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Confluence
Conference
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Tom Gable
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| 2004 was the first time our annual conference was held
in Lewiston. Aptly named for the junction of two of the West’s great rivers,
the Snake and Clearwater, the Confluence Conference was well executed,
well attended and well enjoyed by 84 of your fellow Respiratory Care Practitioners.
Accommodations were top notch at the Red Lion Hotel, which had a separate
Conference Center, a fine restaurant and a brew pub. The weather was mild
and the prevailing west wind swept the paper mill bouquet toward other
climes. |
| The educational program started out on a high note Thursday
morning with a conference call with Idaho Senator Michael Crapo from Washington
DC. Senator Crapo founded the Congressional COPD Caucus earlier this year.
He described the scope and focus of that group and also discussed the present
status of congressional activities regarding air travel with oxygen concentrators
and the legislation supporting reimbursement for administrative costs of
respiratory drugs. At the end of his remarks, the Senator took questions
from the floor. There was a question from Marty Gaither regarding the recently
proposed reduction in reimbursement for hyperbaric oxygen administration.
Senator Crapo indicated he was not aware of that regulatory activity and
would look into it. There was a further query regarding reimbursement for
MDIs, as opposed to nebulized drugs, as a strategy to reduce overall healthcare
costs for respiratory patients. The Senator said he would bring himself
up to speed on that concept. Finally questions regarding the support and
passage of HR2805 or its senate counterpart S2707 (which speak to reimbursement
for respiratory services in the homecare setting) were brought to the table.
Senator Crapo indicated that all bills that are not related to homeland
security or military issues would likely not progress favorably in this
election year. The Senator’s presentation was very clear and forthright.
We are very fortunate to be represented by a person with such an active
interest in individuals with lung disease. |
| The morning continued with a very nice overview of the
GOLD Initiative guidelines for management of COPD by Dr William Holden
from the Portland VA Medical Center. He ended with a quick synopsis of
possible newer pharmacologic approaches to COPD treatment, particularly
the long acting anticholinergic agent tiotropium (Boehriger-Ingelheim sponsored
Dr Holden). Dr Holden returned after lunch to talk about sleep disorders
and cardiovascular disease. This was a good analysis of the results of
the Sleep Heart Health Study. David Walsh, RRT from Chicago gave an interesting
orientation to medical ethical concepts with regard to end of life.
A few case examples brought home the realization that each situation is
very unique and there are wide limits to interpretation of the “rules”.
In another presentation, Greg Paulauskis of Montana State University –
Great Falls described the process of respiratory care re-credentialing
(via education or retesting). The afternoon session had a good overview
of quality assurance in pulmonary diagnostics by Pat Clark (formerly McDowell)
of UW Medical Center. Pat later gave an overview of simple spirometry and
finished with some fun case results for audience interpretation. Terri
Tickner and Wade Scoles of Northwest Medstar (an air transport service)
in Spokane gave an excellent tag team review of neonatal emergent conditions
and their treatment. Packed in the middle of all this was a thorough description
of “high frequency chest wall oscillation,” aka Vest, by Suzanne Olson
of Hill-Rom. |
| Day two (Friday) was scheduled as a half day of education.
Old friend, AARC stalwart (former president and much more), and a presenter
at several previous ISRC meetings, Patrick Dunne gave a very thorough ad
for Xopenex (left handed albuterol). He was followed by another AARC friend,
Bill Dubbs (the Association’s Director of Education & Management),
who gave a very nice overview of “what the AARC does for you”. I
must admit I was absent from the next presentation on ventilator-associated
pneumonia by Brian Neis of the Albuquerque VA. I did, however, scrutinize
the PowerPoint slides and find this to be a very excellent and thorough
review with very specific suggestions for a VAP prevention protocol. The
session ended with a description of the work of the state’s asthma coalition
people in standardizing recommendations for asthma care and this work will
develop into a model for management of other chronic conditions. The report
was presented by the state asthma program czarina, Jean Woodward. |
| The Conference was well supported by purveyors of respiratory
equipment and services. The exhibit area is always a valuable educational
adjunct to the didactic learning opportunities. Another real boon to the
overall quality of this conference was a top-notch, spiral bound syllabus,
which contained the PowerPoint slides of all but two of the presentations.
