ZSFG Respiratory Care Services

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Respiratory Care Services at Zuckerberg San Francisco General has been a renowned leader in respiratory care for over forty years. RCS functions under the guidance of the Department of Anesthesia / School of Medicine at the University of California, San Francisco, one of the world's leading centers of health sciences, research, patient care, and education. 

The primary focus of ZSFG Respiratory Care Service is in critical and acute care and features an expanded scope of practice. The department has a growing presence in outpatient clinics and community services. Our Respiratory Care Practitioners serve as consultants to nursing, physician faculty, and all other members of the healthcare team. We are integral members of the Code Blue, Trauma Resuscitation and Medical Emergency Response Teams (MERT). 

UCSF - ZSFG partnership Since 1864, the UCSF School of Medicine and Zuckerberg San Francisco General Hospital have worked in close collaboration to provide health care services for the people of San Francisco. UCSF physicians, residents, respiratory care practitioners, and laboratory technicians provide patient care at the ZSFG which is regarded as one of the finest public hospitals in the nation. 

Some of UCSF's most groundbreaking research also takes place at ZSFG. For more information about the collaboration between these two leading institutions, please visit UCSF at Zuckerberg San Francisco General. 

About Us

About Respiratory Care Services

Respiratory Care Services at Zuckerberg San Francisco General Hospital operates within the Department of Anesthesia at the University of California, San Francisco School of Medicine. Our primary focus is in critical care/ emergency care and acute care, in which we have an expanded scope of practice. Therapists are integrally involved in ventilator management and are highly experienced in lung-protective ventilation including the NIH ARDS Network protocol, use of super-PEEP, and high-frequency oscillatory ventilation. 

We routinely perform other ancillary therapies such as aerosolized prostacyclin, prone positioning and recruitment maneuvers. In addition, therapists routinely participate in the transport and monitoring of mechanically ventilated patients to special procedure areas and surgery. Our general respiratory care practice includes standard oxygen and aerosol therapy as well as lung expansion and pulmonary hygiene therapies (Incentive Spirometry, EZPAP, Acapella, Metaneb, Cough-Assist), and non-invasive ventilation. Our services emphasize evidenced-based, protocolized management with quality assurance oversight. 

Therapists routinely pre-round with the ICU fellow to review the respiratory care plan prior to participating in multidisciplinary rounds with the entire ICU team. Night-shift therapists routinely round with the on-call ICU resident to review current issues and care plans. The Night Shift has an active role in inpatient sleep medicine screening. 

In the Neonatal ICU setting therapists assist in high risk deliveries and are highly involved in ventilator management including high-frequency oscillatory ventilation. Therapies provided include inhaled nitric oxide, surfactant administration, High Flow and SiPAP. 

Advanced diagnostic testing and monitoring performed by therapists include hemodynamic monitoring (cardiac output determination, vascular resistance studies, mixed venous blood gas determination), jugular venous saturation monitoring, arterial blood gas procurement and point-of-care analysis (punctures and arterial line), physiologic dead-space measurements, pulmonary pressure-volume curves and metabolic studies. 

The Respiratory Care Services provide care throughout the hospital. On the general care wards, therapists function primarily as consultants, emergency response and provide care to tracheotomy patients. In addition, RCS provides full service care in the Progressive Care Unit and Emergency Department’s Clinical Decision Unit. 

Local, Regional and National Representation / Leadership
Respiratory therapists at ZSFG have served on the AARC program committee, the NIH Delphi Committee on VAP Guidelines, and the National Board for Respiratory Care. Therapists have served as peer reviewers for numerous medical journals including The Lancet, CHEST, Critical Care Medicine, Anesthesia & Analgesia, American Journal of Respiratory, Critical Care Medicine, Critical Care and Intensive Care Medicine as well as serving on the editorial board of Respiratory Care. Over the years department members have held leadership positions within Bay-Area Society for Respiratory Care, the California Society for Respiratory Care and the Respiratory Care Section of the Society of Critical Care Medicine. 

About UCSF 
The University of California, San Francisco is one of the world's leading centers of health sciences research, patient care, and education. UCSF's medical, pharmacy, dental, nursing, and graduate schools are among the top health science professional schools in the world and are near the top in research funding from the National Institutes of Health. 

