Background: Burnout is a prevalent psychological disorder among students resulting from demanding educational curriculum and prolonged study durations. As a result, the aim of this study was to assess the prevalence and severity of burnout, as well as its effect on academic performance among healthcare students. Purpose: The study aimed to evaluate the prevalence of BO among healthcare students at Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University. Methods: A cross-sectional study was conducted with participants from four healthcare programs. Data were collected utilizing the Maslach Burnout Inventory - General Survey (S) (MBI-GS(S)), in addition to questions regarding sociodemographic factors. The Statistical Package for the Social Sciences (SPSS) version 29 was utilized for data analysis. Results: The study surveyed a total of 327 healthcare students. The majority of participants were female, with 273 participants (83.5%), while 54 participants (16.5%) were male. The majority group of participants were Respiratory Therapy students (n=90, 27.5%), followed by Physical Therapy students (n=81, 24.8%), Nursing students (n=79, 24.2%), and Occupational Therapy students (n=77, 23.5%). The participants' ages in the study ranged from 19 to 49 years, with a mean of 24.1 years (SD±4.55). The findings indicated that healthcare students exhibited a high level of Emotional Exhaustion (EE) with a mean score of 3.6, a moderate level of Cynicism (CY) with a mean score of 2.0, and a high level of Professional Efficacy (PE) with a mean score of 4.4. The participants' major, educational level, program level, GPA, and work status were associated with BO. Furthermore, participants’ GPA, and working hours were positively correlated with BO. Conclusion: burnout was prevalent among healthcare students. This study found that healthcare students exhibited high emotional fatigue (EE), professional efficacy (PE), and moderate cynicism. Academic performance was associated to burnout. Occupational therapy students, first-year students, employed students, clinical doctorate students, and high GPA students were associated with burnout. Therefore, this study helps educational institutions and stakeholders develop coping techniques and interventions to improve students' mental health and academic performance.

Background: The delivery of an aerosol via a tracheostomy tube has been previously described with both a tracheostomy collar and a T-piece, but not with a Wright mask, or aerosol mask. The primary purpose of this study was to quantify lung doses using different interfaces: tracheostomy collar, Wright mask, and aerosol mask. The secondary purposes were to compare albuterol delivery between an opened vs. a closed fenestration hole and also to determine the effect of inspiratory time:expiratory time (I:E) ratio on aerosol delivery.

Methods: A teaching mannequin (Medical Plastic Labs, Gatesville, TX) with a tracheostomy opening was used. Two of the mannequin's bronchi were connected to a "Y" adaptor, which was attached to a collecting filter (Respirgard ™ II 303, Vital Signs, Englewood, CO), which was connected to a breathing simulator (Harvard Apparatus Dual Phase Control Respirator Pump, Holliston, MA) through a corrugated tube. Settings for spontaneous breathing were respiratory rate 20/min, and tidal volume 400 mL. The I:E ratios were adjusted in the first and second comparisons at 2:1 and 1:2, respectively. The nebulizer was operated by a flow meter (Timemeter, St. Louis, MO) at 8 L/min with 100% oxygen. In every condition, the flow was discontinued at the end of nebulization. The nebulizer was attached to the tracheostomy collar (AirLife™, Cardinal Health, McGaw Park, IL) in the first group, the Wright mask (Wright Solutions LLC, Marathon, FL) in the second group, and the aerosol mask (AirLife™, Cardinal Health, McGaw, IL) in the third group. Drug was eluted from the filter and analyzed by spectrophotometry (276 nm).

Data Analysis: Paired t-test, one-way analysis of variance (ANOVA), repeated measures ANOVA, post-hoc and pairwise comparisons were performed at the significance level of .05, using PASW version 18.0.

Results: Aerosol delivery was greater with the tracheostomy collar than the Wright mask and aerosol mask (p < .05). Closing the fenestration hole increased aerosol deposition significantly at 2:1 ratio (p = .04) compared to opening the fenestration at 1:2 ratio. I:E ratio and aerosol delivery were directly related. Increasing I:E ratio from 1:2 to 2:1 improved aerosol delivery significantly with tracheostomy collar-fenestration opened (p = .009), Wright mask (p = .02) and aerosol mask (p = .01).

Conclusion: This study indicates that the use of a tracheostomy collar is the best method of delivering aerosol therapy among the three interfaces. The I:E ratio of 2:1 caused greater aerosol deposition than 1:2 ratio. The aerosol deposition was better when the fenestration hole was closed compared with opened fenestration.

