On Wednesday night, preceding the conference the hotel has Comedy Night. On Thursday night they have Blues and Brews.

The program is almost finalized with the following topics, speakers, etc:

• 12 AARC CEUs
• Senator Mike Crapo (R) Idaho by teleconference
• New respiratory system drugs available and in research 
• What does the AARC do for me with Bill Dubbs, AARC
• Recredentialing: What does it mean and what does it require of me?
• Ethics
• State Asthma update with Jean Woodward
• VAP
• PFT QC in the Lab
• Bedside spirometry
• Airway clearance
• Aerosol delivery with Patrick Dunne
• Nolan Bybee with ISRC presidential address 
• Vendor Exhibit
• Lunch provided on Thursday

• Word 2000 format - http://www.idasrc.org/2004_ISRC_Registration_Form.doc or 
• Pdf format -  http://www.idasrc.org/2004_ISRC_Registration_Form.pdf

• Word 2000 format - http://www.idasrc.org/2004_conference_schedule.doc or 
• Pdf format -  http://www.idasrc.org/2004_conference_schedule.pdf

I met Toshihiko Koga in December, 1994, while he was visiting Idaho as an International Fellow from Japan. Within the first few minutes of meeting him, I felt I had known him for years. He had the rare ability to make everyone who met him feel that they were his best friend and had known him most of their lives.

Over the years, I have tried many times to describe Dr. Koga to colleagues. I have used words like educator, mentor, kind, considerate, generous, loving, compassionate, brilliant, driven, committed, fun, amazing, incredible, and pioneer. And, once again, I feel that I am not able to describe him adequately.

Dr. Koga was passionate about education. He loved to teach and he loved to learn. He would ask questions all the time, wherever he was, trying to learn the latest developments that might help his patients. When he returned to Japan he would pass this information on to others to try to improve the care of patients in his country.

Dr. Koga attended the AARC International Congress whenever possible. He was an integral part of the International Program. Each year he hosted what was affectionately known as, “Japan Night”. He would provide a venue for 50 – 100 people linked to education and medicine in Japan to allow us all to become better acquainted with each other. This was usually done at a local restaurant at the International Congress.

Dr. Koga had a vision for education in Japan. He wanted to teach Respiratory Care in Japan, but since it was not yet recognized by the government as a profession, there were no formal educational programs. So, Dr. Koga educated select clinicians, who then educated others. He planned to gradually expand this and hoped to create a Respiratory Care Program. He initiated the International Exchange Visit Programme for Respiratory Care Professionals. This Program is being maintained after his passing; the next workshop will be presented in Kamakura, Japan, this July.

Dr. Koga invited me to teach Respiratory Care in Japan. What I thought was a one-time experience turned into an annual workshop on Adult Mechanical Ventilation. However, my students and I are the ones who have benefited most from the teaching; he taught me more about “being” than I taught them about Mechanical Ventilation.

The first time I taught in Japan, I was amazed that during my presentation, Dr. Koga would go from person to person in the audience, sit next to them, and make sure they understood what was being presented and checked to see if they had any questions. He wanted to make sure that each of the students was learning the necessary information.

Dr. Koga tried to increase the amount of medical information available to clinicians in Japan. He spent many years translating medical journals from English into Japanese, translating the AARC Clinical Practice Guidelines, developing a Website for Japanese clinicians, creating a journal for Respiratory Care professionals; he even wrote several textbooks on Respiratory Care. 

Dr. Koga died on April 22, 2004. We will miss him terribly, but never forget him or the lessons he taught us. Thank you, Dr. Koga.

The plan, color-coded in a green-yellow-red stop light pattern, will be a four-part NCR document. One copy goes to the patient’s physician, one to the school and two for the patient for miscellaneous use. The plans will be bundled in pads of 50 and have a reorder sheet inside, much like bank check reorders. The pads will be printed soon and will be distributed throughout the state to doctor’s offices, emergency rooms, pharmacies and schools.

Still to be completed projects are a cover sheet for the pads and development of a label/sticker to be placed on MDIs at schools listing the patient name, name and dosage of medication and the patient’s physician.

The RC staff at St Joseph realized a trend of rising ventilator associated pneumonia (VAP) rates at their hospital.  Along with Infection Control and Intensive Care, Cardiopulmonary began to research how to reduce their rates of these infections.  They located a program developed by Barnes Jewish Hospital and Washington University school of Medicine that helped reduce VAP rates by 49%, and decrease annual costs due to VAP from $1,265,330 to $683,060, a savings of  $582,270 annually.

Based on that program, the following interventions were implemented or updated at St Joseph:

• Head of Bed up at >30 degrees when possible
• Drain condensate before repositioning
• Change out Ambu bag on a per use basis
• Initial sputum on intubation
• Change vent circuits Q30 days or when soiled
• Change inline suction Q7 days or when soiled
• Avoid nasal intubation if at all possible
• Remove NG tubes as soon as possible
• Use of active humidification
• Limit stress ulcer treatment when possible
• Maintain ET tube cuff inflation
• Use of Hi-Lo Evac tube in patients deemed at risk
• Stress the use of a oral care protocol on vented patients
• Meticulous hand hygiene before and after vent contact or suctioning
• Wean early

• An Asthma Day Camp will be held July 7 from 8:30 am to 4:30 pm at Municipal Park in Boise. This experience is for children age 5 to 12. There is a charge of $25 per child ($15 for additional child in family). Financial assistance is available.
• Camp Super Breathers will be held August 2 to 6 at Sawtooth Methodist Camp north of Fairfield. The age range for the camp is 8 to 13. Cost is $200 for four nights and five days.