Kudos to the organizing committee, led by Marty Gaither of St. Joseph RMC
(Lewiston). The coordination of the education, the exhibits, the sponsors
and the social aspects was essentially seamless. |
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Board
of Directors - 2005
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Back Row: Martin Gathier, Lande Lambert,
Kevin Dwello, Con Colby, Chad Rye, Tom Gable, Dana Hagestad
Bottom Row: Rob DeVinsepre, Nolan Bybee,
Lynda Erfurth
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| 2005 Officers and Directors were revealed at the ISRC
Board meeting in Lewiston, September 9. Our President is Dana Hagestad.
Dana, a supervisor at St. Joseph Regional Medical Center in Lewiston, served
this year as President-elect. Our 2005 President-elect is Chad Rye.
Chad is also at St. Joseph and directs the Respiratory Home Care program.
Lynda
Erfurth is our new Vice President for a two-year term. Lynda works
at St. Luke’s Regional Medical Center in Boise and recently earned a Master’s
degree in Public Health, Community Education. The Society’s new Treasurer,
also for a two-year term, is Martin Gaither, a supervisor at St.
Joseph in Lewiston. Marty got his RC training in Great Falls, Montana.
Marty’s management of the financing (as well as organization and scheduling)
of the 2004 ISRC Annual Conference gives him good insight into this position.
The new Secretary (two-year term) is Mary Kimbrel. Mary is a therapist
at St. Luke’s Meridian Medical Center. She was educated and previously
worked in Eugene, Oregon. Lande Lambert is a Board Member at-large
serving the last year of a two-year term. Lande works in pulmonary diagnostics
at Magic Valley Regional Medical Center in Twin Falls. Newly elected to
a two-year term as Board Member at-large is Kelvin Dwello. Kelly
is the Director of Pulmonary and Sleep Services at St. Alphonsus Regional
Medical Center in Boise. Kelly previously was educated and worked in the
Bay Area of California. Our 2004 (and 2003) President Nolan Bybee
remains on the Board as Past President. Dr. Nirmal Charan, a pulmonologist
and researcher at the Veterans Affairs Medical Center in Boise, serves
on the Board as Medical Director. There is one more Board member, the Student
Representative. This is an appointive position that will be designated
by President Hagestad early next year. |
| The Society also has two Delegates. The Delegates are
ex-officio (non-voting) Board members. Starting the last year of a four-year
Delegate term in 2005 is Renie Johnson. Renie lives in Fruitland
and works as a therapist at Holy Rosary Medical Center in Ontario, Oregon.
Our other Delegate is
Rob DeVinaspre. Rob is a therapist at St.
Alphonsus in Boise. |
| Several individuals are ending their official service
on the Board.
Ramona Sailor has served two consecutive two-year
terms as Secretary. Ramona is a therapist at Magic Valley Regional Medical
Center. ReNae Palmer has served a two-year term as Treasurer. ReNae
works in cardiopulmonary rehabilitation at Eastern Idaho Regional Medical
Center in Idaho Falls.
Jody Lester is finishing a two-year term
as Vice President. Jody is a professor in Respiratory Care at Boise State
University. Carmen Totorica Griggs is finishing a term as Board
Member at-large. Carmen is in pulmonary diagnostics at St. Alphonsus Regional
Medical Center. |
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President Nolan Bybee and Secretary Ramona
Sailor receive Distinguished Service Awards
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Congratulations
These individuals achieved NBRC credentials in the Third Quarter
of 2004.
RRT
Essam Ali Aljamhan - Boise
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CRT
Stacie Jacoby* - Nampa
John Lam* - Boise
Ryan Moncur* - Boise
Niki Rawson* - Boise
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| *ISRC Members |
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Lewiston
Leisure Time
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Tom Gable
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| Your editor was greatly entertained
by the social activities at the recent Confluence Conference in Lewiston.