Background: Asthma is a widespread chronic respiratory disease that affects a total of 339 million people of the global population in distinct countries reported by The Global Initiative for Asthma report. Asthma is one of the most common chronic diseases among children and is a noncommunicable disease (NCD) that affects both children and adults. It is necessary to evaluate healthcare students' perceptions to minimize asthma complications since they will play a significant role in diagnosing and controlling asthma in their future careers. Purpose: This study aims to evaluate and compare the perceptions of asthma management among healthcare students lacking clinical experiences including entry-level master's and bachelor's respiratory therapy, graduate physical therapy, graduate occupational therapy, and undergraduate nurses’ programs at Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University. Methods: A descriptive cross-sectional study was performed on participants from four healthcare programs. Data were collected through a self-administered survey to investigate the perceptions, attitudes, and beliefs held by students attending Respiratory Therapy and other healthcare professional programs. The survey consisted of 21 items, and the students' perceptions were measured using a seven-point Likert scale ranging from 1 to 7. The Statistical Package for the Social Sciences (SPSS) program, version 27 is used to analyze the data collected. Results: A total of 398 participants across four programs. Most participants were 338 female participants (84.9%) while 60 were male participants (15.1%). The majority of participants were Nursing students (n=145, 36.4%), followed by Respiratory Therapy (n=91, 22.9%), Occupational Therapy (n=82, 20.6%), and Physical Therapy (n=80, 20.1%). Furthermore, the study revealed that 80 participants (20.1%) self-reported having been diagnosed with asthma, while 318 participants (79.9%) indicated no history of asthma diagnosis. The main results of this study revealed that healthcare students had positive perceptions toward asthma management guidelines. In addition, students who self-reported having asthma rated their awareness of causes, signs, and symptoms and their understanding of asthma treatment significantly higher than non-asthmatic students. The findings from this research showed that there were significant differences in familiarity regarding asthma guidelines between respiratory therapy students and other healthcare students (p<0.001). Conclusion: Healthcare students have positive perceptions regarding asthma management guidelines. Respiratory therapy students exhibited the highest confidence levels compared to other healthcare student programs. Followed by nursing students, occupational therapy students, and physical therapy students who showed the lowest confidence levels among all programs. Further, the current study's findings support the theory that students who self-reported having asthma showed higher levels of awareness toward causes, signs, and symptoms, and their understanding of asthma treatment was also higher than non-asthmatic students.

Background: Stress is a common phenomenon among health sciences students, severely impacting students in different ways. Similar to other students, undergraduate Respiratory Therapy (RT) students are at a high risk of stress exposure that may harm their well-being. To enhance students’ well-being, it is essential to examine the prevalence and determinants of perceived stress among undergraduate RT students. Purpose: This research aims to assess the prevalence of perceived stress and identify variable sources of stress among undergraduate RT students in Saudi Arabia (SA). Methods: A cross-sectional study was conducted during the academic year (2023-2024) to explore the prevalence and determinants of perceived stress. Data was collected through an anonymous self-administered survey consisting of 46 questions, including demographics, the Perceived Stress Scale (PSS-14), and sources of stress survey. Results: A total of 384 participants completed the survey. The study findings revealed a high prevalence of stress among students (60.9%), with a mean PSS score of 28.5±9.2 among participants. Females significantly reported higher levels of stress than males (p<.001). Furthermore, there was a significant difference in the mean PSS score among students at different academic levels (p<.001). Similarly, there was a significant difference in mean PSS score among different categories of GPAs (p<.011). No significant mean PSS difference was found among marital statuses and geographical regions. Academic stress stood out as a prominent source of stress among participants. The PSS correlated positively with all domains of stressors. It had a moderate positive correlation with the academic domain (r =.512, p <.001), a low positive correlation with the psychosocial domain (r =.312, p <.001), health domain (r =.150, p =.003), and with financial strain related to financial instability (r =.196, p <.001). All stress domains had a statistically significant regression coefficient to predict stress (p<.001). Conclusion: Stress is prevalent among undergraduate RT students in SA. Therefore, institutions should establish robust feedback mechanisms and prioritize mental health and counseling services resources, considering students' multifaceted challenges.

