte concentration
   4. Renal failure and cardiopulmonary problems

RTH 121 - Basic Therapeutics

1. Explain the principles related to the appropriate and safe administration of the following basic respiratory care therapeutics:
   1. Medical gas therapy
   2. Oxygen delivery devices
   3. Humidity and aerosol therapy
   4. Hyperinflation therapy
   5. Chest physical therapy
   6. Basic airway management
2. Determine the appropriateness of the prescribed respiratory care plan and recommend modifications where indicated.
3. Select and obtain equipment appropriate to the respiratory care plan.
4. Initiate, administer, monitor, and terminate the above listed therapies.
5. Apply the principles of operation to troubleshooting and correcting malfunctions of equipment used in these procedures.
6. Evaluate the effectiveness of the respiratory care plan based upon the patients’ response to these therapies.

1. Medical Gas Therapy
   1. Production, storage, and delivery of medical gases
   2. Characteristics of medical gases
   3. Oxygen and other medical gas therapies
   4. Oxygen delivery equipment
2. Oxygen Delivery Devices
   1. Clinical indications for oxygen therapy
   2. Identification of low-flow versus high-flow systems
   3. Proper assembly of equipment
   4. Hazards of oxygen therapy
   5. Troubleshooting equipment
3. Humidity and Aerosol Therapy
   1. Clinical indications for humidity and aerosol therapy
   2. General principles of equipment operation
   3. Physics of aerosol delivery
   4. Hazards of aerosol therapy
4. Hyperinflation Therapy
   1. Physiological and clinical application
   2. Incentive spirometry
   3. Intermittent positive pressure breathing
   4. Positive airway pressure therapy
   5. Selecting an approach
5. Chest Physical Therapy
   1. Goals of chest physical therapy
   2. Indications
   3. Patient assessment
   4. Complications and adverse effects of chest physical therapy
6. Basic Airway Management
   1. Indications for artificial airways
   2. Pharyngeal airways
   3. Nasotracheal suctioning
   4. Oropharyngeal suctioning
   5. Complications of suctioning
   6. Equipment needed for suctioning

RTH 121LB - Basic Therapeutics Lab

1. Explain the principles related to the appropriate and safe administration of the following basic respiratory care therapeutics:
   1. Medical gas therapy
   2. Oxygen delivery devices
   3. Humidity and aerosol therapy
   4. Hyperinflation therapy
   5. Chest physical therapy
   6. Basic airway management
2. Determine the appropriateness of the prescribed respiratory care plan and recommend modifications where indicated.
3. Select and obtain equipment appropriate to the respiratory care plan.
4. Initiate, administer, monitor, and terminate the above listed therapies.
5. Apply the principles of operation to troubleshooting and correcting malfunctions of equipment used in these procedures.
6. Evaluate the effectiveness of the respiratory care plan based upon the patients’ response to these therapies.

1. Medical Gas Therapy
   1. Production, storage, and delivery of medical gases
   2. Characteristics of medical gases
   3. Oxygen and other medical gas therapies
   4. Oxygen delivery equipment
2. Oxygen Delivery Devices
   1. Clinical indications for oxygen therapy
   2. Identification of low-flow versus high-flow systems
   3. Proper assembly of equipment
   4. Hazards of oxygen therapy
   5. Troubleshooting equipment
3. Humidity and Aerosol Therapy
   1. Clinical indications for humidity and aerosol therapy
   2. General principles of equipment operation
   3. Physics of aerosol delivery
   4. Hazards of aerosol therapy
4. Hyperinflation Therapy
   1. Physiological and clinical application
   2. Incentive spirometry
   3. Intermittent positive pressure breathing
   4. Positive airway pressure therapy
   5. Selecting an approach
5. Chest Physical Therapy
   1. Goals of chest physical therapy
   2. Indications
   3. Patient assessment
   4. Complications and adverse effects of chest physical therapy
6. Basic Airway Management
   1. Indications for artificial airways
   2. Pharyngeal airways
   3. Nasotracheal suctioning
   4. Oropharyngeal suctioning
   5. Complications of suctioning
   6. Equipment needed for suctioning

RTH 123 - Basic Assessment and Monitoring

1. Integrate the techniques of patient interviewing, collection of the respiratory history, and respiratory physical examination to assess the patient for the presence of pulmonary pathology and once delivered, the effectiveness of respiratory therapy.
2. Assess various types of clinical lab studies, skin testing, and sputum collection for the purpose of diagnosis and treatment in the cardiopulmonary patient.
3. Perform respiratory care procedures that utilize various methods for analyzing oxygenation and ventilation of the patient, and interpret the significance of these results as they relate to patient care.
4. Explain the methods used in pulmonary function testing, perform bedside spirometry, and interpret the significance of the results obtained as they relate to the clinical pathology of the patient.
5. Discuss the physics related to chest radiographs, the use of standard and special views in the assessment of the patient with pulmonary disease, and correlated common pathologic abnormalities seen on chest x-ray films with their related clinical findings.
6. Identify basic and life-threatening electrocardiogram patterns that may occur during care of patients with cardiopulmonary disease.

