Our Respiratory Care team is comprised of Respiratory Therapists (RT), specialists that are trained to treat people who have breathing or cardiopulmonary problems. The department has a full array of devices, tests and methods to use, depending upon the patient’s condition. From lung exercises to monitoring your blood oxygen levels, our therapists are knowledgeable and able to treat a variety of conditions.
The following services are available
- Cardiac Rehabilitation
Sakakawea Medical Center’s Cardiac Rehabilitation program offers focused programs to help cardiology patients improve their fitness levels and return to as much of a normal and healthy lifestyle as possible.
Cardiac Rehabilitation is a medically supervised program that can help each patient restore his or her optimal health after a heart attack, heart surgery, stable angina and other pre-existing cardiac conditions that have caused damage to the heart muscle.
Certified staff can help the patient begin an exercise program that is effective, safe and appropriate for the individual’s health, age and physical activity. Our goal is to make the most of rehabilitation by enhancing the overall quality of life through education, exercise and support while caring for the patient in a friendly and supportive environment. With the assistance of skilled professionals, patients are able to improve their cardiovascular health and alter the progression of heart disease.
- Pulmonary Rehabilitation
The Pulmonary Rehabilitation Program at Sakakawea Medical Center is a twelve-week comprehensive rehab program for patients who have breathing problems resulting from pulmonary diseases such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, asthma and lung cancers. Our Pulmonary Rehabilitation team works directly with each individual to improve their comfort level, respiratory function and understanding of their disease. Our program is tailored to meet each patient’s individual goals.
After successfully completing the twelve-week program, patients have the option of enrolling in a patient pay program that allows them to continue to exercise in a supervised setting.
Your physician can refer you to the program, or you can call us directly. Sakakawea Medical Center will contact your healthcare practitioner to obtain appropriate medical information and approval.
- Cardiac Stress Testing
also known as a cardiac diagnostic test, is a test that measures a heart’s ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or by drug stimulation.
Cardiac stress tests compare the coronary circulation while the patient is at rest with the same patient's circulation during maximum physical exertion, showing any abnormal blood flow to the myocardium (heart muscle tissue). The results can be interpreted as a reflection on the general physical condition of the test patient. This test can be used to diagnose coronary artery disease (also known as ischemic heart disease), and for patient prognosis after a myocardial infarction (heart attack).
The cardiac stress test is done with heart stimulation, either by exercise on a treadmill, pedaling a stationary exercise bicycle ergometer, or with intravenous pharmacological stimulation, with the patient connected to an electrocardiogram (ECG). People who cannot use their legs may exercise with a bicycle-like crank that they turn with their arms.
The level of mechanical stress is progressively increased by adjusting the difficulty (steepness of the slope) and speed. The test administrator or attending physician examines the symptoms and blood pressure response. With use of ECG, the test is most commonly called a cardiac stress test, but is known by other names, such as exercise testing, stress testing treadmills, exercise tolerance test, stress test or stress test ECG
- Home Oxygen Program
- Sakakawea Medical Center believes that the most important aspects of home oxygen therapy is comfort, safety and understanding. We are committed to providing the best service to all of our home oxygen and nebulizer customers.
- Our Services Include
- Prompt and courteous home delivery to your front door.
- Insurance and Medicare/Medicaid assistance.
- Assistance with planning out your oxygen needs when discharged from the hospital.
- Easy to understand instructions on how to use equipment and what to expect.
- Available Oxygen/ Respiratory Therapy Equipment
- Oxygen Concentrators
- Portable Oxygen Cylinders (multiple sizes)
- Oxygen Conserving Devices
- Nebulizers (Adult & Pediatric)
- Sleep Studies
Diagnosis of any sleep disorder begins with your healthcare practitioner through a physical examination and personal history. If further diagnostic work-up is required, a sleep evaluation study may be conducted locally at Sakakawea Medical Center.
Sleep Apnea is the most common of the sleep disorders. It’s estimated that up to 15% of the population has respiratory-related sleep problems. The most common of these is Obstructive Sleep Apnea.
