Egan's Fundamentals of Respiratory Care

12th Edition - October 22, 2019
Authors: Robert M. Kacmarek, James K. Stoller, Albert J. Heuer
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 1 1 2 1 - 7
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 1 1 2 2 - 4
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 5 9 7 9 8 - 2

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… Read more

Purchase options

LIMITED OFFER

Save 50% on book bundles

Immediately download your ebook while waiting for your print delivery. No promo code is needed.

Institutional subscription on ScienceDirect

Request a sales quote

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.

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

Purchase options

Save 50% on book bundles

Institutional subscription on ScienceDirect

Robert M. Kacmarek

James K. Stoller

Albert J. Heuer