Section Head:  Dennis C. Teo, MD
                          Medical Specialist IV

                          Bidelia S. Dionisio (local 1320)
                          Respiratory Therapist IV

The Section of Respiratory Services (SRS) was established in 1999 rising up from the fire that engulfed Lung Center Philippines in May 1998.  SRS was created by merging the two (2) units rendering respiratory procedures/services, namely, Respiratory Therapy Section (for critical care) and the Respiratory Care Laboratory (for non-critical care).  It is a viable income center primarily providing respiratory care services involved in the diagnostic and therapeutic procedures. On 2015, it further expanded to include Cardiovascular Unit.

Vision: To be the prime Pulmonary Laboratory in terms of diagnostic and therapeutic services, training and research.

Mission: To provide the Filipino people a quality service through state-of-the-art facilities with competent and reliable staff.

SRS offers diagnostic and therapeutic procedures/services used in the evaluation and management of the different pulmonary diseases.

For In-Patients, SRS operates 24/7 with shifting hours as follows: 7am-7pm (12hrs), 8-5pm (8hrs), and 7pm-7am (12hrs).

For outpatients, SRS operates Monday to Saturday 8:00 AM to 5:00 PM.

NOTE: Due to COVID-19 Pandemic , all aerosol generating procedures (AGP) are requiring (-) RT-PCR results with 3 days validity.

Diagnostic procedures include:

1. Arterial Blood Gas determination (ABG)

An arterial blood gas (ABG) test evaluates the partial pressure of gas in the artery blood as well as the acid base content.  Understanding and use of blood gas analysis enable providers to interpret respiratory, circulatory and metabolic disorders.

2. Adult and Pediatric Pulmonary Function Testing (PFT/Impulse Oscillometry

Pulmonary function testing (PFT) evaluates and identifies the severity of pulmonary impairment. It has diagnostic and therapeutic roles that helps clinicians answer some general questions about patients with lung disease. It is also an invaluable tool in pre-operative evaluation.
The Impulse Oscillometry diagnose the presence of small airways disease that is sometimes missed out in spirometry. 

3. Hypoxemia Challenge

This test determines the risk of developing hypoxemia by increasing the partial pressure of nitrogen thereby simulating thin oxygen of high altitude during air travel.  We consequently monitoring oxygen saturation, respiratory rate, heart rate and clinical signs of hypoxia such as lightheadedness.  This test evaluates flight fitness.

4. Sputum Induction

Sputum Induction is a procedure used for patients who have trouble or expectorating sputum spontaneously. The patient inhales nebulized hypertonic saline solution, which liquefies airway secretions, stimulating the cough reflex and subsequent expectoration of respiratory secretions.

5. Pulse Oximetry monitoring

A simple non-invasive monitoring of oxyhemoglobin saturation (SPO2) and pulse rate.  It can be used as a continuous or spot checking of oxygen saturation.

6. Nitric Oxide Determination (FeNO)

It’s a simple test that collects exhaled nitric oxide – a substance that can be found in high amounts in people who have sensitive airways, such as uncontrolled asthmatics. It is a measure of airway inflammation. It is a guide to escalate inhaled ICS/LABA.

7. Blood Lactate

In conjunction with ABG it is a measure of tissue hypoxia.  Elevated lactate can signify sepsis, shock, myocardial infarct, severe heart failure, renal failure and uncontrolled diabetes.

Therapeutic procedures include:

1. Inhalations Therapy

Nebulizers deliver liquid or aerosol medications that help you breathe to your lungs via a mask or mouthpiece. Medications given via nebulizer can treat acute conditions or can prevent respiratory problems from developing. Nebulizers have benefits as a treatment for lung disease over oral medications or inhalers. 

2. High Flow Humidification/Oxygen Therapy

Humidified high flow nasal prong (cannula) therapy is a form of non-invasive respiratory support which delivers high flow rates above 20 LPM. This ensures close to 100% FiO2.  This has been an effective oxygen support in certain severe pneumonia cases such as COVID-19. The high flows and humidification improves functional residual capacity and mucociliary clearance of secretions thereby reducing work of breathing.

3. Non-invasive ventilation (CPAP and Bi-PAP)

Bi-level positive airway pressure therapy commonly used in the treatment of type 2 respiratory failure such as seen in chronic obstructive pulmonary disease (COPD), severe obstructive sleep apnea and heart failure.  This has averted intubation in selected patients.