Untreated sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, headaches, apathy, depression, excessive daytime sleepiness. Moreover, untreated sleep apnea may be responsible job impairment and motor vehicle crashes.
Patient education and continual follow-up after a sleep disorder diagnosis ensures that each patient achieves some form of relief. Their treatments can include behavioral therapy, weight loss, the application of continuous positive airway pressure during sleep with a CPAP / BIPAP device, the judicious use of medicines or, in some cases, surgical intervention.
Make an appointment with your healthcare practitioner to discuss how a sleep study may help you sleep better.
- Padnet+ Testing
P.A.D., short for Peripheral Arterial Disease, occurs when arteries in the legs become narrowed or clogged with fatty deposits known as plaque. P.A.D. develops slowly over many years. In the early stages, most people with P.A.D. have no symptoms. Only about one out of three people with P.A.D actually feel there is something wrong with their feet or legs. By that time, their arteries may be so clogged that they are not getting enough oxygen to their leg muscles. The most common sign of P.A.D. include one or more of these problems
- Cramps, tiredness or pain in your legs, thighs or buttocks that always happens when you walk but that goes away when you rest. This is called claudication.
- Foot or toe pain that often disturbs your sleep.
- Skin wounds or ulcers on your feet or toes that are slow to heal.
Lower-extremity P.A.D. is a serious disease that affects about 8 million Americans. The hardened arteries in people with P.A.D. are a sign that they are likely to have hardened and narrowed arteries to the heart and brain. People with P.A.D. are at high risk for having a heart attack or a stroke.
Therapists at Sakakawea Medical Center can administer PADnet+ testing which is a non-invasive diagnostic test that can provide early detection of P.A.D. when treatment options are greatest. PADnet+ detects blockages in arteries and the quality of blood flow. The results from the test will allow your healthcare practitioner to determine the best treatment options.
- PFT — Pulmonary Function Study
Sakakawea Medical Center’s Respiratory Therapist’s use pulmonary function tests (PFT’s) to find out how well you move air in and out of your lungs and how well oxygen enters your body. The most common PFT is spirometry.
- Pre and post spirometry — Spirometry pre and post beta-agonist is a quick, painless test in which a device called a spirometer is used to measure how much air a person's lungs can hold (air volume) and the speed (air flow rate) of inhalation and exhalation during breathing, both before and after receiving a medication (beta-agonist). The spirometer has two pieces: a mouthpiece and a tube that connects to a machine that displays and records the results.
- Why It's Done — Beta-agonists are medications that affect the muscles around the airways in the lungs. In people with asthma, these muscles tighten when the airways become irritated, which can result in breathing difficulties and wheezing. Beta-agonists help these muscles relax, allowing the air passages to widen, which makes breathing easier.
- Most beta-agonists are given by inhalation. Spirometry pre and post beta-agonist lets health care professionals test the effectiveness of these medications for a particular patient and gauge how well his or her lungs are working with and without the medication.
- Methacoline challenges (for asthma testing)
A methacholine challenge test evaluates your lung function and the reactivity (narrowing or tightening) of your airways. It helps diagnose and monitor asthma, a chronic lung disease marked by acute flare-ups of inflammation and swelling of the airways in the lungs.
A methacholine challenge test is a type of bronchoprovocation test, which measures lung function after exposure to factors that commonly trigger wheezing and other asthma symptoms. A methacholine challenge test involves inhaling a mist that contains methacholine, a substance that causes lung constriction in people with asthma.
A methacholine challenge test is only one method to diagnose asthma. Discuss all of your testing methods with your doctor to understand which options are right for you.
- Arterial Blood Gas Sampling
An arterial blood gas (ABG) allows Sakakawea Medical Center’s respiratory therapists to measure the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. This test is used to check how well a patient’s lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. Blood for an ABG test is taken from an artery.
Most other blood tests are done on a sample of blood taken from a vein, after the blood has already passed through the body’s tissues where the oxygen is used up and carbon dioxide is produced.