Aerosol administration via small-volume nebulizers are still being used by selected patient-population. In the economic market, several nebulizer designs have become available, with each incorporating unique features that will potentially establish it as the preferred choice in aerosol delivery. With the continuous rising cost of health care services, clinicians are faced with the task of identifying opportunities for cost reduction in respiratory care. PURPOSE: The purpose of this study was to conduct a cost-benefit analysis of dosimetric nebulization using the Circulaire system and the traditional VixOne nebulizer. The desired outcome was to elevate awareness of the potential impact of the Circulaire, and how its adoption might reduce costs and enhance productivity in respiratory care. METHODS: A retrospective study using existing data collected from an urban tertiary adult hospital with a Level II Trauma Center was completed. DATA ANALYSIS: Descriptive statistics were run for each variable. The total cost of a full-time Registered Respiratory Therapist (RRT) with benefits per hour was calculated. The average number of RRTs per 12-hour shift, average number of nebulizer treatments by an RRT per 12-hour shift, average costs of traditional VixOne nebulizer and the Circulaire system were also calculated. RESULTS: Descriptive statistics indicated the annual cost of delivering aerosol therapy using the traditional VixOne nebulizer at 9-minutes treatment time to be $114,263.25 per year. The Circulaire was compared at two different treatment times of 5-minutes and 3-minutes, and the annual costs were $137,422.50 per year and $116,982.50 respectively. A sensitivity analysis was also conducted, and the treatment load was increased by 30%, with a reduction to 5 RRTs per shift. Data indicated an annual savings of 8% with the Circulaire at 5-minutes treatment time, and 21% with the Circulaire at 3-minutes treatment time. CONCLUSION: The use of the Circulaire system at 5-minutes or 3-minutes treatment time can reduce department expenditure by reducing labor costs.

Background: Arterial Blood Gas (ABG) is an important test that assesses the oxygenation and ventilation status. ABG tests are primarily obtained in intensive care units and emergency room patients. Blood gas analysis is a standard diagnostic method for measuring and assessing the acid-base composition and the various levels of the partial pressure of gases in the blood. These measured gases consist of partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), the potential of hydrogen (PH), and oxyhemoglobin saturation (SaO2). It additionally assesses acid-base balance by measuring bicarbonate (HCO3) and base excess (BE). Healthcare professionals can evaluate and assess patient conditions because of circulatory, metabolic, and respiratory diseases by interpreting ABG results. The interpretation of ABG results provides detailed information about the level and severity of diseases. Blood gas analysis assists in evaluating patient response to medical interventions, monitoring the condition of patients with pulmonary or cardiac diseases, assessing the severity and progression of cardiopulmonary disease, and determining if compensation is occurring. Purpose: This study aimed to evaluate the perception of ABG interpretation among nursing and respiratory therapy students from Byrdine F. Lewis College of Nursing and Health Professions at Georgia State University. Methods: A descriptive cross-sectional study was conducted at Georgia State University. Data was collected from nursing and respiratory therapy students using a convenience sample. Data were collected through a self-administered questionnaire with direct coordination with RT department directors. Data was analyzed using the statistical program of Statistical Package for the Social Sciences (SPSS). Results: A total of 236 responses were received from both programs. The majority of the study participants pursuing bachelor's degree in nursing n= 145 (61.4%); followed by a bachelor's degree in respiratory therapy n= 76 (32.2%); and a master's degree in respiratory therapy n= 15 (6.4%). The current study findings demonstrated that undergraduate and graduate healthcare students exhibited positive perceptions toward ABG interpretation. The findings revealed that healthcare students reported the strongest agreement on the importance of recognizing an abnormal ABG, with a total mean score of 6.85 and a standard deviation of (SD ± .684). There were significant differences in the familiarity regarding ABG interpretation between nursing and respiratory therapy students (P< .001). Lastly, there were significant differences in the perceptions regarding ABG between students who had clinical experience and those who had no clinical experience (P< .001). Conclusion: Healthcare students have positive perceptions toward ABG interpretation. The study's findings also support the theory that bachelor's and master's degree respiratory therapy students exhibited superiority in familiarity regarding ABG interpretation over bachelor's degree nursing students. Additionally, the current study’s findings indicated that experience positively affects the perception regarding ABG interpretation.

Background: Anxiety and depression are prevalent concerns among psychologists, psychiatric professionals, and behavioral scientists across the world. Anxiety is defined as worry-filled thoughts and a pervasive sense of impending doom. It is a broad concern about what will or might occur in the future. Depression is a debilitating disorder, leading to higher death rates and a significant decline in the quality of life. It is characterized by persistent feelings of sadness, emptiness, and lack of happiness. Therefore, anxiety and depression could have a detrimental effect on the well-being and productivity of respiratory therapists. Purpose: The purpose of this study is to investigate the prevalence and severity of anxiety and depression among respiratory therapists employed by public and private hospitals in the western region of Saudi Arabia. Methods: A cross-sectional study was conducted between September 5 and October 7, 2023. The Hospital Anxiety and Depression Scale (HADS) was distributed electronically to respiratory therapists' email addresses through direct collaboration with RT department heads. Data were collected from RT professionals in both public and private hospitals by using a non-probability convenience sampling technique. The data analysis and statistical description provided by the participants were displayed as means, standard deviations, frequencies, and percentages. A one-way ANOVA test was used to determine the significant differences in HADS scores among categorical groups. Results: A total of 307 responses were received from RTs working in the western region of Saudi Arabia. The majority of them were from public hospitals (74.3%) and (25.7%) from private hospitals. The study findings showed that the prevalence of anxiety and depression among RT professionals in the western of SA were found to be 38.8% and 37.5%, respectively. In addition, HADS scores were significantly higher among RT professionals who were female, current smokers, divorced, or widowed. However, HADS showed that anxiety was significantly higher among RT professionals with clinical experience between 1-4 years as well. Conclusion: Anxiety and depression were common psychological disorders among respiratory therapists in the western region of Saudi Arabia. Higher odds of anxiety and depression were significantly found among females, staff with clinical experience between 1 and 4 years, smokers, and divorced/widowed staff. Further studies are required to investigate the prevalence of depression and anxiety among RTs in all regions of Saudi Arabia.

