Egan's Fundamentals of Respiratory Care

Egan's Fundamentals of Respiratory Care

12th Edition - October 22, 2019

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  • Authors: Robert Kacmarek, James Stoller, Al Heuer
  • eBook ISBN: 9780323597982
  • Paperback ISBN: 9780323811224
  • Paperback ISBN: 9780323811217

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Description

Learn the principles and skills you'll need as a respiratory therapist! Egan’s Fundamentals of Respiratory Care, 12th Edition provides a solid foundation in respiratory care and covers the latest advances in this ever-changing field. Known as "the bible for respiratory care," this text makes it easy to understand the role of the respiratory therapist, the scientific basis for treatment, and clinical applications. Comprehensive chapters correlate to the 2020 NBRC Exam matrices, preparing you for clinical and exam success. Written by noted educators Robert Kacmarek, James Stoller, and Albert Heuer, this edition includes new chapters on heart failure as well as ethics and end-of-life care, plus the latest AARC practice guidelines.

Key Features

  • Updated content reflects the newest advances in respiratory care, preparing you to succeed in today's health care environment.
  • UNIQUE! Mini-Clinis provide case scenarios challenging you to use critical thinking in solving problems encountered during actual patient care.
  • Decision trees developed by hospitals highlight the use of therapist-driven protocols to assess a patient, initiate care, and evaluate outcomes.
  • Rules of Thumb highlight rules, formulas, and key points that are important to clinical practice.
  • Learning objectives align with the summary checklists, highlighting key content at the beginning and at the end of each chapter, and parallel the three areas tested on the 2020 NBRC Exam matrices.
  • Learning resources on the Evolve companion website include an NBRC correlation guide, image collection, lecture notes, Body Spectrum electronic anatomy coloring book, and an English/Spanish glossary.
  • Student workbook provides a practical study guide reflecting this edition of the text, offering numerous case studies, experiments, and hands-on activities. Available separately.
  • Full-color design calls attention to the text’s special features and promotes learning.
  • Glossary includes key terms and definitions needed for learning concepts.