1. Bedside Respiratory Assessment
   1. How to communicate with the patient
   2. Interviewing skills
   3. Respiratory history of the patient
   4. Vital signs
   5. Techniques of physical examination
   6. Physical signs of respiratory disease
2. Clinical Laboratory Studies and Assessment
   1. Hematology
   2. Chemistry
   3. Microbiology
   4. Pleural fluid examination
   5. Urinalysis
   6. Histology/cytology
   7. Skin testing
3. Assessment of Oxygenation and Ventilation
   1. Non-invasive monitoring of oxygenation and oxygen delivery – pulse oximetry
   2. Non-invasive monitoring of ventilation - capnography
   3. Arterial blood gas sampling, analysis, and interpretation
4. Basic Assessment of Pulmonary Function Measurements
   1. Indications for pulmonary function testing
   2. Normal values for various tests
   3. Basic equipment utilized during testing
   4. Clinical interpretation of test results
5. Basic Assessment and Clinical Application of Chest Radiography
   1. Indications for chest radiography
   2. Procedures for standard and special views
   3. Basic evaluation of the chest radiograph
   4. Basic interpretation of the chest radiograph
6. Basic Interpretation of Electrocardiogram Tracings
   1. Review of cardiac anatomy and physiology
   2. Indications for electrocardiogram tracings
   3. Electrocardiogram waves
   4. Electrocardiogram leads
   5. Identification of common normal and abnormal heart rhythms
   6. Clinical significance and treatment of common normal and abnormal heart rhythms

RTH 123LB - Basic Assessment and Monitoring Lab

1. Integrate the techniques of patient interviewing, collection of the respiratory history, and respiratory physical examination to assess the patient for the presence of pulmonary pathology and once delivered, the effectiveness of respiratory therapy.
2. Assess various types of clinical lab studies, skin testing, and sputum collection for the purpose of diagnosis and treatment in the cardiopulmonary patient.
3. Perform respiratory care procedures that utilize various methods for analyzing oxygenation and ventilation of the patient, and interpret the significance of these results as they relate to patient care.
4. Explain the methods used in pulmonary function testing, perform bedside spirometry, and interpret the significance of the results obtained as they relate to the clinical pathology of the patient.
5. Discuss the physics related to chest radiographs, the use of standard and special views in the assessment of the patient with pulmonary disease, and correlated common pathologic abnormalities seen on chest x-ray films with their related clinical findings.
6. Identify basic and life-threatening electrocardiogram patterns that may occur during care of patients with cardiopulmonary disease.

1. Bedside Respiratory Assessment
   1. How to communicate with the patient
   2. Interviewing skills
   3. Respiratory history of the patient
   4. Vital signs
   5. Techniques of physical examination
   6. Physical signs of respiratory disease
2. Clinical Laboratory Studies and Assessment
   1. Hematology
   2. Chemistry
   3. Microbiology
   4. Pleural fluid examination
   5. Urinalysis
   6. Histology/cytology
   7. Skin testing
3. Assessment of Oxygenation and Ventilation
   1. Non-invasive monitoring of oxygenation and oxygen delivery – pulse oximetry
   2. Non-invasive monitoring of ventilation - capnography
   3. Arterial blood gas sampling, analysis, and interpretation
4. Basic Assessment of Pulmonary Function Measurements
   1. Indications for pulmonary function testing
   2. Normal values for various tests
   3. Basic equipment utilized during testing
   4. Clinical interpretation of test results
5. Basic Assessment and Clinical Application of Chest Radiography
   1. Indications for chest radiography
   2. Procedures for standard and special views
   3. Basic evaluation of the chest radiograph
   4. Basic interpretation of the chest radiograph
6. Basic Interpretation of Electrocardiogram Tracings
   1. Review of cardiac anatomy and physiology
   2. Indications for electrocardiogram tracings
   3. Electrocardiogram waves
   4. Electrocardiogram leads
   5. Identification of common normal and abnormal heart rhythms
   6. Clinical significance and treatment of common normal and abnormal heart rhythms

RTH 124 - Pharmacology for Respiratory Care

1. Explain general principles of drug therapy, including receptor theory of drug actions and methods of administration.
2. Perform calculations of drug dosages.
3. Describe the autonomic nervous system control of airway smooth muscle.
4. Describe the alpha and beta receptor pathway theory.
5. Describe the appropriate dosage ranges and duration of effects of drugs used via the inhalation route.
6. Describe appropriate medications to treat specific cardiopulmonary disorders.
7. Describe methods employed in evaluating and monitoring the effects of drugs delivered via the inhalation route.
8. Describe the effects, contraindications, and hazards associated with drugs commonly administered by respiratory care practitioners.
9. Describe the effects, contraindications, and hazards associated with drugs administered for the control of respiratory muscles and used in the treatment of disorders associated with the cardiorespiratory system.
10. Evaluate the effectiveness of the respiratory prescription based upon the patient’s response therapy.

