___________________________TACOMA COMMUNITY COLLEGE___________________________
Division of Health, Justice, and Human Services
Respiratory Therapy Program
COURSE:
SECTION:
ITEM#
RC 182 Respiratory Therapy Clinical II
A&B
0849 & 0850
CREDITS: 3
TIME/DAYS:
Section A: T/Th 8:00 – 11:30
Section B: T/Th 12:00 – 3:30
INSTRUCTOR:
Greg Carter Phone: 253-566-5231, E-mail: gcarter@tacomacc.edu
Cell: 253-227-5329 (Emergency only)
OFFICE HOURS:
TCC 13-232
LOCATION: 13-245
Monday 9a – 10a
Wednesday 9a – 12p
Friday 9a – 12p
Course Description:
Course is intended to prepare the third quarter respiratory care student to care for patients in the
Intensive Care Unit (ICU). Topics covered will include the initiation and care of the patient receiving
mechanical ventilation and special RC procedures. This class consists of a lab/clinical rotation
Text Books:
 Basic Clinical Lab Competencies for Respiratory Care, 5th ed., by Gary White
 Egan's Fundamentals of Respiratory Care, 10th ed., by Kacmarek et. al.
 Data Arc Clinical Software
The instructor will provide lecture outlines, handout and videos via Canvas Recommended professional
journals include: Respiratory Care, AARC Times, Advance for Respiratory Care Practitioners, RT,
Chest, American Journal of Respiratory & Critical Care Medicine, New England Journal of Medicine,
JAMA, American Journal of Nursing and RN. Students are encouraged to utilize the resources of the
TCC Learning Center, especially the Infotrac journal search for articles to be used for assignments.
Materials/Equipment:
You are required to have for lab/clinical:
 Scrubs w/ TCC Resp. logo
 Watch w/second hand or digital
 Leather shoes
 Stethoscope



TCC photo ID/nametag
Data-Arc
Eye protection
Academic Honesty:
Academic dishonesty is inconsistent with the values and mission of Tacoma Community College and the
Respiratory Care Program. Students at TCC are expected to be honest and forthright in their academic
endeavors. Cheating, plagiarism, fabrication or other forms of academic dishonesty corrupt the learning
process and threaten the educational environment for all students.
Academic dishonesty is a violation of Tacoma Community College Chapter 132V-121 WAC: The
complete administrative process for academic dishonesty is available on the TCC website.
http://www.tacomacc.edu/abouttcc/policies/administrativeprocedureforacademicdishonesty/
Assignments:
All students are responsible for completing and submitting all homework assignments and completing
clinical skills in a timely manner. Assignments/Grading will consist of:
LAB
 Ventilator skill Performance
100 pts
 Ventilator Exercises
40 pts
 Lab Questions
10 pts
CLINICAL
 Patient Case Study (1)
 Ventilator Sheets(2)
 Clinical Performance
 Data/Arc
 Physician interaction
Total points
40 pts
30 pts
100 pts
40 pts
20 pts
380 pts
NOTE: Students need to complete the specific lab performance sheet prior to checking off a clinical skill
in lab with the instructor. All lab skills are due by Friday 5/2 and prior to attending clinical. Failure to
complete the lab skills deadline will result in a 15% deduction in the final Lab skill grade for each week
past the due date. Students will also be penalized for any clinical work/documentation that is late.
Grading:
Grades are based on the percentage of total points accumulated during the quarter. Letter grades will
be assigned as follows:
A > 92%
D = 60 to 72%
B > 83%
E < 60%
C > 75%
Note: A letter grade of < “C” will result in dismissal from the program.
Documentation:
 Make sure to fill out the adult/pediatric daily log
 Make sure the daily evaluations are completed in full. Points will be deducted for incomplete
evaluations.
 Failure to complete any of the required hours of time will result in a lower grade.
 Any two unsatisfactory ratings (< 2) on the clinical performance evaluation sheets will result in
lowering the course grade in RC 182 by one letter grade
 Any three unsatisfactory ratings may result in dismissal from the program
*All forms/Data Arc submissions are due by noon the following Tuesday with the exception of
week 5 which is due the Friday before finals week. Late assignments will NOT be accepted.
Students can run a standard report on Data Arc to make sure documents were accepted.
Documentation turned in late will be given a “0”. It’s the student’s responsibility to make sure
clinical documentation is complete and turned in on time
Ventilator Worksheet
Each student is required to submit 2 ventilator worksheets during the quarter. Students should be
prepared to present these to your group in RC 152.
