Benefits and costs to hospitals affiliating with a respiratory therapist educational program.

UNLABELLED: The services provided and revenue generated by health science students are often not considered when hospital administrators calculate the costs of affiliating with educational programs. METHODS: We documented the services provided and revenue generated by one class of students being trained as therapists in a university program. RESULTS: Fifteen students with no previous work experience in respiratory therapeutics who had demonstrated preclinical competencies for basic therapeutics and who were guided by quantitative clinical objectives collectively replaced the loss of clinical services and revenue of the staff therapists who were assigned to be their clinical instructors. CONCLUSION: The use of a qualified staff therapist as a clinical instructor can be a cost-effective approach for providing clinical education in basic therapeutics, and the contributions that students make to hospital services should be considered when affiliation agreements are being negotiated.

Effects of syringe material and needle size on the minimum plunger-displacement pressure of arterial blood gas syringes.

We determined the minimum systolic pressures required for blood to enter and begin to displace the plungers of four brands of 3-ml and 5-ml plastic and glass arterial blood gas syringes by combining samples of each syringe size with three sizes of short-beveled needles--25 gauge, 5/8"; 22-gauge, 1"; and 20-gauge, 1 1/2". We measured pressures by use of an arterial-vessel model that incorporated whole human blood and simulated the conditions of a percutaneous arterial puncture. We concluded that all the arterial blood gas syringes that we studied would self-fill in most clinical situations when they were combined with 20- or 22-gauge needles, but that 22-gauge needles with glass syringes were preferable for persons whose systolic pressures were less than 70 mm Hg, for persons in shock, and for persons undergoing CPR. Only glass 3-ml syringes should be used with 25-gauge needles, as two brands of plastic 3-ml syringes with 25-gauge needles required systolic pressures greater than 158 mm Hg and all brands of plastic and glass 5-ml syringes with 25-gauge needles required systolic pressures greater than 247 mm Hg. Because we found no clinical or statistical differences between 20- and 22-gauge needles, we do not recommend use of the larger 20-gauge needle. The syringe-needle combinations that we do recommend should negate the need for, and the potential trauma of, manual aspiration of the syringe plunger.