COPD Day 2016

Today is #WorldCOPDday . #Educate , #Prevent ,  #Diagnose and #Manage.

“While 4% of Canadians aged 35 to 79 self-reported being diagnosed with chronic obstructive pulmonary disease (COPD), direct measurements of lung function from the Canadian Health Measures Survey (CHMS) indicate that 13% of Canadians had a lung function score indicative of COPD.” [1]


Check out Lung Association’s website for list of free resources:

Educate yourself about smoking cessation information with this free module by The Ontario Tobacco Research Unit :

 Help your patients quit smoking:


COPD Management Guidelines:

Canadian Thoracic Society






1. Chronic obstructive pulmonary disease in Canadians, 2009 to 2011. Statistics Canada.

Thank You.

  Respiratory Therapy Week is here, and I would like to take a quick moment to thank few individuals who have helped me in my growth and practice in this field.

  A quick thank you to my parents, Sherry and Mohsen, for believing in me and their ongoing support in my life.  They have given me values and guidelines that continue to drive me to be a  patient focused and knowledgeable clinician.

  I am lucky to have had many quality instructors and preceptors that taught  and motivated me in this journey:

  • Bernie Ho.  A registered technologist who taught me about PFTs while I was receiving my PFT clinical rotation at Women’s College.  He is genuinely a kind person, a caring clinician, a skillful technologist and an effective preceptor.  His years of experience, his drive to continue to learn, and his passion to teach students make him a great preceptor.  He has always been open and willing to answer my questions and concerns.  Thanks Bernie.
  • Paul Smith. An instructor at Michener Institute. He treats students as adults, doesn’t look down at them, and holds them accountable for their performance and growth. He has a positive attitude and great sense of humour.  In the field of respiratory therapy instructors/academics, he is a role model.   Thanks Paul.
  • Andrea W. Markham provided ongoing support during my CRE certification process.  She has years of experience as an educator, and is open and ready to help students/clinicians. Thanks Andrea.
  • Sunnybrook’s Sandra Said, Gary Ackerman and Rob Boudah. These preceptors stand out by having a positive and respectful attitude toward students, and having a willingness to teach their students.  They create a supportive environment to challenge and teach SRTs, new RRTs and even experienced RRTs. Thanks Sandra, Gary and Rob.

  I would like to also thank, my fellow RRTs,  Katherine Tran, Mieke Fraser, and Dilshad Moosa.  Katherine has been a very supportive friend.  She pushes me to grow by suggesting different continuing education events, articles and resources.  Dilshad Moosa has been a great resource for me as she is open and willing to share her thoughts and advice about RT networking and career pathways.  Thank you Mieke for your ongoing support and motivation.

  I would like to extend my thank you to Dr. A. Amaral (Sunnybrook), Dr. Y. Shukla (Sunnybrook and Toronto Lung Clinic), and Dr. A. Born (North York General Hospital and Universal Pulmonary Lab).  These individuals have a positive and respectful attitude toward students and new staff.  They have and continue to put aside time from their busy schedules to help me grow in diagnostics and acute care. Thanks.
As an RT I have worked with more nurses than respiratory therapists.  Thanks to all the supportive nurses who taught,helped and supported to become a better clinician and a more effective interprofessional team member.

Respiratory Therapy is a specialized field as there are different subcategories/groups.  The evolving nature of this field can make learning and understanding of the RT career pathways challenging at times. My involvement in social media began with a goal of helping student RTs and recent RTs in their growth.  I had watched educational Youtube videos of Thomas Pirano in class as part of our ventilation physiology lesson.  It was inspiring to watch a dedicated and motivated individual share his knowledge with the world.  I became motivated to be an active RT-blogger (around two years ago).  A big thank you to John Meloche, the CEO of Melotel Inc, who became a big supporter of my online presence.  He is always ready to answer my technical and social media questions.   Also, a thank you to Andrina Stan who educated me about social media and suggested ways that I could improve my blog.  A big thank you to CSRT and Katherine Nollet for their support and encouragement of my social media presence.

I encourage everyone to be respectful and supportive of new student/new RTs.   Invest in RTs who lack the knowledge and experience. By improving our clinicians, we can further empower our field.  Quality respiratory therapists will have a great impact in patient care and outcomes.

Happy Respiratory Therapy Week!