Physician Interaction (12 points per quarter.)
It is the responsibility of the student to seek physician interaction. The clinical preceptors will try to
facilitate these activities by providing access to patient rounds, etc. Students must seek opportunities to
solicit feedback, clarification of orders, etc. Documentation of physician interaction is accomplished
through DataArc using the daily log function. Physician interaction points are earned in 4 categories;
Patient Focused, Tutorial, Small group, and Large Group. Patient focused interaction earns 4 points per
hour, tutorial interaction earns 3 points per hour, small group interaction earns 2 points per hour, and
large group interaction earns 1 point per hour. An example of small group interaction is patient rounds.
An example of patient focused interaction is contacting a physician regarding the care of your patient.
Grading of physician interaction is as follows:



100% 15 points or greater
90% 12-14 points
80% 10-11 points



70% 8-9 points
60% 6-7 points
50% 2-5 points
Attendance/Punctuality
Attendance is mandatory. Each student is allowed a maximum of 1 absence for this rotation and still be
able to successfully meet the objectives of the course. However, grade points will be deducted. Greater
than one (1) absence will require a clinical make up day or an incomplete for the class. Students are
responsible for scheduling their own clinical time with the discretion of the Director of Clinical Education.
Students are expected to adhere to professional conduct which includes responsibility for one’s actions
and punctuality. Students are required to report to clinical 15 minutes before the start of the shift.
Daily Logs
Daily Logs are to be completed each day after your clinical rotation and are due by noon the following
Tuesday. Your daily log is where you must enter physician contact time, the day’s most significant
experience, and the procedures you completed that day. Failure to complete the daily log on time will
result in a “0” score for the day.
Daily Evaluations
Your clinical instructor will provide an evaluation of your performance every day. It’s the student’s
responsibility to get this done! It’s also the student’s responsibility to make sure they are completely filled
out. Points (-.5) will be deducted for any blank not filled out. Daily Evaluations are due by noon the
following Tuesday each week.
For the Daily Evaluation final grade, an average of the evaluations is used to give a percentage of the
final daily evaluation score. See table below:
Avg. Score
5.0
4.9
4.8
4.7
4.6
4.5
4.4
4.3
Clinical Performance - Percentage Factor
%
Avg. Score %
Avg. Score
100%
4.2
90%
3.4
98%
4.1
89%
3.3
97%
4.0
88%
3.2
96%
3.9
86%
3.1
95%
3.8
85%
3.0
94%
3.7
84%
2.9
92%
3.6
83%
2.8
91%
3.5
82%
2.6
%
80%
79%
78%
77%
75%
72%
69%
65%
Any two evaluations with a score of 2 or lower will result in lowering of the course grade by one letter
grade. Any 3 evaluations with a score of 2 or lower will result in the failing of the course.
Cellular Phones/Pagers:
Due to the distracting nature of pagers and cellular phones, students will be required to turn these
devices to a vibrate mode or entirely off during class/lab/clinical. An option is to use a voice mail
message system for the pager or phone and to pick up messages between classes.
Students with Special Needs:
All students are responsible for all requirements of the class, but the way they meet these requirements
may vary. If you need specific auxiliary aids or services due to a disability, please contact the Access
Services office in Building 7 (253-566-5328) or you can send a request to accesstesting@tacomacc.edu.
They will require you to present formal, written documentation of your disability from an appropriate
professional. When this step has been completed, arrangements will be made for you to receive
reasonable auxiliary aids or services. The disability accommodation documentation prepared by Access
Services must be given to me before the accommodation is need so that appropriate arrangements can
be made
Chain of Command in Classroom Concerns/Disputes
If you have questions or concerns about this class or me, please come to talk with me about your
concerns. If we are unable to resolve your concerns, you may talk next with Dean Krista Fox. Krista can
be contacted by calling 566-5147.
Program Learning Outcomes
Upon successful completion of the Associates in Applied Sciences Degree in Respiratory Therapy,
students will:
1. Apply the respiratory care knowledge necessary to function in a health care setting.
2. Use critical thinking skills to recommend appropriate diagnostic and therapeutic procedures using
patient data from laboratory and physiologic evaluations (CRT, IIT).
3. Perform cardio-pulmonary therapeutic procedures and modalities appropriate to level of training
(CRT).
4. Function effectively as a member of a healthcare team (COM, LWC, RES).
5. Exemplify professional and ethical behavior (RES).
Course Objectives:
To obtain a passing grade for this course, students must demonstrate competency in the following areas:
1. Exemplify a professional demeanor when responding to differences of opinion/thought, religion,
class, gender and abilities in dealing with patients, fellow students, instructors, clinical preceptors
and hospital personnel. PLO: 4, 5
2. Demonstrate the ability to communicate effectively with the medical team. PLO: 1, 2, 4, 5
3.