Background: In response to the COVID-19 pandemic, electronic learning (E-learning) has emerged as the primary method for delivering educational materials, particularly within the scope of Saudi Arabian (SA) Respiratory Therapy (RT) education. PURPOSE: To evaluate the perception of E-learning among RT students in the Kingdom of Saudi Arabia (KSA) by comparing face-to-face learning to E-learning during the COVID-19 pandemic. METHODS: A cross-sectional survey to investigate the perception of E-learning was conducted and distributed using a convenience sample of RT students through an online platform (Google Forms) between September and November 2023. RESULTS: Overall, 221 RT students, with females accounting for 119 (53.8%), replied to the online survey. The study revealed several advantages of E-learning, including the ability to study at home (67.9%), access to online materials (64.7%), and learning at own pace (62.4%). The main disadvantages as indicated by most respondents were the lack of interactions with patients (70.1%), technical problems (56.6%), and reduced interaction with teachers (50.7%). No significant difference in the perceptions of knowledge enhancement between face-to-face and E-learning methods (P = .32). However, E-learning was considered a lower effective method than face-to-face learning for both clinical skill development (P < .001), and social competencies (P < .001). Additionally, respondents reported that they were less actively engaged during E-learning classes compared to face-to-face classes (P < .001). Nonetheless, a significant percentage of respondents (71.9%) claimed that E-learning was an enjoyable experience. CONCLUSION: This research emphasizes the potency of E-learning in terms of increasing knowledge as a valuable tool for educating Saudi RT students. Nevertheless, it highlights the need for a meticulously planned strategy and a proactive implementation approach to effectively implement clinical and social skills E-learning into the educational framework of RT students.

Background: Insomnia is a common sleep disorder characterized by difficulties falling asleep, staying asleep, or waking up early in the morning, along with significant distress and impairments of daytime functioning. It is a prevalent sleep complaint among health science students, due to an overburdened academic load, protracted intensive study periods, and stressful lifestyles to maintain an outstanding grade point average (GPA). Therefore, insomnia can adversely affect students' health and academic performance. Purpose: This study aimed to assess the prevalence of insomnia and its impact on academic performance among respiratory therapy students in Saudi Arabia (SA) and the United States of America (USA). Methods: A cross-sectional study was conducted between June 9 and September 12, 2023. Insomnia Severity Index (ISI) was distributed electronically to students' email addresses through direct coordination with RT department directors. Data were collected from RT students in both countries by using a non-probability convenience sampling technique. Descriptive statistics of the participants were presented in frequencies, percentages, means, and standard deviations. A one-way ANOVA test was used to measure the significant differences of ISI scores among categorical groups. Results: A total of 403 responses were received from both countries. The majority of them were from Saudi Arabia (79.9%) and (20.1%) from the United States. The study findings showed that the prevalence of insomnia among RT students in SA and the USA was found to be 32% and 21%, respectively. In addition, ISI scores were significantly higher among Saudi RT students who were female, in their second academic year, current smokers, single, and those with a poor cumulative GPA. However, ISI scores were significantly higher only among current smoker RT students in the USA. Conclusion: Insomnia was a prevalent sleep disorder among respiratory therapy students in both Saudi Arabia and the United States. Insomnia was negatively correlated with students' academic performance. Several demographic factors were significantly associated with a higher level of insomnia, including gender, academic year, smoking status, marital status, and GPA. Therefore, this study provides valuable insights for educational institutions and stakeholders to work collaboratively to implement tailored interventions and coping strategies that support students' healthy sleep habits, mental well-being, and academic achievement.

