Advanced Respiratory Practice

What you will study

This module is provided as part of a interdisciplinary Framework within the Faculty of Health Studies. The Framework enables students to create an individualised programme of study that will meet either their needs and/or their employers’ needs for a changing diverse workforce within a modern organisation.

Module content comprises of:

Respiratory pathologies

Common and less common respiratory pathology resultant in critical care admission: COPD and acute/infective exacerbation of COPD; management of asthma include acute and stable presentation; pneumonia including ventilator associated pneumonia (VAP) and sepsis secondary to chest sepsis; COVID-19/ARDS/ALI; pulmonary embolism (PE); unusual anatomy and physiology and ramifications for respiratory health: kyphosis, scoliosis, spinal cord lesion; alpha 1 anti-trypsin deficiency; cystic fibrosis.

Invasive ventilation

Indications and contraindications for invasive ventilation; settings and modes of invasive ventilation including rationale for these.  Nursing practices of care of the invasively ventilated patient to include tracheal tube management, humidification, suctioning, patient positioning.  Patient challenges during invasive ventilation: time-critical emergencies: bronchospasm/laryngospasm, compromised airway, blocked/misplaced tube, difficult intubation, tension pneumothorax and non-time critical emergencies: ventilator asynchrony; weaning; deterioration including prone positioning and referral to ECMO.

Non-invasive ventilation

Indications and contraindications for non-invasive ventilation (NIV); settings/modes to include BIPAP and CPAP and interfaces (face masks, nasal cannulae and hoods) used/not used to deliver these modes.  Nursing practices in the care of the patient during NIV to include: pressure area care, eye and mouth hygiene, hydration and nutrition needs.  Patient challenges during NIV: non-concordance; cardiovascular effects; failure; ethical decision-making – to invasively ventilated or not, managing ceilings of care.

Tracheostomy and laryngectomy care

Based upon the content of the Electronic Learning for Health e-learning programme: Tracheostomy Safety (NTSP).  This programme covers: Understanding Tracheostomies and Laryngectomies; Emergency Care; Basic Care Done Well; Emergency Front of Neck Airway. Following this study day students will be advised to complete the ELfH e-learning programme if they have not already done so.

Therapeutics: chest drains, physiotherapy and pharmacology

Indications and contraindications for chest drains, types of chest drains, their use and care.  The contribution and scope of respiratory/chest physiotherapy including the role of the specialist physiotherapist.  The indications, side-effects, contradictions and doses of a range of medicines to include: beta-agonists such as salbutamol, antimuscarinic bronchodilators such as ipratropium and tiotropium, theophylline and aminophylline, corticosteroids such as beclomethasone, budesonide and fluticasone, leukotriene receptor antagonists such as montelukast and antihistamines such as cetirizine and chlorphenamine.  Anti-bacterials, antifungals and anti-virals used in the treatment of respiratory disease will be covered briefly.  Mucolytics and isotonic/hypertonic saline in respect of secretion management will also be covered briefly.  In this session the pharmacodynamics and pharmacokinetics of drug families will be focused upon with brief reference only to afore mentioned examples of name drugs/medications.