The UCSF Medical Center is located on the main campus on Parnassus Ave, near Twin Peaks. The UCSF School of Medicine also staffs departments at 4 additional locations: Zuckerberg San Francisco General, Veterans Hospital, Mount Zion Hospital, and the newly opened Mission Bay campus. 

About ZSFG
Zuckerberg San Francisco General is a licensed general acute care hospital within the Community Health Network, which is owned and operated by the City and County of San Francisco, Department of Public Health. ZSFG provides a full complement of inpatient, outpatient, emergency, skilled nursing, diagnostic, mental health, and rehabilitation services for adults and children. It is the largest acute inpatient and rehabilitation hospital for psychiatric patients in the City. Additionally, it is the only acute hospital in San Francisco that provides twenty-four hour psychiatric emergency services. 

ZSFG is world renowned for its expertise in trauma and neurotrauma / neurologic critical care. It is the only Level I Trauma Center for 1.5 million residents of San Francisco and northern San Mateo County. As a UCSF affiliate, ZSFG has a long and distinguished history of research in diverse areas including trauma, neurotrauma / neurologic critical care, AIDS, anesthesia and critical care. 

ZSFG Trauma Center 
Respiratory Care Services works very closely with the renowned trauma service at ZSFG. ZSFG operates the only level 1 trauma center for more than 1.5 million residents of San Francisco and northern San Mateo County. RCS plays a vital role in the emergency department which treats more than 3,000 severely injured patients every year. 

For more information about the ZSFG Trauma center please visit Trauma Team 

 

Ranking

Recent US News and World Report surveys ranked:

  • UCSF Professional / Graduate schools (2006)
    • 4th overall among research-based medical schools
    • Top 10 in seven of the eight medical school specialty programs assessed
      • 1st in AIDS medical care
      • 2nd in women's health
      • 2nd in internal medicine.
      • 5th for drug and alcohol abuse program
      • 5th overall in doctoral programs in the biological sciences 
        • 1st neuroscience
        • 3rd third in biochemistry and cell biology programs
        • 6th in molecular biology 
        • 9th in microbiology.
      • 9th pediatrics
      • 9th geriatrics
      • 10th for primary training
      • 10th family medicine
  • School of Nursing  (2003)
    • 2nd overall
    • In the top 10 in seven of the rated eight nursing specialties: 
      • 1st  family nurse practitioner program
      • 2nd training adult/medical-surgical nurses
      • 3rd adult nurse practitioner and psychiatric/mental health programs
      • 4th pediatric nurse practitioner
      • 5th gerontological/geriatric
      • 9th community/public health
  • School of Pharmacy (2005) 
    • 1st in the nation
  • In addition, the UCSF Medical Center in 2006 was ranked by US News and World Report the 9th-best hospital in the nation, making it the highest-ranked medical center in Northern California.

 

 

Research

Respiratory Care Research at ZSFG

RCS has had a long history of participating in clinical research, beginning in the 1970’s, under the leadership of then department director Eric Gjerde. This included technical assistance for landmark clinical studies on the physiologic effects of mechanical ventilation (including the seminal study on Optimal PEEP) by H. Barrie Fairley, MD, Peter Suter, MD, Jeffrey Katz, MD, and others. In 1975, RCS began to design and publish its own research in collaboration with the UCSF/SFGH Departments of Anesthesia, Surgery, Chest Medicine, and the UCSF Cardiovascular Research Institute.

From 1975 through 2017, 15 members of ZSFG RCS have authored (or coauthored) 120 abstracts and 88 peer-reviewed papers in 16 journals including: The Lancet, New England Journal of Medicine, Anesthesiology, Thorax, American Journal of Respiratory and Critical Care Medicine, American Journal of Surgery, Chest, Critical Care Medicine, and Minerva Anestiologica. From 1996 through 2008, RCS members served as clinical research coordinators for the NIH ARDS Network and participated in 11 clinical trials, including the landmark ARMA Trial of low tidal volume ventilation that revolutionized the management of ARDS.