- Preliminary Overnight Oximetry Saturation Studies
Overnight Pulse Oximetry is a simple test using a small device with a finger probe that uses an infra-red light to measure the saturation levels. You will simply wear the probe on your finger during the night while you sleep and return the device in the morning. The results will be uploaded from the device to a computer and your doctor will discuss the results with you.
The test allows your doctor to have a picture of your breathing and pulse rate while you are asleep. The oxygen levels help determine whether or not you are dropping below the normal level of 90% SpO2 or if you have periodic drops in oxygen levels throughout the night. If the oxygen is dropping below the normal level of 90% SpO2, then it might be that your doctor will prescribe supplemental oxygen therapy. Based on the periodic drops in oxygen levels could be indicative of an underlying sleep disorder. Typically the next step is to have an additional sleep study to get a more detail picture with additional recordings of breathing patterns at night.
An overnight pulse oximetry can also be used to ensure if your doctor has prescribed the proper liter flow of supplemental oxygen at night by using the pulse oximetry at night while also using the supplemental oxygen. If the levels saturation levels are remaining below the 90% SpO2, then the liter flow may need to be increased.
Another use is to use the pulse oximetry with CPAP/BIPAP therapy. This gives a snapshot of to see if the therapy is eliminating the periodic drops in saturation levels. If the periodic drops are present, then your doctor may prescribe an auto titrating CPAP/BIPAP to reevaluate the pressure settings needed to overcome the apnea or hypopnea that’s still occurring.
- Oxygen Saturation Checks with Exercise/Resting
Your red blood cells carry oxygen through your arteries to all of your internal organs. They must carry enough oxygen to keep you alive. Normally, when red blood cells pass through the lungs, 95%-100% of them are loaded, or "saturated," with oxygen. If you have lung disease or other types of medical conditions, fewer of your red blood cells may be carrying their usual load of oxygen, and your oxygen saturation might be lower than 95%. If your blood oxygen saturation is too low, you may need to be given oxygen to breathe.
Respiratory Therapists at Sakakawea Medical Center can take an estimate of your oxygen saturation which is performed easily and painlessly with a clip that fits on your finger. This clip shines a light through one side of your finger; a detector measures the light that comes through the other side. This machine can make a good estimate of your oxygen saturation because blood cells that are saturated with oxygen absorb and reflect light differently than those that are not. Blood cells are a bright red when they are loaded with oxygen, and they change to a bluish color when they are no longer carrying a full load of oxygen. The finger clip machine cannot give a perfect measurement of your oxygen saturation; it can give only a rough estimate, and its measurement can be affected by things as simple as red nail polish on your finger.
Sleep Screener Questionairex Choose the most appropriate number for each situation:
0 = Would never doze or sleep
1 = Slight chance of dozing or sleeping
2 = Moderate chance of dozing or sleeping
3 = High chance of dozing or sleeping
Do I Need a Test for PAD?X
Meet Our Team
Kim Hirchert, Registered Respiratory Therapist, grew up in Mandan, ND and graduated from Mandan High School. Kim graduated from the University of Mary/CHI St. Alexius Respiratory Therapy program in 1991. Kim worked in Rapid City from 1991 to 1997 and most recently CHI St. Alexius Health from 1997.
Lindsey S. Ahlschlager, Registered Respiratory Therapist, grew up in Beulah, ND and graduated from Beulah High School. In 2009, Lindsey earned her Bachelor of Science in Respiratory Therapy from the University of Mary in Bismarck, North Dakota. Lindsey has been practicing at Sakakawea Medical Center since June 2009.
Robyn Wieland, Registered Respiratory Therapist, graduated from the University of Mary/CHI St. Alexius Respiratory Therapy program in 1997. In addition to Respiratory Therapy, Robyn is a certified Neonatal/ Pediatric Specialist and Pulmonary Function Technologist. Robyn is responsible for staff development and training and acts as the organization’s Infection Prevention Coordinator.
Before joining the team at Sakakawea Medical Center in 1997, Robyn worked at St. Alexius Medical Center in Bismarck, ND.