Publications by authors named "Raymond P Tuttle"
Background: Current strategies for diagnosing ventilator-associated pneumonia (VAP) favor the use of quantitative methods; however, semi-quantitative cultures of endotracheal aspirates are still commonly used.
Methods: The microbiological results of patients with suspected VAP who had both quantitative cultures with non-bronchoscopic bronchoalveolar lavage (BAL) and semi-quantitative cultures of endotracheal aspirate obtained within 24 hours of each other were retrospectively reviewed and compared, using a quantitative threshold of >or=10(4) colony-forming units/mL as a reference standard.
Results: 256 patients with paired cultures were identified.
Background: Respiratory therapist (RT) driven protocols decrease ventilator days and resource utilization in the intensive care unit (ICU). Protocols have been studied in non-ICU settings, but their effect on mortality has been incompletely studied.
Methods: In our neurosurgery step-down, trauma/surgery step-down, and trauma/surgery general units we initiated an RT-driven evaluate-and-treat protocol that included a standardized, quantitative, RT-driven patient-assessment scale and protocolized interventions.
Background: The respiratory care department of one campus within our health system evaluated simulation-based medical education for training and competency evaluation of the mini bronchoalveolar lavage (mini-BAL) procedure, with an emphasis on patient safety and procedure performance standards.
Methods: Training and competency evaluation occurred in 4 phases. In phase one, 24 staff respiratory therapists (RTs) were randomly chosen and individually underwent a simulation-based test of their mini-BAL performance, using a patient-simulator mannequin.