1. General Principles of Pharmacology
   1. Fundamental terms
   2. Legislation affecting drugs
   3. Naming drugs
   4. Process of drug approval
   5. Sources of drug information
   6. Principles of drug action
   7. Advantages and disadvantages of the different routes of drug administration
2. Drug Dose Calculations
   1. Systems of measurement used in drug dosage
   2. Calculating dosages from prepared strength liquids, tablets, and capsules
   3. Calculating dosages from percentage-strength solutions
   4. Calculating pediatric drug dosages
3. Central and Peripheral Nervous Systems
   1. Autonomic nervous system
   2. Parasympathetic branch
   3. Sympathetic branch
   4. Autonomic control of the lung
4. Bronchodilators
   1. Sympathomimetics
   2. Parasympatholytics
   3. Methylxanthines
5. Drugs Used to Control Airway Mucus and Edema
   1. Mucus-controlling agents
   2. Surfactant agents
   3. Corticosteroids
   4. Antiasthmatics
   5. Anti-Infective agents
6. Drugs Used in the Management of Ventilator Patients and Patients with Cardiorespiratory Disorders
   1. Skeletal muscle relaxants
   2. Drugs affecting the central nervous system
   3. Cardiovascular agents
   4. Diuretic agents

RTH 135LC - Clinical Procedures I

1. Follow departmental policies and procedures for both reporting and medical record data entry.
2. Utilize a medical record to retrieve patient care information.
3. Utilize universal precautions and infection control procedures to provide respiratory care in a safe manner for both the patient and the health care worker.
4. Demonstrate how to setup, administer, monitor, maintain, and discontinue medical gas therapy on adult floor patients requiring basic respiratory care.
5. Verify patient orders, setup, administer, monitor, maintain, and discontinue aerosol and humidity therapy, IPPB therapy, incentive spirometry, small volume nebulizer therapy, chest physiotherapy, basic airway management therapy, and medical gas therapy.
6. Evaluate the appropriateness and effects of the basic respiratory therapeutic procedures.
7. Effectively communicate with patients, families, physicians, and other health care providers.
8. Perform basic techniques of cardiopulmonary resuscitation and use of advanced adjunctive equipment when indicated.
9. Perform arterial blood gas puncture procedure, analysis, and interpretation.
10. Demonstrate a comprehensive understanding of patient case management.

1. Clinical Site Orientation
   1. Hospitality and Respiratory Department policies and protocols
   2. Review hospital safety procedures
   3. Use of electronic medical record to retrieve orders, document, and review patient information
2. Infection Control Procedures
   1. Universal precautions
   2. Medical asepsis
   3. Equipment disinfection and processing
3. Basic Respiratory Care Procedures
   1. Medical Gas Therapy
   2. Aerosol and Humidity Therapy
   3. Hyperinflation Therapy
   4. Chest Physiotherapy
4. Emergency Respiratory Care Procedures
   1. Airway management
   2. Arterial Blood Gas Puncture
   3. Arterial Blood Gas analysis
   4. Basic Cardiopulmonary resuscitation procedures
5. Patient Care Management
   1. Patient care plans
   2. Case Study Presentation

RTH 156 - Cardiopulmonary Diseases I

1. Describe anatomic alterations of various lung pathologies.
2. Describe various causes, predisposing conditions and common co-morbidities of lung pathologies.
3. Identify clinical manifestations that develop as a result of pathophysiologic mechanisms.
4. Gather clinical data, formulate a respiratory assessment and develop an effective treatment plan.
5. Use the Internet to research, critically evaluate, and present a cardiopulmonary related topic.

1. Obstructive Lung Disease
   1. Chronic bronchitis
   2. Emphysema
   3. Asthma
   4. Bronchiectasis
2. Infectious Pulmonary Diseases
   1. Vocabulary of infectious diseases
   2. Pneumonia
   3. Lung abscess
   4. Tuberculosis
   5. Fungal diseases
3. Pulmonary Vascular Diseases
   1.  Pulmonary edema
   2.  Pulmonary embolism
   3. Pulmonary hypertension
4. Diseases of the Pleura and Chest Wall
   1.  Pleural effusion and empyema
   2. Flail chest
   3. Pneumothorax
   4.  Kyphoscoliosis
5. Diffuse Alveolar Disease and Other Pulmonary Topics
   1. Acute respiratory distress syndrome
   2. Near drowning/wet drowning
   3. Smoke inhalation and thermal injuries
6. Neurologic Disorders
   1. Guillain-Barré Syndrome
   2. Myasthenia gravis
7. Environmental and Neoplastic Lung Diseases
   1. Interstitial lung diseases
   2. Cancer of the lung