Table of Contents

  • Cover image
  • Title Page
  • Table of Contents
  • Copyright
  • Dedication
  • Contributors
  • Reviewers
  • Preface
  • Organization
  • Features
  • New to This Edition
  • Learning Aids
  • For the Instructor
  • Section I Foundations of Respiratory Care
  • 1 Early History of Respiratory Care
  • Definitions
  • History of Respiratory Medicine and Science
  • Development of the Respiratory Care Profession
  • Professional Organizations and Events
  • Respiratory Care Education
  • Summary Checklist
  • References
  • 2 The Profession of Respiratory Therapy
  • Introduction
  • Scope of Respiratory Care Practice Today
  • Practice Settings
  • Respiratory Therapy Department Composition
  • Designations and Credentials of Respiratory Therapists
  • Professional Respiratory Care Organizations Today
  • Other Organizations Affecting Respiratory Care
  • Respiratory Therapy Education
  • State Licensure
  • Professionalism
  • The Future of Respiratory Care
  • Summary Checklist
  • References
  • 3 Quality, Patient Safety, and Communication
  • Quality Considerations
  • Safety Considerations
  • Communication
  • Conflict and Conflict Resolution
  • Summary Checklist
  • References
  • 4 Principles of Infection Prevention and Control
  • Spread of Infection
  • Strategies for the Prevention of Infection
  • Disinfection and Sterilization
  • Equipment-Handling Procedures
  • Surveillance for Hospital-Acquired Infections
  • Summary Checklist
  • References
  • 5 Ethical and Legal Implications of Practice
  • Philosophical Foundations of Ethics
  • Ethical Dilemmas of Practice
  • Codes of Ethics
  • Ethical Theories and Principles
  • Ethical Viewpoints and Decision-Making
  • Legal Issues Affecting Respiratory Care
  • Interaction of Ethics and the Law
  • Professional Licensure Issues
  • Respiratory Therapists Who Speak Out About Wrongdoing
  • Healthcare and Change
  • Summary Checklist
  • References
  • 6 Physical Principles of Respiratory Care
  • States of Matter
  • Change of State
  • Gas Behavior Under Changing Conditions
  • Fluid Dynamics
  • Summary Checklist
  • References
  • 7 E-Medicine in Respiratory Care
  • The Electronic Health Record and the Electronic Medical Record
  • Applications for Patient Care
  • Informatics and Clinical Decision Support
  • Telehealth and Telemonitoring
  • Sources of Health Information
  • Applications in Healthcare Administration
  • Applications in Training and Education
  • Future of E-Medicine
  • Summary Checklist
  • References
  • 8 Fundamentals of Respiratory Care Research
  • Overview of Respiratory Care Research
  • How to Review and Evaluate the Literature
  • Evaluating the Quality of Research
  • How to Begin Doing Research
  • How to Submit a Paper for Publication
  • Summary
  • Summary Checklist
  • References
  • Section II Applied Anatomy and Physiology
  • 9 The Respiratory System
  • Development of the Respiratory System
  • Transition From Uterine to Extrauterine Life
  • Postnatal Lung Development
  • Respiratory System in the Adult
  • Pulmonary Vascular, Lymphatic, and Nervous Systems
  • Anatomy of the Respiratory Tract
  • Summary Checklist
  • References
  • 10 The Cardiovascular System
  • Functional Anatomy
  • Control of the Cardiovascular System
  • Events of the Cardiac Cycle
  • Summary Checklist
  • References
  • Bibliography
  • 11 Ventilation
  • Mechanics of Ventilation
  • Static Versus Dynamic Mechanics
  • Mechanics of Exhalation
  • Work of Breathing
  • Distribution of Ventilation
  • Efficiency and Effectiveness of Ventilation
  • Summary Checklist
  • References
  • 12 Gas Exchange and Transport
  • Diffusion
  • Variations From Ideal Gas Exchange
  • Oxygen Transport
  • Carbon Dioxide Transport
  • Abnormalities of Gas Exchange and Transport
  • Summary Checklist
  • References
  • 13 Solutions, Body Fluids, and Electrolytes
  • Solutions, Colloids, and Suspensions