Background: Pulmonary Rehabilitation (PR) program is an effective non-pharmacological intervention for patients with COPD. It aims to improve quality of life, exercise capacity, and lung function. PR has been shown to reduce mortality and morbidity rate. To enhance COPD management strategies, it is essential to examine students' perceptions toward PR programs to determine the need for the implementation of educational courses about the effectiveness of PR programs. This study would also be considered one of the initial steps in developing a pulmonary rehabilitation education course in the curriculum of all healthcare programs at Georgia State University. Purpose: was to assess the perceptions of various enrolled healthcare students at a large urban university. Methods: The data used for this study were collected from three different healthcare programs at GSU using a convenience sample. Data were collected through a self-administered survey consisting of 38 questions on a 5-point Likert- type scale evaluating the perceptions. The survey was examined for face validity by respiratory therapy educators from GSU. Data was analyzed using the statistical program of Statistical Package for the Social Sciences (SPSS). Results: A total of 178 participants from three programs. The majority of respondents were respiratory therapy students (43.3%); followed by physical therapy (39.9%); occupational therapy (16.9%). The study findings revealed there were differences in the perception of students regarding pulmonary rehabilitation. There was a significant difference in positive perceptions between students who had experience attending PR programs and those who did not (p=0.043). There were no differences found among students in familiarity with PR programs (p=0.060). Finally, there were no differences in the perception of students regarding the factors that could influence COPD patients' decisions not to participate in the PR programs. Conclusion: Healthcare students value and have a positive perception toward PR. The results of this study support the idea of the implantation of PR courses throughout the healthcare program curriculum. Healthcare students felt that they had an important role in PR programs, but barriers to participating and assisting in PR included their own lack of knowledge and clinical experience. They considered that there should be more teaching on pulmonary rehabilitation and that these should feature in both the curriculum and clinical. Further studies with a higher number of participants and different institutions are recommended.

Abstract

Background: Tobacco use is a global health concern that results in millions of deaths annually. This study focuses on Saudi Arabian respiratory therapy students in the Western region to assess smoking prevalence, secondhand smoke exposure, smoking cessation education, and perceptions of smoking cessation. Purpose: The purpose of this study is to evaluate the smoking prevalence among Saudi respiratory therapy students in the Western region, their exposure to secondhand smoke, smoking cessation education, and their perceptions of the positive effects of quitting smoking. Methods: Using a descriptive exploratory methodology, this study collected data on smoking prevalence, secondhand smoke exposure, and attempts to quit smoking among students. The Global Health Professional Students Survey (GHPSS) was employed as the survey instrument. Results: The results indicate that the prevalence of cigarette smoking among male respiratory therapy students was 52%, while it was lower among females at 3.7%. The study also revealed high rates of exposure to secondhand smoke in public settings (52%), whereas exposure at home was relatively low (28%). This emphasizes the importance of enforcing smoking bans in public spaces to safeguard individuals from the effects of secondhand smoke. Conclusion: This study sheds light on the smoking prevalence, secondhand smoke exposure, smoking cessation education, and perceptions of smoking cessation among Saudi Arabian respiratory therapy students in the Western region. The findings highlight the need for targeted interventions to address smoking behaviors among students. Additionally, the study reveals the importance of creating smoke-free environments, as the rates of exposure to secondhand smoke in public settings were alarmingly high.

Background: Noninvasive ventilation (NIV) is a modality that supports patient breathing through different types of face ‏interfaces, such as a full-face mask and nasal mask. Noninvasive Ventilation modalities have proven to improve morbidity and mortality rates for patients suffering from respiratory failure in the hospital setting and Outpatient. It also helped prevent escalating the treatment to more advanced methods such as invasive ventilation. However, several elements are required for optimizing the therapy, including Health care providers' training in operating the different brands of NIV, equipment availability, cost, and appropriate adjustment to the settings according to patient response. Purpose: This study aims to assess the level of perception of maximizing patient comfort during non-invasive ventilation devices among respiratory therapists at KFSH&RC by utilizing specific features of NIV. For instance, ramp, Flex, humidification, and auto-adjusting pressure. In addition, how RTs perceive mask selection and other contributing factors that contribute to maximizing patients' comfort. Methods: The study used an online, cross-sectional survey with 20 questions were sent to Respiratory therapists at KFSH&RC. In this survey, data collected from targeted population regarding their perceptions of skills for maximizing patient comfort during non-invasive ventilation will be analyzed using the Statistical Package for the Social Sciences (SPSS). Result: The findings indicated that respiratory therapists at KFSH&RC generally hold a positive view about utilizing various aspects of NIV, such as auto-adjusting pressure, noise reduction, humidification, and specific NIV settings, to maximize patient comfort. They also recognized the importance of effective communication, patient encouragement, and addressing patient comfort before and after initiating NIV therapy. The study found that demographic factors like gender, country of graduation, years of experience, and age did not significantly impact the therapists' attitudes, except for therapists working in respiratory care community services (RCCS), who placed greater emphasis on maximizing patient comfort during NIV (P=.019). Conclusion: This research conducted at King Faisal Specialist Hospital & Research Centre (KFSH&RC) concluded that respiratory therapists demonstrated positive perception about utilizing different elements of NIV to maximize patient comfort during therapy. Majority of therapists believed that features such as auto-adjusting pressure, noise reduction, humidification, and the utilization of certain NIV settings such as the FLEX and RAMP have significance for enhancing patient comfort.