RTH 162 - Principles of Mechanical Ventilation

1. Distinguish and use basic terms and concepts of mechanical ventilation.
2. Identify and apply the physical aspects of mechanical ventilation in equipment and patient care.
3. Determine the need for non-invasive positive pressure ventilation versus invasive mechanical ventilation.
4. Select modes and initial settings for mechanical ventilation of the adult based on patient pathology and situation.
5. Perform advanced level physical assessments on critically ill patients to include the patient’s airway, breathing and circulation, interpreting the findings and utilizing critical thinking skills to make correct respiratory care decisions based on these findings.
6. Perform advanced respiratory assessment monitoring in the intensive care unit to assess ventilatory status, evaluate oxygenation and oxygen transport, interpret and utilize critical thinking skills to make correct respiratory care decisions based on these findings.
7. Interpret basic waveform graphics, recognize problems, troubleshoot the issues, and apply decision making skills to alleviate the problem.

1. Establishing the Need for Mechanical Ventilation
2. Mechanical Ventilation
   1. Non-invasive
   2. Invasive
3. The Physiologic Basis of Ventilatory Support
   1. Respiratory distress versus respiratory failure
   2. Oxygenation versus ventilation issues
4. Physical Principles of Positive Pressure Ventilation
   1. Power and controls
   2. Variables (pressure versus volume)
   3. Modes of ventilation
   4. Output
   5. Alarms
5. Physical Assessment of the Critically Ill Patient
   1. Airway assessment
   2. Breathing assessment
   3. Circulatory assessment through non-invasive means
6. Interpreting Basic Waveform Graphics
   1. Scalar versus flow-volume
   2. Troubleshooting and decision making
7. Respiratory Monitoring in the Intensive Care Unit
   1. Ventilatory assessment and related monitoring equipment
   2. Oxygenation assessment, estimates of oxygen transport, and related monitoring equipment
   3. Calculations

RTH 241 - Application of Mechanical Venilation

1. Recognize special airways for ventilation.
2. Describe indications for initiation of mechanical ventilation.
3. Explain weaning parameters and methods of liberation from mechanical ventilation.
4. Interpret, apply, and manage advanced modes of mechanical ventilation.
5. Describe mechanical ventilation in the nontraditional setting.
6. Identify characteristics of ventilator waveforms.

1. Special Airways for Management
   1. Oropharyngeal and nasopharyngeal
   2. Esophageal obturators
   3. Laryngeal mask airway
   4. Esophageal-tracheal combitube
   5. Double-lumen endobronchial tube
2. Airway Management in Mechanical Ventilation
   1. Indications for intubation
   2. Characteristics of endotracheal and tracheostomy tubes
   3. Management of endotracheal and tracheostomy tubes
   4. Management of cuff pressures
   5. Speaking valves
   6. Predictors and procedures for planned and unplanned extubation
3. Initiation of Mechanical Ventilation
   1. Goals of mechanical ventilation
   2. Primary indicators for mechanical ventilation
   3. Contraindications for mechanical ventilation
   4. Initial ventilator settings
   5. Initial ventilator alarm settings
   6. Hazards and complications of mechanical ventilation
4. Weaning from Mechanical Ventilation
   1. Weaning success, in progress, and failure
   2. Weaning criteria for assessing ventilation, oxygenation, and pulmonary measurements
   3. Rapid shallow breathing index
   4. Weaning procedures
   5. Indicators and causes of weaning failure
   6. Withholding and withdrawing mechanical ventilation
5. Management of Mechanical Ventilation
   1. Strategies to improve ventilation
   2. Strategies to improve oxygenation
   3. Interpreting arterial blood gases
   4. Troubleshooting ventilator alarms and events
   5. Caring for the ventilator circuit and artificial airway
   6. Fluid, electrolyte balance, and nutrition
   7. Adjunctive management strategies
6. Operating Modes of Mechanical Ventilation
   1. Review of assist/control and synchronized intermittent mandatory ventilation
   2. Mandatory minute ventilation and pressure support ventilation
   3. Adaptive support ventilation and proportional assist ventilation
   4. Volume assured pressure support and pressure-regulated volume control
   5. Adaptive pressure control, volume ventilation plus, and pressure-controlled ventilation
   6. Airway pressure release ventilation, biphasic positive airway pressure, and inverse ration ventilation
   7. Neutrally adjusted ventilator assist and high-frequency oscillatory ventilation
7. Mechanical Ventilation in Nontraditional Settings
   1. Indications, contraindications, and equipment selection for mechanical ventilation at home
   2. Mechanical ventilation in a mass casualty setting
   3. Mechanical ventilation in hyperbaric and hypobaric conditions
   4. Portable ventilators at high altitudes
8. Ventilator Waveform Analysis
   1. Waveform characteristics of flow-time, pressure-time, and controlled mandatory ventilation
   2. Waveform characteristics of spontaneous breathing during mechanical ventilation
   3. Effects of flow, circuit and lung characteristics on pressure-time waveform
   4. Waveform characteristics of pressure-controlled ventilation (PCV) vs. volume-controlled ventilation
   5. Waveform characteristics of pressure-supported ventilation
   6. Changing lung characteristics on PCV waveforms
   7. Identifying patient-ventilator dyssynchrony, increased airway resistance, loss of elastic recoil, decreased lung compliance, gas trapping, and circuit leaks
   8. Pressure-volume and flow-volume loops