  • Electrolytic Activity and Acid-Base Balance
  • Body Fluids and Electrolytes
  • Summary Checklist
  • References
  • 14 Acid–Base Balance
  • Hydrogen Ion Regulation in Body Fluids
  • Acid Excretion
  • Acid-Base Disturbances
  • Clinical Acid-Base States
  • Summary Checklist
  • References
  • 15 Regulation of Breathing
  • Medullary Respiratory Center
  • Pontine Respiratory Centers
  • Reflex Control of Breathing
  • Chemical Control of Breathing
  • Ventilatory Response to Exercise
  • Carbon Dioxide and Cerebral Blood Flow
  • Summary Checklist
  • References
  • Section III Assessment of Respiratory Disorders
  • 16 Bedside Assessment of the Patient
  • Interviewing the Patient and Taking a Medical History
  • Physical Examination
  • Summary Checklist
  • References
  • Bibliography
  • 17 Interpreting Clinical and Laboratory Data
  • Interpreting Clinical Laboratory Tests
  • Microbiology Tests
  • Clinical Application of Laboratory Data
  • Summary Checklist
  • References
  • 18 Interpreting the Electrocardiogram
  • Basic Principles of Electrophysiology
  • Electrocardiogram Procedural Summary
  • Summary Checklist
  • References
  • 19 Analysis and Monitoring of Gas Exchange
  • Invasive Versus Noninvasive Procedures
  • Monitoring Fractional Inspired Oxygen
  • Sampling and Analyzing Blood Gases
  • Blood Gas Monitoring
  • Oximetry
  • Capnometry and Capnography
  • Summary Checklist
  • References
  • 20 Pulmonary Function Testing
  • Pulmonary Function Testing
  • Reference Values and Interpretation of Results
  • Principles of Measurement and Significance
  • Individual Tests and Measurements
  • Interpretation of the Pulmonary Function Report
  • Summary Checklist
  • References
  • 21 Review of Thoracic Imaging
  • Overview of the Chest X-Ray
  • Pleura
  • Lung Parenchyma
  • Mediastinum
  • Summary Checklist
  • References
  • 22 Flexible Bronchoscopy and the Respiratory Therapist
  • Flexible Bronchoscopy
  • Diagnostic Bronchoscopy
  • Therapeutic Bronchoscopy
  • The Role of the Respiratory Therapist in Bronchoscopy
  • Special Considerations for Bronchoscopy During Mechanical Ventilation
  • Physiologic and Mechanical Alterations Associated With Flexible Bronchoscopy in Intubated Patients
  • Emerging Bronchoscopic Interventions
  • Conclusion
  • Summary Checklist
  • References
  • 23 Nutrition Assessment
  • Nutrition Assessment
  • Outcomes of Nutrition Assessment
  • Macronutrients and Energy Requirements
  • General Aspects of Nutrition Support
  • Routes of Administration
  • Nutrition Support in Specific Circumstances
  • Summary Checklist
  • References
  • Section IV Review of Cardiopulmonary Disease
  • 24 Pulmonary Infections
  • Classification
  • Pathogenesis
  • Microbiology
  • Clinical Manifestations
  • Chest X-Ray
  • Risk Factors for Mortality and Assessing the Need for Hospitalization
  • Diagnostic Studies
  • Antimicrobial Therapy
  • Prevention
  • Tuberculosis
  • Role of the Respiratory Therapist in Pulmonary Infections
  • Summary Checklist
  • References
  • 25 Obstructive Lung Disease
  • Chronic Obstructive Pulmonary Disease
  • Asthma
  • Bronchiectasis
  • Role of the Respiratory Therapist in Obstructive Lung Disease
  • Summary Checklist
  • References
  • 26 Interstitial Lung Disease
  • Characteristics of Interstitial Lung Disease
  • Selected Specific Types of Interstitial Lung Disease and Therapies
  • Nonspecific Therapies
  • Summary
  • Role of the Respiratory Therapist in Interstitial Lung Disease
  • Summary Checklist
  • References
  • 27 Pleural Diseases
  • The Pleural Space
  • Pleural Effusions
  • Pneumothorax
  • Role of the Respiratory Therapist in Pleural Diseases
  • Summary Checklist
  • References
  • 28 Pulmonary Vascular Disease
  • Venous Thromboembolic Disease
  • Pulmonary Hypertension
  • Role of the Respiratory Therapist in Pulmonary Vascular Disease
  • Key Points
  • References