Abstract

Background: Covid-19 is a recent pandemic that spread globally. Consequently, little research focused on Covid-19 that compared different mechanical ventilator modalities that were suitable for these cases. Investigating appropriate mechanical ventilation techniques such as APRV that control the pandemic is necessary to confront any future pandemic. RTs' beliefs and practices of utilizing mechanical ventilation during the Covid-19 pandemic are essential to establish a guideline to manage ventilated Covid-19 cases. Purpose: This study aims to evaluate the perception, prevalence, and utilization of APRV mode with Covid-19 patients among respiratory therapists in Saudi Arabia. Methods: The study utilized an online, cross-sectional survey with 29 questions administered to a convenience sample of Saudi Arabian RTs. The survey was divided into three sections to obtain information from respondents. These sections are demographic data, perceptions regarding APRV and ARDS, and the prevalence of utilizing APRV on patients with Covid-19 associated ARDS. Result: Eighty-six responses were obtained from the online survey that was sent to many respiratory therapy departments in different regions across SA. Two participants refused to participate, and n=47 (54.7%) of responders did not complete the survey, and their answers were excluded. Therefore, n=37 (43%) respondents completed the survey. The majority of respondents were male n=31 (83.8%), whereas the female accounted for n=6 (16.2%) of respondents. Most of the respondents held a bachelor's degree n=32 (86.5%), while only n=5 (13.5%) held a master's degree. There were no responders who held associate or Ph.D. degrees. The result showed there was a high level of confidence among RTs that using APRV with Covid-19 cases was effective with a mean of (2.97± 0.763). Furthermore, the results showed that RTs believed that Covid-19 associated ARDS had a similar clinical picture of non-Covid-19 associated ARDS n=28 (75.7%). A Kruskal-Wallis Test revealed no significant difference in using APRV with Covid-19 cases during the pandemic between the region of practice in Saudi Arabia, Kruskal-Wallis H=3.219, p=.395. Also, the results showed that there was no significant difference among different qualifications (p=0.875). Conclusion: The overall level of perception of APRV needs to be improved, which, in turn, can improve and strengthen the management of ARDS and respiratory disorders and increase the average survival rate in Saudi Arabia. More educational sessions and classes are required for this purpose.

ABSTRACT

BACKGROUND: The level of anxiety and sleep disturbances among healthcare providers plays an essential role in overcoming epidemics, especially those on the front lines. It is the responsibility of RTs to provide care to patients with respiratory illnesses. Because of their importance in the health care team, respiratory therapists must have good mental health to do their job to the fullest. It is necessary to identify the subpopulations of healthcare workers who are particularly vulnerable to sleep deprivation and anxiety to characterize them to develop targeted interventions and plan for future crises. PURPOSE: The aim of this study was to assess the prevalence of sleep disturbance and anxiety among RTs in Saudi Arabia during the COVID-19 winter of 2022. METHODS: The study employed a cross-sectional survey that was conducted online and consisted of 44 questions administered to a convenience sample of RTs in Saudi Arabia. The survey was divided into three parts, which were Pittsburgh Sleep Quality Index (PSQI), Zung Self-Rating Anxiety Scale (SAS), and demographic questions. The data analysis was conducted using SPSS version 27. RESULTS: The sample of this research involves 34 respiratory therapists. The majority of the respondents were males 67.6% (n=23), while the females comprised 32.4% (n=11). In addition, 32.4% (n=11) of the participants were from the central region, 14.7% (n=5) were from the east region, 5.9% (n=2) were from the north region and 11.8% (n=4) were from the south region, and 35.3% (n=12) were from the west region. The study showed that the majority of respiratory therapists in Saudi Arabia (79.4%) reported that they had sleep disturbances. The study findings of seven components of the Pittsburg sleep quality index (PSQI) among RTs in Saudi Arabia showed that the component “Sleep latency” was the highest mean score (M=1.8 ± 1.0). The finding revealed that twenty-seven participants out of thirty-four (79.4 %) Reported normal anxiety, with only 20.6% having mild-to-moderate anxiety. Moreover, the study findings indicated no significant difference in sleep disturbances and anxiety levels between RTs in the different regions of Saudi Arabia; sleep disturbances H (4) = 5.026, P = .285, anxiety H (4) = 3.299, P=.509. Additionally, the study found no evidence that anxiety statistically correlated with sleep disturbances among RTs in Saudi Arabia. (P = 0.139). Conclusion: This study provides important insights into the prevalence of sleep disturbances and anxiety among respiratory therapists in Saudi Arabia during the COVID-19 winter of 2022. It is found that a significant proportion of respiratory therapists in Saudi Arabia experienced sleep disturbances. Further research is needed to explore effective strategies to support mental health and quality of sleep among respiratory therapists.