RTH 241LB - Application of Mechanical Ventilation Lab

1. Recognize special airways for ventilation.
2. Describe indications for initiation of mechanical ventilation.
3. Explain weaning parameters and methods of liberation from mechanical ventilation.
4. Interpret, apply, and manage advanced modes of mechanical ventilation.
5. Describe mechanical ventilation in the nontraditional setting.
6. Identify characteristics of ventilator waveforms.

1. Special Airways for Management
   1. Oropharyngeal and nasopharyngeal
   2. Esophageal obturators
   3. Laryngeal mask airway
   4. Esophageal-tracheal combitube
   5. Double-lumen endobronchial tube
2. Airway Management in Mechanical Ventilation
   1. Indications for intubation
   2. Characteristics of endotracheal and tracheostomy tubes
   3. Management of endotracheal and tracheostomy tubes
   4. Management of cuff pressures
   5. Speaking valves
   6. Predictors and procedures for planned and unplanned extubation
3. Initiation of Mechanical Ventilation
   1. Goals of mechanical ventilation
   2. Primary indicators for mechanical ventilation
   3. Contraindications for mechanical ventilation
   4. Initial ventilator settings
   5. Initial ventilator alarm settings
   6. Hazards and complications of mechanical ventilation
4. Weaning from Mechanical Ventilation
   1. Weaning success, in progress, and failure
   2. Weaning criteria for assessing ventilation, oxygenation, and pulmonary measurements
   3. Rapid shallow breathing index
   4. Weaning procedures
   5. Indicators and causes of weaning failure
   6. Withholding and withdrawing mechanical ventilation
5. Management of Mechanical Ventilation
   1. Strategies to improve ventilation
   2. Strategies to improve oxygenation
   3. Interpreting arterial blood gases
   4. Troubleshooting ventilator alarms and events
   5. Caring for the ventilator circuit and artificial airway
   6. Fluid, electrolyte balance, and nutrition
   7. Adjunctive management strategies
6. Operating Modes of Mechanical Ventilation
   1. Review of assist/control and synchronized intermittent mandatory ventilation
   2. Mandatory minute ventilation and pressure support ventilation
   3. Adaptive support ventilation and proportional assist ventilation
   4. Volume assured pressure support and pressure-regulated volume control
   5. Adaptive pressure control, volume ventilation plus, and pressure-controlled ventilation
   6. Airway pressure release ventilation, biphasic positive airway pressure, and inverse ration ventilation
   7. Neutrally adjusted ventilator assist and high-frequency oscillatory ventilation
7. Mechanical Ventilation in Nontraditional Settings
   1. Indications, contraindications, and equipment selection for mechanical ventilation at home
   2. Mechanical ventilation in a mass casualty setting
   3. Mechanical ventilation in hyperbaric and hypobaric conditions
   4. Portable ventilators at high altitudes
8. Ventilator Waveform Analysis
   1. Waveform characteristics of flow-time, pressure-time, and controlled mandatory ventilation
   2. Waveform characteristics of spontaneous breathing during mechanical ventilation
   3. Effects of flow, circuit and lung characteristics on pressure-time waveform
   4. Waveform characteristics of pressure-controlled ventilation (PCV) vs. volume-controlled ventilation
   5. Waveform characteristics of pressure-supported ventilation
   6. Changing lung characteristics on PCV waveforms
   7. Identifying patient-ventilator dyssynchrony, increased airway resistance, loss of elastic recoil, decreased lung compliance, gas trapping, and circuit leaks
   8. Pressure-volume and flow-volume loops

RTH 243 - Advanced Assessment and Monitoring

1. Assess cardiac output and heart function and identify methods of measuring cardiac output.
2. Explain and relate invasively monitored hemodynamic pressures to their clinical application in the care of the critically ill patient and utilize critical thinking skills to make correct respiratory care decisions based on these findings.
3. Identify and assess sleep-related breathing disorders and utilize critical thinking skills to make correct respiratory care decisions based on these findings.
4. Describe the inter-dependence of respiration and nutrition and assess respiratory related factors in nutritional assessment.
5. Describe the causes of various advanced cardiac arrhythmias and the treatment procedures used in each.
6. Explain the different methods that can be used to perform a cardiac stress test.
7. Explain the use of bronchoscopy and the role of the respiratory therapist during the assessment procedure.