Review all information contained in the patient's medical record regarding history, established
diagnoses, current care regimen and current signs and symptoms to give a patient report. PLO: 1,
4, 5
4. Perform respiratory documentation per facility policy and procedure. PLO: 1, 4, 5
5. Demonstrate proper infection control using universal precautions, isolation procedures and aseptic
technique. PLO: 1, 3, 4
6. Demonstrate the ability to properly fit the appropriate NPPV mask on a patient. PLO: 3
7. Execute the following Respiratory Care modalities according to the AARC Clinical Practice
Guidelines: a)Initiation of NPPV b)Initiation of mechanical ventilation c)Weaning from mechanical
ventilation d)Mechanical ventilator circuit check e)Ventilator/patient system care and maintenance.
PLO: 1, 3, 4
8. Trouble shoot and solve common problems with NPPV and mechanical ventilation. PLO: 1, 2, 3,
9. Adjust NPPV and mechanical ventilation to meet the needs of the patient. PLO: 1, 2, 3
10. Differentiate the various modes of mechanical ventilation: control, assist-control, SIMV, CPAP, and
PSV. PLO: 1, 3
11. Discuss the changes that might occur in the parameters of pressure, volume, flow and time with
changes in compliance and resistance. PLO: 1, 2, 3
12. Given patient scenarios, determine the most appropriate mode of ventilation and initial settings
when initiating mechanical ventilation. PLO: 1, 2, 3
13. Determine the location and proper setting of available alarms on critical care and home care
ventilators. PLO: 1, 3
14. Identify the various weaning modalities found on commercially available ventilators PLO: 1, 2, 3
15. Discuss the clinical considerations, including contraindications, for determining weaning readiness.
PLO: 1, 2, 3
16. Evaluate the objective measurements required for determining weaning readiness. PLO: 1, 2, 3
17. Evaluate and implement a weaning protocol. PLO: 1, 2, 3, 4
18. Carry out the proper therapeutic services to achieve and maintain adequate tissue and arterial
oxygenation. PLO: 1, 2, 3, 4
19. Demonstrate the ability to educate the patient and family members/caregivers as to the planned
therapy and goals. PLO: 1, 2, 3, 4, 5
COURSE SCHEDULE
TOPIC
ASSIGNMENTS
Week 1 (March 30 – April 3)
 Tuesday
 Thursday
Week 2 (April 6 – 10)
 Tuesday
 Thursday
Week 3 (April 13 – 17)
 Monday/Tuesday
 Thursday
Week 4 (April 20 – 24)
 Monday
 Thursday
Week 5 (April 27 – May 1)
 Tuesday
 Wednesday
 Thursday
 Friday
Week 6 (May 4 - 8)
 Tuesday
 Thursday
Week 7 (May 11 - 15)
 Tuesday
Ventilator Practice
Ventilator Practice
** RCSW Conference **
No Class
Ventilator Practice
Ventilator Practice
Ventilator Practice
Ventilator Practice
Ventilator Practice
Ventilator Skills Exam
Ventilator Skill Exam
Ventilator Skill Exam
Ventilator Skill Exam
Clinical Week 1
Clinical Week 1
Clinical Week 2
 Thursday
Week 8 (May 18 - 22)
 Tuesday
Clinical Week 2
 Thursday
Week 9 (May 25 – 29)
 Monday
Clinical Week 3
 Tuesday
 Wednesday
Lab Question Worksheets due by 4p
Clinical Week 3
Week 1 - clinical paper work due (by 12p)
Week 2 - clinical paper work due (by 12p)
Ventilator sheet 1 Due (by 12p)
** Memorial Day **
No School
Clinical Week 4
Week 3 - clinical paper work due (by 12p)
Note: Due to Holiday, documentation can be turned in
on Wed this week only
 Thursday
Week 10 (June 1 - 5)
 Tuesday
 Thursday
 Friday
Clinical Week 4
Clinical Week 5
Week 4 - clinical paper work due (by 12p)
Ventilator sheet 1 Due (by 12p)
Clinical Week 5
Week 5 - clinical paper work due (by 12p)
* Patient Case Studies due (by 12p)
The information in this syllabus is subject to change.
Any changes may be made via class announcements only.
Please come to class regularly.
You are responsible for obtaining missed information if you are absent.