BACKGROUND: Aerosol therapy using albuterol is one of the most prescribed asthma treatments. The most frequently used methods of aerosol delivery are pneumatic jet nebulizer (JN), pressurized metered-dose inhaler (pMDI), and breath-actuated nebulizer (BAN). Choosing among these devices is usually not based on thorough comparison of efficiency or cost. We compare the efficiency of these three devices using a spontaneously breathing adult model.

METHODS: We connected each aerosol generator—JN, BAN, or pMDI with a valved holding chamber (VHC)—to the face of an adult teaching manikin. Below the bifurcation, an elbow adaptor was connected to a corrugated tube and was angled to be at a lower level than the collecting filter to prevent droplets from dripping directly into the collecting filter. From the collecting filter, another corrugated tube was connected to a prevention filter, which was then connected to an adult breathing simulator. Spontaneous breathing parameters were V_T 450 mL, RR 20/min, and I: E ratio 1:2. First, we compared JN, BAN (2.5 mg/3 mL), and pMDI (4 puffs); second, we compared JN and BAN 2.5 mg/0.5 mL plus 0.5 mL normal saline. Data were analyzed using spectrophotometry (276 nm). One-way ANOVA and independent sample t-tests were used (p<0.05).

RESULTS: There were no differences in inhaled mass percentage (p=0.172) JN, BAN, and pMDI in the first experiment. Treatment time with BAN was significantly longer (p=0.0001) than with JN or pMDI. In the second experiment, BAN delivered more medication (p=0.004) than jet nebulizer. Treatment time was significantly less with JN (p=0.010). There was no difference in residual volume among JN and BAN in both experiment (p=0.765, p=0.115).

CONCLUSIONS: All the devices that were compared using a 3 ml or 4 pMDI puffs delivered comparable amount of medication with no significant difference. However, BAN using 1ml fill volume delivers more drug compared to JN. Additionally, treatment time was longest with BAN. Even with reduction of its filling volume, BAN delivers a higher amount of medication to that of pMDI but was not statistically significant.

Background: Pediatric acute respiratory distress syndrome (PARDS) significantly contributes to morbidity and mortality in young children. Children with PARDS often require intensive care admission and mechanical ventilation. Unfortunately, not much information is available to support management strategies in PARDS beyond lung protective ventilation. Examining proper mechanical ventilation techniques such as Airway Pressure Release Ventilation mode (APRV) that can support and manage these patients. Respiratory therapists' beliefs and practices of using mechanical ventilation are essential to establish guidelines for managing ventilated PARDS cases. Purpose: This study aims to evaluate the prevalence and attitude of APRV mode with PARDS patients among respiratory therapists in Saudi Arabia. Methods: The study used an online, cross-sectional survey with 22 questions administered to a convenience sample of respiratory therapists in Saudi Arabia. The survey was divided into three sections to obtain information from respondents. These sections are demographic data, the prevalence of utilizing APRV on patients with PARDS, and attitudes regarding APRV with PARDS. Results: seventy-seven responses were received from the online survey sent to respiratory therapy departments in different regions across Saudi Arabia. Three participants refused to participate, and n=20 (28,5%) of responders did not complete the survey, and their answers were excluded. Therefore, n=54 (70,1%) respondents completed the survey. The result showed that most participants have a bachelor's degree (n=43, 79,6%), master's degree (n= 8, 14,8%), associate degree (n= 2, 3.7%), and only one participant have a Ph.D. degree (n=1, 1.9). Most participants were males (n= 34, 63%). At the same time, the females were (n=20, 37%). Most of the responses were from the middle region (n=28, 51.9. The majority of respondents worked in a governmental hospital (n=52, 96.3%), while two worked in private hospitals (n=2 ,3.7%). Half of the respondents (n=27, 50%) reported that their hospital uses the APRV mechanical ventilation mode with pediatric ARDS patients. Among those who reported using APRV mode, only (n=9, 33.3%) reported following the current guidelines of the Pediatric Acute Lung Injury Consensus Conference (PALICC). In comparison, (n=6, 22.2%) reported not following the guidelines, and (n=12, 44.4%) were unsure. The findings suggest variation in the respiratory therapists' experience and confidence in using APRV. However, most participants believe it is a safe ventilation mode and can be used as both an initial and rescue mode. Conclusion: the study reveals variations in the experience and confidence of respiratory therapists in using APRV, which may influence their willingness to use it in pediatric patients with ARDS. Most participants, however, believe it is a safe ventilation mode that can be used as both an initial and rescue mode. The results of this study could inform the development of training programs and protocols designed to improve respiratory therapists' knowledge and confidence in using APRV and to promote its consistent use in pediatric patients with ARDS.