1. Cardiac Output Assessment
   1. Measurement of cardiac output and heart function
   2. Determinants of heart function
   3. Methods of measuring cardiac output
2. Invasive Hemodynamic Monitoring
   1. Arterial pressure monitoring
   2. Central venous pressure monitoring
   3. Pulmonary artery pressure monitoring
   4. Clinical applications of hemodynamic monitoring
   5. Technical considerations for invasive hemodynamic monitoring
3. Assessment of Sleep-Related Breathing Disorders
   1. Normal sleep stages
   2. Sleep disorders and sleep apnea
   3. Assessment of sleep-related breathing disorders
   4. Polysomnography basics
4. Nutritional Assessment and the Respiratory System
   1. Inter-dependence of respiration and nutrition
   2. Metabolism
   3. Methods of meeting nutritional requirements
   4. Nutritional assessment
5. Advanced Cardiac Arrhythmia Interpretation
   1. Review of normal rhythms
   2. Axis deviation
   3. Atrial dysrhythmias, causes and treatments
   4. Junctional dysrhythmias, causes and treatment
   5. Ventricle dysrhythmias, causes and treatment
   6. Conduction abnormalities, causes and treatments
6. Cardiac Stress Testing
   1. Treadmill stress test
   2. Nuclear treadmill stress testing
   3. Non-exercise nuclear stress testing
   4. Value of three dimensional echocardiogram in heart testing
7. Bronchoscopy
   1. Indications for bronchoscopy
   2. Procedure and equipment required
   3. Performance of therapeutic/diagnostic procedure
   4. Role of the respiratory therapist
   5. Assessment of critical findings

RTH 243LB - Advanced Assessment and Monitoring Lab

1. Assess cardiac output and heart function and identify methods of measuring cardiac output.
2. Explain and relate invasively monitored hemodynamic pressures to their clinical application in the care of the critically ill patient and utilize critical thinking skills to make correct respiratory care decisions based on these findings.
3. Identify and assess sleep-related breathing disorders and utilize critical thinking skills to make correct respiratory care decisions based on these findings.
4. Describe the inter-dependence of respiration and nutrition and assess respiratory related factors in nutritional assessment.
5. Describe the causes of various advanced cardiac arrhythmias and the treatment procedures used in each.
6. Explain the different methods that can be used to perform a cardiac stress test.
7. Explain the use of bronchoscopy and the role of the respiratory therapist during the assessment procedure.

1. Cardiac Output Assessment
   1. Measurement of cardiac output and heart function
   2. Determinants of heart function
   3. Methods of measuring cardiac output
2. Invasive Hemodynamic Monitoring
   1. Arterial pressure monitoring
   2. Central venous pressure monitoring
   3. Pulmonary artery pressure monitoring
   4. Clinical applications of hemodynamic monitoring
   5. Technical considerations for invasive hemodynamic monitoring
3. Assessment of Sleep-Related Breathing Disorders
   1. Normal sleep stages
   2. Sleep disorders and sleep apnea
   3. Assessment of sleep-related breathing disorders
   4. Polysomnography basics
4. Nutritional Assessment and the Respiratory System
   1. Inter-dependence of respiration and nutrition
   2. Metabolism
   3. Methods of meeting nutritional requirements
   4. Nutritional assessment
5. Advanced Cardiac Arrhythmia Interpretation
   1. Review of normal rhythms
   2. Axis deviation
   3. Atrial dysrhythmias, causes and treatments
   4. Junctional dysrhythmias, causes and treatment
   5. Ventricle dysrhythmias, causes and treatment
   6. Conduction abnormalities, causes and treatments
6. Cardiac Stress Testing
   1. Treadmill stress test
   2. Nuclear treadmill stress testing
   3. Non-exercise nuclear stress testing
   4. Value of three dimensional echocardiogram in heart testing
7. Bronchoscopy
   1. Indications for bronchoscopy
   2. Procedure and equipment required
   3. Performance of therapeutic/diagnostic procedure
   4. Role of the respiratory therapist
   5. Assessment of critical findings