Arriving a day early, my travel companion and I were treated to a fishing
expedition on the Snake River by 2005 President-elect Chad Rye. Chad played
the guide role in delivering us to numerous steelhead “hot spots” in his
18 foot, 175 horsepower, jet boat. In truth it was too hot for the “hot
spots” (water temperature above 70 degrees), but the lack of steelhead
was made up for by the activity of the warm water species – especially
smallmouth bass. We had a beautiful day of fishing, sightseeing and catching
up on old times and new times with Chad. Our expedition concluded with
a demonstration of white water wave jumping – a great way to cool off. |
| Evenings at the Red Lion Hotel
meant bargain-priced micros at TJ Barleyhopper’s Pub and lots of fellowship
with old friends and new. One evening the pub featured comedians, the next
evening, live blues. Each night ended for me with a pool lesson from Theresa
D’Ambrosio, a therapist at St. Luke’s Meridian Medical Center. |
| Friday at noon as the educational
program concluded, about 60 of us head over to Clarkston to board a big
jet boat for a tour of Hell’s Canyon of the Snake. The spacious river cruiser
is fully powered by two 450 horsepower engines. That combined 900 hp allows
us to virtually fly across the various rapids we encounter, at least going
upstream. From Clarkston and Lewiston the trip is on relatively flat water
for several miles past Asotin, Washington to about the confluence of the
Grande Ronde River. The hills on both sides are beautiful and a particularly
spectacular formation of fractured columnar basalt across from the Grand
Ronde confluence is well appreciated by those of us with a geologic fascination
– the best I have seen. There are plenty of eyes peeled for wildlife and
a number of mule deer are spotted along the way. I am impressed by the
multitude of Great Blue Herons standing as sentinels, seemingly about every
100 yards along the bank. |
| We stop for a break and refreshments
at the lodge at Heller’s Bar. Upstream from Heller’s the river is truly
free flowing and rapids abound. Now we are in the actual Hell’s Canyon.
The first few miles have numerous cabins, from basic to fantastic. Apparently
all building materials were boated in. The cabin area gives way to steep
canyon walls and wild river as we continue upstream. Sharp-eyed participants
soon spot wild sheep and more mule deer along the hills. We continue to
blow through rapids as the canyon walls get deeper and steeper. As we stop
to view some mining ruins, our captain fills us in on some area highlights
of mining and shipping history (they used paddlewheel steamboats back in
the day!). We again pour the diesel to the 900 horsepower and are careening
over the white water. We pass the confluence of the Salmon River and see
many rafters and kayakers finishing the lower Salmon float. At the confluence
of the Imnaha River on the Oregon side we get another history lesson about
the mining efforts at that place. |
| This is as far as our voyage is
scheduled to penetrate the canyon (there are longer trips available by
our outfitter, Beamers). We turn to head back and soon find that the rapids
are much different going downstream. There is a lot of jumping and bucking
and splashing, much to the delight of all of us. We see more sheep along
the way. We stop in mid-river for photographs several times. There were
some pretty impressive rams close at hand. A final punctuation to our memorable
voyage is a stop at an ancient native American petroglyph site. The enigmatic
images chipped into the black patina of the basalt are evocative and amazing.
After photos are taken to commemorate the day and this site, we head back
to Beamers dock in Clarkston and the end of our five hour odyssey. Thank-yous
were sincere for Marty Gaither and his organizing committee for treating
us so excellently and sharing their little bit of middle Idaho with us. |
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Photography
by
ISRC Delegate Rob DeVinaspre
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Loading Up the River Boat - Everybody is Ready to Go
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Conrad Colby is On Board
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Refreshment Stop at Heller's Bar Lodge
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The Deck at Heller's Bar Lodge
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President-elect Chad Rye and his Girls
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ISRC Board Member Kelly Dwello
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Canyon Cabins - No Roads into Here
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Past the Cabins - Into the Wild River
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Palisading Basalt Cliffs in Hell's Canyon
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Steep Beautiful Country
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Bighorn Sheep are Abundant in Hell's Canyon
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Thank
You for Your Support
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This issue of the Mountain Air is supported
financially by:
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Product
Review
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Lande Lambert
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| In today’s world we no longer have to wait for “word
of mouth” to get information, we have the computer to help us network.