BACKGROUND: Evidenced-based practice (EBP) is applying or translating research findings in our daily patient care practices and clinical decision-making. EBP also involves integrating the best available evidence with clinical knowledge and expertise, while considering patients’ unique needs and personal preferences. Since the role of RTs has increased, the importance of choosing the most effective treatment available is vital. Therefore, it is essential to evaluate RTs' EBP beliefs and their implementation level and obtain important information about their daily clinical practice. PURPOSE: The purpose of this study was to measure the level of implementation, describe beliefs about EBP among respiratory therapists in the clinical setting in Saudi Arabia. METHODS: The study utilized an online, cross-sectional survey with 34 questions administered to a convenience sample of RTs in Saudi Arabia. The survey is divided into three sections: belief and implementation, and demographics questions. Data were analyzed using descriptive statistics and one-way ANOVA tests. A significance level was set at 0.05. All analyses were performed in SPSS version 26. RESULTS: The total sample consisted of 49 respiratory therapists consisting of three experience levels: less than 5 years (n=38, 77.55%), 5 to 10 years (n=6, 12.24%), and more than 10 years (n=5, 10.20%). The majority of the respondents were males (57%, n=28), while the females comprised (40% n=20). Most of the respondents in the study are between 25 and 30 years old (59% n=29), under 25 years (32% n=16), and over 35 years old (8% n=4) There were no statistically significant differences between male and female respondents or years of experience in the belief or implementation scales. CONCLUSION: In conclusion, the respiratory therapists' community in Saudi Arabia reported their positive beliefs about EBP, but most of them did not frequently implement it in their daily clinical practice. Further research is required due to a lack of literature on evidence-based practice in respiratory therapy, and to assess the correlates of negative EBP' implementation levels among RTs in Saudi Arabia

Background: Despite the growing research about the effectiveness of using Extracorporeal membrane oxygenation (ECMO) in different countries, there is a lack of research that addresses Respiratory therapists (RTs') practice, perception, and prevalence regarding the use of ECMO specifically in Saudi Arabia. Therefore, it is essential to evaluate RTs' perceptions, prevalence, and attitudes toward working with ECMO patients in Saudi Arabia to address the need for designing a target intervention to improve the awareness of understanding ECMO, generate advanced practitioners, enhance the healthcare quality, and decrease mortality.

Purpose: The primary purpose of this study was to evaluate the perception, prevalence, and attitudes toward the application of ECMO among respiratory therapists in Saudi Arabia.

Methods: A cross-sectional study was designed with 28 survey-based questions divided into four sections: demographic data, general questions about using ECMO, general questions about the knowledge of using ECMO, and general questions about the attitudes toward using ECMO among RTs in SA. Data were analyzed using descriptive statistics and the Chi-square tests. A convenience sample of Respiratory Therapists working in Saudi Arabia was collected online through social media platforms (Twitter, Facebook, and WhatsApp).

Results: A total of 49 RTs responded. More than half of the respondents were male 29 (60.4%), and 19 (39.6%) were female. The majority of respondents were working in urban regions (76.6%), 12.8% (n=6) of respondents were in suburban areas, and only 10.6% (n=5) were in rural areas. Approximately half of the respondents revealed they were uncomfortable with their knowledge while working with patients on ECMO (45.8%). Also, sixteen (34%) of respondents were uncomfortable with their knowledge when decisions are made in their unit relating to the initiation and withdrawal of the ECMO circuit. In comparison, they were knowledgeable in managing the mechanical ventilation of patients receiving ECMO (37.5%). The findings showed that most respiratory therapists working in intensive care units (ICU), most likely the cardiovascular ICU that provides ECMO (52.1%). However, most of them learned about ECMO from their college or university studies. Still, most hospitals did not offer ECMO training for RTs in SA (41.4%). Also, significant differences were received in RTs' attitudes toward ECMO depending on their working area (urban, suburban or rural).

Conclusion: The respiratory therapists showed a limited perception regards working with ECMO patients. However, the findings of this study revealed the experience positively impacts the perception of working with ECMO patients. This study found that education programs and country regions affect the practicing and understanding the patients in ECMO. Future studies should include larger sample size and compare respiratory therapists to other ICU professionals in managing ECMO patients.