RTH 245LC - Clinical Procedures II

1. Perform advanced clinical physical assessment on critically ill patients to include the patient’s airway, breathing and circulation, interpret the findings, and utilize critical thinking skills to make correct respiratory care decisions based on the findings.
2. Perform advanced respiratory assessment monitoring in the intensive care unit to assess ventilatory status, evaluate oxygenation and oxygen transport, interpret the findings, and utilize critical thinking skills to make correct respiratory care decisions based on the findings.
3. Perform appropriate airway management procedures to include oro/naso-artificial airway suctioning, artificial airway care, cuff pressure determinations, manual ventilation, and extubation.
4. Set up, calibrate, maintain, monitor, and discontinue ventilatory support equipment and monitors.
5. Respond using data gathered, to patient care needs from measurements or events observed during ventilatory support or in the care of the critically ill adult patient.
6. Assess cardiac output, pump function, and other invasively monitored hemodynamic pressures and utilize critical thinking skills to make correct cardiorespiratory care decisions based on these findings.
7. Observe and evaluate procedures in the following areas: pulmonary function lab, bronchoscopy, radiology, medical conferences, cardiac care, hyperbaric oxygen therapy, and various respiratory care delivery environments.
8. Utilize information from the medical record and previous classroom learning to complete a case study presentation.

1. Clinical Assessment of the Critical Care Patient (Weekly Patient Care Plans)
2. Advanced Airway Management
3. Advanced Respiratory Assessment Monitoring
4. Adult Mechanical Ventilation
5. Transport of the Critically Ill Patient
6. Care Decisions in Mechanically Ventilated Adult Patients
7. Hemodynamic Assessment of the Critically Ill Patient
8. Observation In Various Respiratory Care Delivery Environments
9. Interaction With Medical Director and Case Study Presentation

RTH 251 - Neonatal and Pediatric Specialty Therapeutics

1. Utilize critical thinking skills to determine the need for, monitor the patient, evaluate the effectiveness of, and perform basic and advanced respiratory care procedures on neonatal and pediatric patients.
2. Perform pediatric advanced life support (PALS), neonatal resuscitation procedures, mock code situations, cardiopulmonary medication administration, and mechanical ventilation.
3. Determine which patients would benefit from pulmonary rehabilitation, establish patient learning needs, develop lesson plans for patient education, prescribe an exercise testing and training program, and evaluate the effectiveness of the training program.
4. Determine which patients would benefit from respiratory home care, what equipment and training they need, how they are monitored in the home, and describe how homecare companies operate.

1. Pediatric Advanced Life Support (PALS)
   1. Core concepts
   2. Application and practice of core concepts
   3. Written assessment
   4. Core case scenario assessment
2. Assessment and Monitoring of the Neonatal and Pediatric Patient
   1. Examination and Assessment
   2. Pulmonary Function Testing
   3. Invasive blood gas analysis and cardiovascular monitoring
   4. Noninvasive monitoring
3. Therapeutic Procedures for Treatment of Neonatal and Pediatric Disorders
   1. Oxygen and gas mixtures
   2. Aerosol and Humidity Therapy
   3. Airway management and clearance
   4. Surfactant Therapy
   5. Noninvasive mechanical ventilation
   6. Management of invasive mechanical ventilation
   7. Special procedures ECMO and thoracic organ transplant
4. Pulmonary Rehabilitation
   1. Program structures
   2. Components of rehabilitation
   3. Ventilation retraining
   4. Exercise retraining
5. Home Care
   1. The home care team
   2. Financial concerns of home care
   3. Home ventilator care
   4. Tracheotomy care in the home setting
   5. Home care companies

RTH 251LB - Neonatal and Pediatric Specialty Therapeutics Lab

1. Utilize critical thinking skills to determine the need for, monitor the patient, evaluate the effectiveness of, and perform basic and advanced respiratory care procedures on neonatal and pediatric patients.
2. Perform pediatric advanced life support (PALS), neonatal resuscitation procedures, mock code situations, cardiopulmonary medication administration, and mechanical ventilation.
3. Determine which patients would benefit from pulmonary rehabilitation, establish patient learning needs, develop lesson plans for patient education, prescribe an exercise testing and training program, and evaluate the effectiveness of the training program.
4. Determine which patients would benefit from respiratory home care, what equipment and training they need, how they are monitored in the home, and describe how homecare companies operate.

1. Pediatric Advanced Life Support (PALS)
   1. Core concepts
   2. Application and practice of core concepts
   3. Written assessment
   4. Core case scenario assessment
2. Assessment and Monitoring of the Neonatal and Pediatric Patient
   1. Examination and Assessment
   2. Pulmonary Function Testing
   3. Invasive blood gas analysis and cardiovascular monitoring
   4. Noninvasive monitoring
3. Therapeutic Procedures for Treatment of Neonatal and Pediatric Disorders
   1. Oxygen and gas mixtures
   2. Aerosol and Humidity Therapy
   3. Airway Management and Clearance
   4. Surfactant Therapy
   5. Noninvasive mechanical ventilation
   6. Management of invasive mechanical ventilation
   7. Special procedures ECMO and thoracic organ transplant
4. Pulmonary Rehabilitation
   1. Program structures
   2. Components of rehabilitation
   3. Ventilation retraining
   4. Exercise retraining
5. Home Care
   1. The home care team
   2. Financial concerns of home care
   3. Home ventilator care
   4. Tracheotomy care in the home setting
   5. Home care companies