The ISRC web site is an excellent place for RT’s to get and give some feedback
on products we use. |
| The PIKO-1 has been on the market for about 2 years now
but I have just recently started using it in our Patient Assessment/Teach
Program here at Magic Valley Regional Medical Center. We have all used
standard Peak Flow Meters in teaching patients how to assess and manage
their respiratory disorders and as we know very few patients utilize the
diary to track their therapy. The PIKO-1 will do several things such as: |
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Give an instant digital reading of PEF
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Give the FEV1
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Show what range the effort is in based on the programmed
“predicted”
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Store 96 trials for later download
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The 96 trials are downloadable to a computer for graphing
results
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It is smaller than most peak flow meters
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| This has been an excellent tool when trying to find the
optimal medicine and dosage for patients. If you have been using the PIKO-1
and have either positive or negative experiences with this device please
send your comments in to ISRC so we can all share. To find more information
on this device just search “PIKO-1” on the net and you’ll get all sorts
of data to include Dr. Crapo’s research. If you want to get in contact
with a regional representative just contact me, she can get the best pricing
I’ve found. |
| If you have been using any Respiratory devices and have
found issues you would like to share, send Tom Gable a line and he can
get it put into our ISRC site. |
Lande Lambert
landel@mvrmc.org
208-737-2686 |
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ISRC
Web Site
www.idasrc.org
Education
- Resources - Employment
- Meetings/Events - Scholarships
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ISRC
Board Minutes
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September 9, 2004
Lewiston, Idaho
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| Members present: Renie Johnson, Conrad Colby,
Nolan Bybee, Martin Gaither, Nancy Roberts, Jan Ford, Rob DeVinespre, Tom
Gable, Ramona Sailor, Dana Hagestad, Venna Love, Kelly Dwello, Chad Rye. |
| President Elect Nolan Bybee called the meeting to order. |
| The minutes of the previous meeting were read and approved. |
| Treasurer’s report: See attached financial report.
A motion was passed to take $3,500.00 from savings and add the money gained
from the conference and put these into a CD, putting in a minimum of $10,000.00. |
| PACT: The senate finance committee is sponsoring
bill 2707 and they are trying to make it revenue neutral. Contact
your senator to support this bill. March 5-6, 2005 is the next PACT
meeting. |
| Committee Reports: |
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Membership: The AARC was offering 3 month trial memberships.
The deadline was Sept. 30.
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Delegates: The House of Delegates will be meeting for two
and one half days, instead of two as was previous.
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Elections: Results as follows: President elect-Chad
Rye, Vice president-Linda Erfurth, Secretary-Mary Kimbel, Treasurer-Marty
Gaither, Director at large-Kelly Dwello. Positions to be filled next
year are president elect, vice president and delegate.
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Bylaws: No report
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| Old Business: |
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Renie went to the House of Delegates meeting in June.
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The fall conference was a great success and big thank you
to Marty Gaither for pulling it all together.
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There will be another Asthma Educator’s conference again
next year.
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Coalition for Healthy Idaho: No report
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| New Business: |
The ISRC scholarship was awarded to Raquel Bravo.
Respiratory Care week is October 24-30.
The place for the 2005 fall conference was discussed.
It was decided to look at the conference evaluations to see if any place
was mentioned more often.
There is a House of Delegates meeting in December as
part of the International Congress.
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There is a House of Delegates meeting in December as
part of the International Congress.
The next meeting will be November 5th, 2004, in Boise
at the BSU Health Science Riverside building, at 7:00 PM. |
| Respectfully submitted,
Ramona Sailor
ISRC Secretary |
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ISRC
Board Meeting
7:00 p.m.
January 14, 2005
Health Science Riverside
Building
Boise State University,
Boise
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Contact
Dana Hagestad for more information at dhagestad@sjrmc.org
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2004
ISRC Board of Directors
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Nolan Bybee (Rexburg), President
Dana Hagestad (Lewiston), President elect
Nancy Roberts (Boise), Past President
Jody Lester (Boise), Vice President
Ramona Sailor (Twin Falls), Secretary
ReNae Palmer (Idaho Falls), Treasurer |
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Renie Johnson (Ontario, OR), Delegate
Rob DeVinaspre (Boise), Delegate
Carmen Totorica Griggs (Boise), Director at Large
Lande Lambert (Twin Falls), Director at Large
Dr. Nirmal Charan (Boise), Medical Director |
Visit http://www.idasrc.org/contact_us.htm
to contact a Board Member.
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The Mountain Air newsletter editor is Tom Gable. If you
would like to contribute information/articles, please contact Tom by e-mail:
gablet@slrmc.org,
or fax (208) 381-3498.
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