4. Mechanical Ventilation

Our modern mechanical ventilators has been saving lives of critically ill patients, it has modern modes, monitors and safety features that is indispensable in the care of patients.  The waveforms and feedback monitoring are a valuable teaching tool for our pulmonary fellows as well as our respiratory therapist.

SRS PERSONNEL:

  • Section Head
  • 1 Respiratory Therapsit IV
  • 1 Respiratory Therapists III
  • 3 Respiratory Therapists II
  • 9 Respiratory Therapist I
  • 9 Respiratory Therapist II – Job Order
  • 1 Administrative Aide VI
  • 1 Nursing Attendant – Job Order

TRAINING

Existing Programs

Internship Program for BS Respiratory Therapy 4th Year Students

Internship Program is conducted every 3 months, with the following scope:

  • Orientation – Rules and regulations of the section.

                          Standard Operating Procedures of the section

                          Interns’ duties and responsibilities.

                          Introduction of the institution’s officials, Quality Policy,

                                   Mission and Vision

  • Theoretical Aspects – Staff Lectures

                                        Written Examination

                                        Practical Examination

  • Clinical Application – All diagnostic and Therapeutic procedures

The Respiratory Care Institute (RCI) of the Lung Center of the Philippines was established primarily to upgrade the Respiratory Care skills in the areas of Critical Care, Pulmonary Function Testing and Ward Therapy. Qualified enrollees are graduates of Bachelor of Science in Respiratory Therapy and any allied medical workers who are performing respiratory care duties.

Vision: Establish the Respiratory Care Institute to be the premier center for respiratory care training throughout the archipelago.

Mission: Enhance the health care workers in their respiratory care skills.

Program Objective: To provide opportunities to develop necessary knowledge, skills and attitude in respiratory care practice.

Learning Objective: To demonstrate the basic knowledge, skills and attitude in the practice of respiratory care duties.

Modules:

  • Mechanical Ventilator Management (3 weeks)
  • Basic Spirometry (2 weeks)
  • Arterial Blood Gas (2 weeks)
  • Bronchial Hygiene Therapy (2 weeks)
  • Basic Electrocardiography (2 weeks)

The Pre-Employment and BSRT Internship Training program has the following General Objectives:

  1. To develop academic and professional knowledge and skills required for job acquisition, retention and advancement.
  2. To become competent in the use of advanced diagnostic equipment to enable an accurate diagnosis of the severity of respiratory dysfunction in patients.
  3. To integrate teaching and research for continuous learning in the health care profession.

Specific Objectives:

  1. To enhance their knowledge in both theoretical and practical skills in the areas of Arterial Blood Gas Analysis, Electrocardiography, Spirometry, Aerosol and Oxygen Therapy, Mechanical Ventilation, Airway Management, High Flow Oxygen

Those who are qualified for the Pre-Employment Training Program must be graduates of a Bachelor of Science in Respiratory Therapy. They will be rotated in the Diagnostic procedures (Spirometry, ABG, ECG) and Therapeutic procedures (Aerosol Therapy, Mechanical Ventilation, High Flow Oxygen Therapy) and the training program will last for one month. 

SUB-UNIT AREA: The Section of Respiratory Services’ Cardiovascular Unit (CVU) was established on October 2015 as a sub-unit of SRS to provide diagnostic services relevant to cardiovascular diseases. These include 2-Dimensional (2D) Echocardiography, Electrocardiography (EKG), 24-hour Holter Monitoring, Stress Echocardiography, Cardio Pulmonary Exercise Test (CPET) and Cardiac Stress Testing, both in and out-patients.

The unit operates 8:00 AM to 5:00 PM from Monday to Saturday (in and out-patient) and during holidays and on demand basis for in-patients.

New Services of the Cardiovascular Unit

  1. 24-hr Holter Monitoring
  2. Stress Echocardiography
  3. Stress Echocardiography with Doppler
  4. Dobutamine Stress Echocardiogram (DSE)
  5. Echocardiographic Global Longitudinal Strain (GLS) 

Diagnostic Procedures for Cardiovascular Unit

  1. Electrocardiography- (ECG or EKG)
  2. 2-Dimensional Echocardiography (2-D echo)
  3. 2-D Doppler Echocardiogram with Color Flow
  4. Treadmill Exercise Testing (StressTest)
  5. Cardiopulmonary ExerciseTest (CPET)
  6. 24-hour Ambulatory Blood Pressure Monitoring – is a method to measure blood pressure on a continuous basis. It is measured for up to 24 hours. Your BP is measured even as you sleep.