Title:  Automatic Tube Compensation:  Does It Really Matter?
L.J. Ashworth, M.Ed., R.R.T., T.J. Wing, B.S., R.R.T., R.G. Peterson and J.K. Goldman.  Boise State University, Boise, ID.

Rationale. In modern mechanical ventilators Automatic Tube Compensation (ATC) is designed to deliver the set pressure to the distal end of the artificial airway, compensating for the resistance of the endotracheal tube (ETT) or tracheostomy tube. The accuracy of the pressure delivered to the trachea by different ventilators has not been well documented.

Methods. We studied three ventilators: Viasys Avea (VA), Drager Evita 2 (DE) and Puritan Bennett 840 (PB). Peak and mean pressures were measured at the distal end of a 7.5 mm ETT connected to a dual-lung laboratory model (Michigan Instruments Training Test Lung). Each ventilator was placed in Continuous Positive Airway Pressure (CPAP) at 0, 5, 10, 15, 20, 25, and 30 cm H2O. Varying inspiratory flowrates were generated by a second ventilator at 20, 40, 60, 80, 100, and 120 LPM.

Results. At CPAP 10 cm H2O and a flowrate of 40 LPM, the measured peak pressure with ATC off versus (vs) ATC on at the distal end of the ETT were: VA 18 vs 17 cm H2O, DE 15 vs 15 cm H2O and PB 16 vs 17 cm H2O. The measured mean pressures with ATC off vs ATC on at the distal end of the ETT were: VA 9 vs 10 cm H2O, DE 8 vs 10 cm H2O and PB 10 vs 10 cm H2O.

Conclusions. The peak pressures and mean pressures measured at the distal end of the 7.5 mm ETT were no different with ATC off or on, in this artificial lung model at a flowrate of 40 LPM and CPAP 10 cm H2O. Similar findings were noted at the other flowrates and CPAP levels tested. Further trials are necessary to evaluate the usefulness of ATC.

“Grow your own” was the phrase that came to Magic’s mind. After much scrutiny and painstaking research, the RT department decided to create and drive its own student program under a “student exemption” licensure and California College’s heavy Associates program. The investment in our local community members that have invested much of their lives in the area has reaped great benefits. The three outstanding candidates are many months into their journey in Respiratory Therapy and have not only been given a golden opportunity as full-time employees, but have raised the professional bar in the department. This was accomplished by making each RT accountable to the “RT students” and their success. Beginning with light routine floor care, of course, after the first quarter agenda and clinical evaluation check stations were established, we are confident these students will all be moving into the critical care areas by the end of next year and closing in on sitting for the CRT and RRT exams in 2006.

Do you meet or know of someone who meets the qualifications stated below and would benefit from a scholarship to help them continue their education?

1. Student in a formal CRT or RRT program and residing in the state of Idaho 
2. Completed one year of an RT program 
3. An AARC member 

President Elect Nolan Bybee called the meeting to order.

The minutes of the previous meeting were read and approved.

Treasurer’s report: No report.

PACT: Renie read a letter from the AARC about HR 2905.  This is the bill for recognition of Respiratory Therapists under the Medicare Home Health Services Benefit.  A lot of work needs done yet, but everyone can help by logging on to Capital Connection either on the AARC or the ISRC web site and sending a message to your legislator in favor of this bill.  At the PACT meeting in Washington D.C. the delegation only got to meet with the aides.  The legislators were out. See attached for more information.

Committee Reports:

• Membership: Nolan has brochures about the advantages to joining the AARC. Everyone was encouraged to take some and pass them out to non-members. 
• Delegates: Rob cannot go to the HOD meeting in June. Dana will go. Renie read the only resolution and the vote was for a yes. See attached.
• Newsletter: Tom is collecting items for the next one, which will be in 2-3 weeks.  If you have any items of interest let him know.
• Nominations/Elections: There is a need for a president elect. Let Nolan or Michelle know if anyone is interested.
• Bylaws: No report

• Martin reports that speakers have been lined up and they are sending out flyers to all the hospitals as a promotion. The registration forms will be following. 
• Dana reported on the State President’s conference in Dallas.
• The Asthma Educator’s conference is in August.  Contact Con or Michelle for more information. There are still some openings.

• The Coalition for a Healthy Idaho and the Association for a Tobacco Free Idaho will be meeting May 20 in Boise. Contact Rob for more information.

Respectfully submitted,

Ramona Sailor
ISRC Secretary

Do you meet or know of someone who meets the qualifications stated below and would benefit from a scholarship to help them continue their education?

1. Student in a formal CRT or RRT program and residing in the state of Idaho 
2. Completed one year of an RT program 
3. An AARC member