  • 29 Acute Respiratory Distress Syndrome
  • Physiology of Pulmonary Edema
  • Definition and Diagnosis
  • Key Features
  • Therapeutic Approach
  • Role of the Respiratory Therapist in Acute Respiratory Distress Syndrome
  • Summary Checklist
  • References
  • 30 Respiratory Management of Trauma, Obesity, Near Drowning, and Burns
  • Life-Threatening Trauma
  • Obesity
  • Near Drowning
  • Burns
  • Summary Checklist
  • References
  • 31 Acute Heart Failure
  • Definition, Epidemiology, and Burden of Care
  • Pathophysiology of Acute Heart Failure
  • Medical Management of Acute Heart Failure
  • Monitoring and Assessment of Cardiac Function
  • Treatment
  • Pharmacotherapy
  • Alternative Interventions (Other Than Pharmacotherapy)
  • Respiratory Support and Monitoring During Acute Heart Failure
  • Summary Checklist
  • References
  • 32 Lung Cancer
  • Epidemiology
  • Classification
  • Pathophysiology
  • Clinical Features
  • Diagnosis
  • Staging
  • Preoperative Evaluation for Lung Resection Surgery
  • Screening
  • Treatment and Outcomes
  • Future Scenario
  • Role of the Respiratory Therapist in Managing Patients With Lung Cancer
  • Summary Checklist
  • References
  • 33 Neuromuscular and Other Diseases of the Chest Wall
  • Pathophysiology and Pulmonary Function Testing
  • Clinical Signs and Symptoms
  • Monitoring and Assessing Patients With Neuromuscular Respiratory Weakness
  • Management of Respiratory Muscle Weakness
  • Specific Neuromuscular Diseases
  • Disorders of the Thoracic Cage
  • The Role of the Respiratory Therapist in Caring for Patients With Neuromuscular Weakness and Other Diseases of the Chest Wall
  • Summary Checklist
  • References
  • 34 Disorders of Sleep
  • Pathophysiology
  • Clinical Features
  • Screening Questionnaires
  • Laboratory Testing
  • Treatment
  • Role of the Respiratory Therapist in Disorders of Sleep
  • Summary Checklist
  • References
  • 35 Neonatal and Pediatric Respiratory Disorders
  • Neonatal Respiratory Disorders
  • Neonatal Resuscitation
  • Pediatric Respiratory Disorders
  • Role of the Respiratory Therapist in Neonatal and Pediatric Respiratory Disorders
  • Summary Checklist
  • References
  • Section V Basic Therapeutics
  • 36 Airway Pharmacology
  • Principles of Pharmacology
  • Adrenergic Bronchodilators
  • Anticholinergic Bronchodilators
  • Mucus-Controlling Agents
  • Inhaled Corticosteroids
  • Nonsteroidal Antiasthma Drugs
  • Aerosolized AntiInfective Agents
  • Inhaled Pulmonary Vasodilators
  • Summary Checklist
  • References
  • 37 Airway Management
  • Suctioning
  • Establishing an Artificial Airway
  • Airway Trauma Associated With Tracheal Tubes
  • Airway Maintenance
  • Extubation or Decannulation
  • Summary Checklist
  • References
  • 38 Emergency Cardiovascular Life Support
  • Causes and Prevention of Sudden Death
  • Basic Life Support
  • Advanced Cardiovascular Life Support
  • Summary Checklist
  • References
  • 39 Humidity and Bland Aerosol Therapy
  • Humidity Therapy
  • Bland Aerosol Therapy
  • Selecting the Appropriate Therapy
  • Summary Checklist
  • References
  • 40 Aerosol Drug Therapy
  • Characteristics of Therapeutic Aerosols
  • Hazards of Aerosol Therapy
  • Aerosol Drug Delivery Systems
  • Assessment-Based Bronchodilator Therapy Protocols
  • Special Considerations
  • Controlling Environmental Contamination
  • Summary Checklist
  • References
  • 41 Storage and Delivery of Medical Gases
  • Characteristics of Medical Gases
  • Storage of Medical Gases
  • Distribution and Regulation of Medical Gases
  • Summary Checklist
  • References
  • 42 Medical Gas Therapy
  • Oxygen Therapy
  • Hyperbaric Oxygen Therapy
  • Other Medical Gas Therapies
  • Summary Checklist
  • References
  • 43 Lung Expansion Therapy
  • Causes and Types of Atelectasis
  • Clinical Signs of Atelectasis
  • Lung Expansion Therapy
  • Initiation of Therapy
  • Selecting an Approach