Some of the research published by RCS has been ground breaking. This has included the seminal study on work of breathing imposed by ventilator triggering performance (that was the impetus for advances in trigger sensitivity technology that emerged in the 1990s),[4] the landmark studies on aerosolized pentamidine for the treatment of pneumocystis pneumonia during the early years of the AIDS pandemic,[5,7-9] elucidating the cause of post-obstructive pulmonary edema,[14] the landmark study on early elevation of physiologic dead-space fraction and its impact on mortality in ARDS,[26] and the discovery that tidal volume mismatch between patient and ventilator imposes work of breathing (which became particularly relevant with the advent of lung-protective ventilation).[15,25,34,40] Since 1996, RCS-directed research at ZSFG has garnered 15 national awards from both the American Association for Respiratory Care and the Society of Critical Care Medicine.

It is our belief that excellence in respiratory care requires an environment that fosters curiosity, creativity and critical thinking. Clinical research, along with quality assurance projects, provide the unique opportunity to introduce clinicians to the principles of scientific research and how knowledge is acquired. This is a crucial aspect of maintaining the highest degree of professionalism possible.

Bibliography of RCS Participation in Studies at ZSFG

  1. Gjerde GE. A method for spontaneous breathing with expiratory positive pressure. Respir Care. 1975 Sep;20(9):839-40.
  2. Gjerde GE. Retrograde pressurization of a medical oxygen pipeline system: safety backup or hazard? Crit Care Med. 1980 Apr;8(4):219-21.
  3. Gjerde GE, Kraemer R. An oxygen therapy fire. Respir Care. 1980 Mar;25(3):362-3.
  4. Katz JA, Kraemer RW, Gjerde GE. Inspiratory work and airway pressure with continuous positive airway pressure delivery systems. Chest. 1985 Oct;88(4):519-26.
  5. Montgomery AB, Debs RJ, Luce JM, Corkery KJ, Turner J, Brunette EN, Lin ET, Hopewell PC. Aerosolised pentamidine as sole therapy for Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome. Lancet. 1987 Aug 29;2(8557):480-3.
  6. Turner JR, Corkery KJ, Eckman D, Gelb AM, Lipavsky A, Sheppard D. Equivalence of continuous flow nebulizer and metered-dose inhaler with reservoir bag for treatment of acute airflow obstruction. Chest. 1988 Mar;93(3):476-81.
  7. Montgomery AB, Debs RJ, Luce JM, Corkery KJ, Turner J, Brunette EN, Lin ET, Hopewell PC. Selective delivery of pentamidine to the lung by aerosol. Am Rev Respir Dis. 1988 Feb;137(2):477-8.
  8. Montgomery AB, Debs RJ, Luce JM, Corkery KJ, Turner J, Hopewell PC. Aerosolized pentamidine as second line therapy in patients with AIDS and Pneumocystis carinii pneumonia. Chest. 1989 Apr;95(4):747-50.
  9. Leoung GS, Feigal DW, Montgomery AB, Corkery K, Wardlaw L, Adams M, et al. Aerosolized pentamidine for prophylaxis against pneumocystis carinii pneumonia. The San Francisco community prophylaxis trial. N Engl J Med 1990;323(12):769-75.
  10. Marks JD, Schapera A, Kraemer RW, Katz JA. Pressure and flow limitations of anesthesia ventilators. Anesthesiology. 1989 Sep;71(3):403-8.
  11. Charney W, Corkery KJ, Kraemer R, Wugofski L. Engineering and Administration Controls to Contain Aerosolized Ribaviran: Results of Simulation and Application to One Patient. Respir Care 1990;35(7):1042-46.
  12. Montgomery AB, Corkery KJ, Brunette ER, Leoung GS, Waskin H, Debs RJ. Occupational exposure to aerosolized pentamidine. Chest. 1990 Aug;98(2):386-8.
  13. Kallet R. Effects of flow patterns upon gas exchange, lung mechanics and circulation. Respir Care 1996; 41:668-675.