RTH 255LC - Clinical Procedures III

1. Perform clinical physical assessment on neonatal/pediatric patients to include the patient’s airway, breathing, and circulation, and interpret the findings and utilize critical thinking skills to make correct respiratory care decisions based on the findings.
2. Perform basic respiratory therapeutics on pediatric and neonatal patients.
3. Perform respiratory assessment monitoring in the neonatal and pediatric intensive care units to assess ventilatory status, evaluate oxygenation and oxygen transport, and interpret the findings and utilize critical thinking skills to make correct respiratory care decisions based on these findings.
4. Perform appropriate airway management procedures to include oro/naso-artificial airway suctioning, artificial airway care, cuff pressure determinations, manual ventilation, and extubation on neonatal and pediatric patients.
5. Set up, calibrate, maintain, monitor, and discontinue neonatal/pediatric ventilatory support equipment and monitors.
6. Respond to patient care needs from measurements or events observed during ventilatory support or in the care of the critically ill adult and neonatal/pediatric patient.
7. Perform respiratory care procedures, patient education, and pulmonary rehabilitation and develop plans of care for patients in specialized environments.
8. Utilize information from the medical record, and previous classroom learning to complete a case study presentation.

1. Clinical Assessment of the Neonatal/Pediatric Patient
2. Advanced Airway Management of the Neonatal/Pediatric Patient
3. Advanced Respiratory Assessment Monitoring of the Neonatal/Pediatric Patient
4. Adult and Neonatal/Pediatric Mechanical Ventilation
5. Care Decisions in Mechanically Ventilated Adult and Neonatal/Pediatric Patients
6. Observation and Participation in Various Respiratory Care Delivery Environments
7. Cast Study Presentation Preparation

RTH 256 - Cardiopulmonary Diseases II

1. Describe patient assessment in cardiopulmonary or cardiovascular disorders.
2. Describe what clinical manifestations would be exhibited in common neonatal, and pediatric cardiopulmonary and cardiovascular disorders.
3. Identify the pathophysiologic basis for the clinical manifestations associated with cardiopulmonary and cardiovascular disorders.
4. Identify the etiology for the various cardiopulmonary and cardiovascular disorders.
5. Identify the appropriate diagnostic studies necessary to assist in the evaluation of a patient with a cardiopulmonary or cardiovascular disorder.
6. Develop a respiratory care plan based on the information obtained through assessment of the patient.
7. Assess if the respiratory care plan has provided the patient with a cardiopulmonary or cardiovascular disorder, the desired outcome.

1. Neonatal Development
   1. Assessment of the Developing Fetus and the Neonate
   2. Fetal Assessment
   3. Neonatal Assessment
2. Cardiovascular Disorders and Congenital Anomalies of the Newborn
   1. Non-Congenital Cardiovascular Disorders of the Newborn
   2. Congenital Cardiovascular Disorders of the Newborn
   3. Congenital Anomalies of the Newborn
3. Cardiopulmonary Disorders of the Newborn
   1. Respiratory Distress Syndrome
   2. Transient Tachypnea of the Newborn
   3. Meconium Aspiration
   4. Bronchopulmonary Dysplasia
4. Pediatric Cardiopulmonary Disorders
   1. Cystic Fibrosis
   2. Laryngotracheobronchitis (Croup)
   3. Epiglottitis
   4. Bronchiolitis
   5. Diaphragmatic Hernia

RTH 257LB - Clinical Applications and Professional Development

1. Using therapist driven protocols and clinical practice guidelines, determine appropriate care for individual patient scenarios, evaluate the effectiveness of treatment, and make modifications to care.
2. Examine the national board matrix for respiratory care regarding expectations for the entry level and advanced practitioners level therapist exams in preparing for the examinations.
3. Utilizing the Internet, connect with Applied Measurement Professionals, Inc. and successfully complete the computerized version of the entry level self-assessment exam.
4. Utilizing the Internet, connect with Applied Measurement Professionals, Inc. and experience the written registry and clinical simulation self-assessment examinations.
5. Prepare a professional resume for an entry level respiratory therapist position.
6. Interact with the executive of the Board of Examiners for Respiratory Care in the state of Arizona to apply for licensure and understand the rules and regulations governing the practice of respiratory care in the state of Arizona.
7. Perform community service learning projects regarding respiratory care.

1. Application of Therapist Drive Protocols and Clinical Practice Guidelines
2. Resume Preparation
3. Computer-Based Entry Level Respiratory Care Exam Matrix, Review, and Self-Assessment Exam
4. Computer-Based Written Registry and Clinical Simulation Exam Matrix, Review, and Self-Assessment Exams
5. Licensure Requirements
6. Community Service Project
7. Professionalism Reports