Farzad ‘Raffi’ Refahi


Blood Lab. Values

Happy Saturday everyone.
Hope you are enjoying your Thanksgiving long weekend in Canada. To everyone exposed to Hurricane Matthew, I hope you are safe.

I wanted to remind myself of a normal blood lab value, and my Google search lead me to this useful document from Fraser Health 2011 (Anita Dickson, LPN, PID) :
The mentioned document has three different categories of Chemistry , Hematology and Urine Tests.  For each test, the author has included Normal Findings, Indications, Test Explanation, Interfering Factors, and Test Results and Clinical Significance (i.e. Causes of increased/decreased levels).

(For EDUCATIONAL purposes. If you plan to use this resource for your clinical practice, I STRONGLY recommend double checking the accepted values with your facility guidelines.)

Resources for RT Week 2016

Today is Monday October 3rd, 2016.  A reminder that Respiratory Therapy Week is  20 days away (October 23 to October 29, 2016).  Respiratory therapists, individually and part of an interprofessional team, contribute in prevention, diagnosis and management of cardiopulmonary disorders and diseases.  It is important to recognize and share the contributions of this field and respiratory therapists.  I encourage you to get involved with the RT Week.  Check out  CSRT’s website for a list of ideas and resources.

#IAmRT #RTweek #RTweek2016

Photo by F.R. 

The Power Of A Great Team


Today our PFT clinic survived a clinical audit.  I have been anticipating this day from the moment I got hired, which was around one year and three months ago.  I was hired to replace the Lead RRT/Chief Technologist.  To excel in this new role, I spent a lot of time studying and learning about ATS and IHF (independent health facility) recommendations/guidelines.   As some of you may know, a lot of effort is required to implement and continue standards of practice in a clinic.  Over my employment in this clinic, I have worked with various RRTs and Respiratory Technicians.  The success of today’s audit is purely due to a great team effort.  I work within a team who cares about their work and that includes: the clinic, the patients, the drive to learn and to grow, and the growth of the team.  Even during the audit Viral Patel, Grace Fontanilla and myself were taking notes and were listening to constructive criticism provided by Mr. Bernie Ho and Dr. Raymond Gottschalk.  Thank you Viral and Grace for making my first audit as a chief technologist/Lead RRT, an easy and successful one!

-Farzad ‘Raffi’ Refahi RRT CRE HBSc


Happy Learning

I get really excited when I come across individuals, groups and organizations that work hard to provide quality resources for health care providers.  There are plenty of them out there! Recently I came across
” The Lung Association’s Provider Education Program (PEP), funded by The Ministry of Health and Long-Term Care (MoHLTC), has a mandate to develop, implement and evaluate accredited continuing medication education (CME) programs and materials that promote the Canadian Thoracic Society (CTS) respiratory guidelines. ” (1).

You can view variety of information such as information about workshops, conferences, Online Learning/modules, work-related Asthma, Spirometry, and additional resources.

I strongly encourage you to check out this page.  This post is expressing my personal opinion (no conflict of interest).

Happy Learning!


1. Provider Education Program. The Lung Association – Ontario. Welcome.

Artificial Intelligence and Pulmonary Function Testing

European Respiratory Society (ERS): Artificial intelligence could improve diagnostic power of lung function tests

This new ERS post talks about a new research that has incorporated the use of artificial intelligence, AI, in Pulmonary Function Testing, PFT, interpretations. This technology will use data from PFT, background clinical information and other testing to generate an automated diagnosis. “The benefit of this method is a more accurate and automated interpretation of pulmonary function tests, and thus better disease detection.”
I recognize an ongoing movement in healthcare and other industries to create an automated and cost saving technology and, to reduce the number of Healthcare professionals involved in diagnoses and management of diseases. While this technology may simplify and speed up the process, it may limit and reduce the time spent between healthcare provider and patients. Pulmonary Function Testing session is more than just a diagnostic testing. During the initial and the following testings doctors, respiratory therapist, respiratory educators, pulmonary function technologist and nurses have a chance to offer patient education. Patient education can include answering questions about symptoms, proper puffer techniques, smoking cessation methods, and providing a psychological support.
The best case scenario for patients is to redirect some of the funds, saved from utilizing AI, toward replacing the lost face to face time with scheduled patient education sessions.