Respiratory therapists are commonly found in intensive-care units, emergency rooms, critical care transport teams and operating room environments, as well as other areas of a hospital setting. Respiratory therapists treat virtually every patient population, and often the most critically ill patients in the hospital. They may work in sleep diagnostic facilities, cardiac catheterization labs, cardiac stress testing labs, and pulmonary function testing labs. Respiratory therapists are also a critical part of the code team and perform CPR. Particularly, establishing a patent airway. The respiratory therapist’s duties include delivery of oxygen via all types of oxygen delivery devices, administration of aerosolized drugs, Endotracheal Intubation (emergent and elective)suctioning, management of life support, weaning of ventilation or life support, insertion of arterial lines, management of tracheostomies, drawing and interpretation of arterial blood gas samples. Advanced skills include central line insertions and chest tube insertions. Some Respiratory Therapists go on to work as cardiovascular perfusionists or anesthesia assistants.

Adapted from the Wikipedia article Respiratory therapy, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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* Emergency Room: ATLS and ACLS certified personnel. The ER Medical director has done training in ER Management on Beth Israel Deaconess Medical Center.

* Operating room: Ready for all mayor surgeries, 24/7

* Laboratory

* Pharmacy

* Pathology

* Blood Bank

* Medical Imaging: Including X-Rays, MRI, Multidetector CT, Ultrasound, Nuclear Medicine, Fluoroscopy, Angiography Lab, Mammography and Bone Densitometry.

* Endoscopy

* Physical therapy

* Hyperbaric oxygen therapy

* Cardiologic testing lab: Including Holter monitor, EKG, Echocardiography and Cardiac Stress Tests, they have a special unit to do Cardiac CTs.

* Delivery Rooms

* Hemodialysis

Adapted from the Wikipedia article Hospital Nacional, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Stress tests do not detect atheromata (lipid deposits within the walls, not lumens, of arteries) or vulnerable plaques, which cause most heart attacks, or myocardial infarctions. Recent (late 1990s) clinical studies have shown that the vulnerable plaques are commonly present within many regions of the coronary arteries, yet are typically ”relatively flat” and do not protrude into the arterial lumen sufficiently to produce enough stenosis (usually less than 50%, average 20% by some IVUS studies) to be detectable by stress test methods. Thus, over the last 20 years or so, newer approaches in both research and clinical assessment/management have increasingly focused on measuring [http://www.emedicine.com/Radio/topic865.htm coronary calcification], intima-media thickness (IMT), or using intravascular ultrasound, along with (or in place of) the longer used techniques of coronary angiography, to detect plaque within the walls of arteries at earlier stages of progression, before the arterial lumen becomes more severely compromised.

The major limitation of the stress test approach is that it requires high-grade stenosis to indicate heart attack risk. And high-grade stenosis, while a good indicator of advanced arterial disease, is not the major cause of myocardial infarctions. This issue is also reflected in the results of the COURAGE trial, which demonstrated that “intensive pharmacologic therapy and lifestyle intervention” produced better survival and quality of life than invasive interventions such as angioplasty.

Like all tests, stress testing has problems with both falsely positive and falsely negative results compared with other clinical tests.

Adapted from the Wikipedia article Cardiac stress test, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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After a cardiac surgery it is but natural to feel tired and in pain. Yet, beginning physiotherapy immediately after the surgery rather than allowing oneself a period of rest seems incredulous. But that is exactly what the doctor’s order are.

A cardiac surgery can include one or more of several different procedures – bypass surgeries, placing stents, angioplasty, replacements of valves – or even a complete heart transplant. Cardiac patients can derive several benefits from physiotherapy, both after surgery and to alleviate symptoms of cardiac diseases like chest pains, cardiomyopathy, artery diseases, heart failures or cardiac arrests.

About a fortnight after you have the surgery, the physiotherapy program commences. Initially, a stress test is administered to determine the person’s capacity for exercise. Generally, these tests include using the treadmill or a stationary bike while the doctor or nurse keeps a track of the person’s vital signs.

This tracked data is collated and analyzed. Based on the results, a routine for physiotherapy is determined. The initial sessions are often conducted under the vigilance of hospital staff to ensure the medical safety of the patient.

Cardiac patients perform their initial exercises in the presence of horses and their physiotherapist. In case there is any discomfort to the patient while performing these exercises the medical personnel can immediately take over and manage the situation. Thee exercises involve similar cardiovascular exercises as the first test se

Once this initial monitored phase passes, cardiac patients can continue their exercise sin the privacy of their homes. Before they are permitted to do that, however, they are instructed on various exercises, for warming up and stretching, and taught when it is ideal for them to stop. Unless they are acing severe complications, they are advised to exercise a minimum of three and a maximum of five times a week.

After cardiac surgery, swimming is also advisable. As a cardiovascular exercise it is effective without straining a patients joints, and can be continued for longer durations. The one thing that must be kept in mind before commencing swimmingis that all open wounds on the body must have healed completely.

Physiotherapy staff are not always required to instruct a patient on exercises. Hospital staff are also trained to rehabilitate cardiac surgery patients. The principles of therapy remain the same and physiotherapy staff can be involved if so required.

The physiotherapist sketches out the routine for physical therapy. In the first 6 weeks after surgery, few activities are allowed, including, but not limited to light housework and occasional excursions to movie theatres. On till the third month after surgery, other activities are included in the person’s routine. It is possible for a patient to return to full-time or part-time work, and begin driving again. After the third month, gradually all normal activities can be resumed.

Without physiotherapy, a patient will remain weak, and may even grow weaker. Physiotherapy is a routine that allows a person to go back to their original lifestyle as early as is possible. With the correct exercises, a patient will become healthier than they were before they underwent cardiac surgery.

Dr Alex B. Miguel

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Treadmill is probably the best available equipment to burn fats from the body. For most of the people afflicted with high cholesterol and excessive fat deposition, treadmill comes as a rescuer against possibility of cardiac diseases. Most of the superior quality treadmills now a days come with various preprogrammed workouts specially designed to reduce high cholesterol or excessive fat in order to prevent cardiovascular diseases or possibility of stroke.

These treadmills are also equipped with belt to monitor pulse rate and echo level of heart that is displayed by display unit of treadmill. These superior treadmill models are known as cardiac treadmill as they are specifically meant for folks who are either anticipating cardiac complications or are already afflicted with it.

Cardiac treadmills could be also found at hospitals or with health care providers. Various cardiac tests are performed while a patient is put on a workout on a cardiac treadmill. One of the most common tests performed with treadmill workout is ECG. With the help of cardiac treadmill your heart’s condition is analyzed. You get to know, how your heart works when it is put on stress. Cardio Treadmill also happens to be equipped with blood cholesterol level monitor.

There could be a number of other cardio features available in your treadmill. These treadmills offer an excellent cushioning system that ensures a completely jerk free workout. This jerk free deck is particularly helpful for cardiac patients. They comfortably undergo cardiac endurance test on these cardio

While choosing a cardio treadmill for home you must consult an expert physical trainer and you should also seek opinion of your health care provider. Most of the reputed brands now a days come with their cardio models.

Most of the superior cardio treadmills come with lifetime warranty. Two very popular cardio models are Smooth 9.25X and Landice L8. Brand Landice offers other cardio models as well. These include Landice L7. Nordic track also offers a series of cardio treadmills. The brand happens to be credible. A cardio tread equipment would often be costlier than treadmills meant to serve normal exercise needs.

I would suggest new buyers of cardio treadmills to go through consumer reviews before choosing a treadmill as it will enable them pick the best possible cardio treadmill.

Ashish Jain

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