  • Summary Checklist
  • References
  • 44 Airway Clearance Therapy
  • Physiology of Airway Clearance Therapies
  • General Goals and Indications
  • Determining the Need for Airway Clearance Therapy
  • Airway Clearance Methods
  • Selecting Airway Clearance Techniques
  • Summary Checklist
  • References
  • Section VI Acute and Critical Care
  • 45 Respiratory Failure and the Need for Ventilatory Support
  • Hypoxemic Respiratory Failure (Type I)
  • Hypercapnic Respiratory Failure (Type II)
  • Chronic Respiratory Failure (Type I and Type II)
  • Assessment of Respiratory Fatigue, Weakness, Failure, and Work of Breathing
  • Choosing a Ventilatory Support Strategy for Different Causes of Respiratory Failure
  • Summary Checklist
  • References
  • 46 Mechanical Ventilators
  • How Ventilators Work
  • Identifying Modes of Mechanical Ventilation
  • Comparing Modes of Mechanical Ventilation
  • Types of Ventilators
  • Summary Checklist
  • References
  • 47 Physiology of Ventilatory Support
  • Pressure and Pressure Gradients
  • Effects of Mechanical Ventilation on Ventilation
  • Effects of Mechanical Ventilation on Oxygenation
  • Effects of Positive Pressure Mechanical Ventilation on Lung Mechanics
  • Minimizing Adverse Pulmonary Effects of Positive Pressure Mechanical Ventilation
  • Physiologic Effects of Ventilatory Modes
  • Cardiovascular Effects of Positive Pressure Mechanical Ventilation
  • Minimizing Cardiovascular Effects of Positive Pressure Mechanical Ventilation
  • Effects of Positive Pressure Mechanical Ventilation on Other Body Systems (Box 47.2)
  • Complications of Mechanical Ventilation
  • Summary Checklist
  • References
  • 48 Patient–Ventilator Interactions
  • Effects of Poor Patient–Ventilator Interaction on Outcome
  • Causes of Poor Patient–Ventilator Interactions
  • Variables Controlled During Mechanical Ventilation
  • Types of Asynchrony
  • Causes of Asynchrony
  • Flow Asynchrony
  • Trigger Asynchrony
  • Cycle Asynchrony
  • Mode Asynchrony
  • Patient–Ventilator Assessment
  • Summary Checklist
  • References
  • 49 Initiating and Adjusting Invasive Ventilatory Support
  • Goals of Mechanical Ventilation
  • Ventilator Initiation
  • Initial Ventilator Settings
  • Adjusting Ventilatory Support
  • Oxygenation
  • Ventilation
  • Summary Checklist
  • References
  • 50 Noninvasive Ventilation
  • History and Development of Noninvasive Ventilation
  • Indications for Noninvasive Ventilation
  • Selecting Appropriate Patients for Noninvasive Ventilation
  • Equipment Used for Noninvasive Ventilation
  • Management of Noninvasive Ventilation
  • Complications of Noninvasive Ventilation
  • Time and Costs Associated With Noninvasive Ventilation
  • Summary Checklist
  • References
  • 51 Extracorporeal Life Support
  • The Respiratory Therapist as Extracorporeal Membrane Oxygenation Specialist
  • International Registry
  • Patients Receiving Extracorporeal Membrane Oxygenation
  • Physiology
  • Equipment
  • Anticoagulation Management
  • Cannulas
  • Types of Support
  • Initiation of Support
  • Maintenance of an Extracorporeal Membrane Oxygenation Run
  • Transporting a Patient on Extracorporeal Membrane Oxygenation
  • Risks and Complications
  • Blood Products During Extracorporeal Membrane Oxygenation
  • Weaning and Decannulation
  • Summary Checklist
  • References
  • 52 Monitoring the Patient in the Intensive Care Unit
  • Principles of Monitoring
  • History
  • Pathophysiology and Monitoring
  • Monitoring Oxygenation
  • Arterial Pulse Oximetry
  • Oxygen Consumption
  • Monitoring Ventilation
  • Capnography
  • Monitoring of Inspired and Exhaled Gas Volumes
  • Peak and Plateau Pressures
  • Mean Airway Pressure
  • Driving Pressure
  • Resistance
  • Monitoring Lung and Chest Wall Mechanics
  • Respiratory System Compliance
  • Chest Wall Compliance
  • Transpulmonary Pressure
  • Lung Stress and Strain
  • Monitoring the Patient–Ventilator System
  • Stress Index
  • Auto–Positive End-Expiratory Pressure (Intrinsic Positive End-Expiratory Pressure)
  • Monitoring Breathing Effort and Patterns
  • Lung Imaging at the Bedside
  • Lung Ultrasound
  • Electrical Impedance Tomography
  • Cardiac and Cardiovascular Monitoring
  • Electrocardiography
  • Monitoring of Arterial Blood Pressure
  • Monitoring of Central Venous Pressure–Right Atrial Pressure
  • Monitoring of Pulmonary Artery Pressure
  • Preload
  • Contractility
  • Afterload
  • Cardiac Output
  • Cardiac Muscle Injury
  • Monitoring Renal Function
  • Monitoring Liver Function
  • Nutritional Monitoring
  • Acute Physiology and Chronic Health Evaluation (APACHE)
  • Neurologic Monitoring
  • Troubleshooting
  • Summary Checklist
  • References
  • 53 Discontinuing Ventilatory Support
  • Reasons for Ventilator Dependence
  • Patient Evaluation
  • Preparing the Patient
  • Caregiver Preparation
  • Methods
  • Newer Techniques for Facilitating Ventilator Discontinuance
  • Selecting an Approach
  • Monitoring the Patient During Weaning
  • Extubation
  • Ventilator Discontinuance Failure
  • Prolonged Mechanical Ventilation
  • Chronically Ventilator-Dependent Patients
  • Terminal Weaning
  • Summary Checklist
  • References
  • 54 Neonatal and Pediatric Respiratory Care
  • Assessment of the Newborn
  • Respiratory Care
  • Continuous Positive Airway Pressure
  • Mechanical Ventilation
  • Specialty Gases
  • Neonatal and Pediatric Transport
  • Summary Checklist
  • References
  • Section VII Patient Education and Long-Term Care
  • 55 Patient Education and Health Promotion
  • Patient Education
  • Teach Back or Echo Method
  • Health Education
  • Health Promotion and Disease Prevention
  • Chronic Disease Management and Population Health
  • Summary Checklist
  • References
  • 56 Cardiopulmonary Rehabilitation
  • Definitions and Goals
  • Historical Perspective
  • Physical and Psychosocial Basis
  • Structure of a Pulmonary Rehabilitation Program
  • Financial Considerations
  • Cardiac Rehabilitation
  • Conclusion
  • Summary Checklist
  • References
  • 57 Respiratory Care in Alternative Settings
  • More Recent Developments and Trends
  • Relevant Terms and Goals
  • Standards
  • Traditional Acute Care Versus Alternative Setting Care
  • Discharge Planning
  • Oxygen Therapy in Alternative Settings
  • Ventilatory Support in Alternative Settings
  • Other Modes of Respiratory Care in Alternative Sites
  • Patient Assessment and Documentation
  • Equipment Disinfection and Maintenance
  • Summary Checklist
  • References
  • 58 Ethics and the End of Life
  • Introduction
  • “Goals of Care” as an Essential Organizing Framework
  • Management of Pain and Other Symptoms at the End of Life: Legal and Ethical Considerations
  • Ethical Conflict at the End of Life
  • The Respiratory Therapist as Ethical Practitioner
  • Summary Checklist
  • References
  • Glossary
  • A
  • B
  • C
  • D
  • E
  • F
  • G
  • H
  • I
  • J
  • K
  • L
  • M
  • N
  • O
  • P
  • Q
  • R
  • S
  • T
  • U
  • V
  • W
  • X
  • Z
  • Index
  • Abbreviations

Product details

  • No. of pages: 1400
  • Language: English
  • Copyright: © Mosby 2020
  • Published: October 22, 2019
  • Imprint: Mosby
  • eBook ISBN: 9780323597982
  • Paperback ISBN: 9780323811224
  • Paperback ISBN: 9780323811217

About the Authors

Robert Kacmarek

Affiliations and Expertise

Professor of Anesthesiology, Harvard Medical School; Director, Respiratory Care, Massachusetts General Hospital, Boston, MA

James Stoller

Affiliations and Expertise

Jean Wall Bennett Professor of Medicine, Cleveland Clinic,Cleveland Clinic Lerner College of Medicine Chair, Education Institute Cleveland Clinic

Al Heuer

Affiliations and Expertise

Program Director and Professor,Masters in Health Care Management Rutgers - School of Health Professions Newark

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