  14. Kallet RH, Daniel B, Gropper M, Matthay MA. Pulmonary edema following acute upper airway obstruction:  A case report and brief review. Respir Care 1998; 43:476-480.
  15. Kallet RH, Alonso JA, Luce JM, Matthay MA. Exacerbation of acute pulmonary edema during assisted mechanical ventilation using a low-tidal volume, lung-protective ventilator strategy. Chest. 1999 Dec;116(6):1826-32.
  16. Matthay MA, Fukuda N, Frank J, Kallet R, Daniel B, Sakuma T. Alveolar epithelial barrier. Role in lung fluid balance in clinical lung injury. Clin Chest Med. 2000 Sep;21(3):477-90.
  17. Kallet RH, Campbell AR, Alonso JA, Morabito DJ, Mackersie RC. The effects of pressure control versus volume control assisted ventilation on patient work of breathing in acute lung injury and acute respiratory distress syndrome. Respir Care. 2000 Sep;45(9):1085-96.
  18. Kallet RH, Katz JA, Pittet JF, Ghermey J, Siobal M, Alonso JA, Marks JD. Measuring intra-esophageal pressure to assess transmural pulmonary arterial occlusion pressure in patients with acute lung injury: a case series and review. Respir Care. 2000 Sep;45(9):1072-84.
  19. Katz JA, Kallet RH, Alonso JA, Marks JD. Improved flow and pressure capabilities of the Datex-Ohmeda SmartVent anesthesia ventilator. J Clin Anesth. 2000 Feb;12(1):40-7.
  20. Kallet RH, Jasmer RM, Luce JM, Lin LH, Marks JD. The treatment of acidosis in acute lung injury with tris-hydroxymethyl aminomethane (THAM). Am J Respir Crit Care Med. 2000 Apr;161(4 Pt 1):1149-53.
  21. Kallet RH, Corral W, Silverman HJ, Luce JM. Implementation of a low tidal volume ventilation protocol for patients with acute lung injury or acute respiratory distress syndrome. Respir Care. 2001 Oct;46(10):1024-37.
  22. Siobal M, Kallet RH, Kraemer R, Jonson E, Lemons D, Young D, Campbell AR, Schecter W, Tang J. Tracheal-innominate artery fistula caused by the endotracheal tube tip: case report and investigation of a fatal complication of prolonged intubation. Respir Care. 2001 Oct;46(10):1012-8.
  23. Kallet RH, Siobal MS, Alonso JA, Warnecke EL, Katz JA, Marks JD. Lung collapse during low tidal volume ventilation in acute respiratory distress syndrome. Respir Care. 2001 Jan;46(1):49-52.
  24. Kallet RH, Luce JM. Detection of patient-ventilator asynchrony during low tidal volume ventilation, using ventilator waveform graphics. Respir Care. 2002Feb;47(2):183-5.
  25. Kallet RH, Alonso JA, Diaz M, Campbell AR, Mackersie RC, Katz JA. The effects of tidal volume demand on work of breathing during simulated lung-protective ventilation. Respir Care. 2002 Aug;47(8):898-909.
  26. Nuckton TJ, Alonso JA, Kallet RH, Daniel BM, Pittet JF, Eisner MD, Matthay MA. Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome. N Engl J Med. 2002 Apr 25;346(17):1281-6.
  27. Kallet RH, Liu K, Tang J. Management of acidosis during lung-protective ventilation in acute respiratory distress syndrome. Respir Care Clin N Am. 2003 Dec;9(4):437-56.
  28. Kallet RH. Pressure-volume curves in the management of acute respiratory distress syndrome. Respir Care Clin N Am. 2003 Sep;9(3):321-41.
  29. Kallet RH, Katz JA. Respiratory system mechanics in acute respiratory distress syndrome. Respir Care Clin N Am. 2003 Sep;9(3):297-319.
  30. Siobal MS, Kallet RH, Pittet JF, Warnecke EL, Kraemer RW, Venkayya RV, Tang JF. Description and evaluation of a delivery system for aerosolized prostacyclin. Respir Care. 2003 Aug;48(8):742-53.
  31. Kallet RH. How to write the methods section of a research paper. Respir Care. 2004 Oct;49(10):1229-32.
  32. Kallet RH, Alonso JA, Pittet JF, Matthay MA. Prognostic value of the pulmonary dead-space fraction during the first 6 days of acute respiratory distress syndrome. Respir Care. 2004 Sep;49(9):1008-14.
  33. Kallet RH. Evidence-based management of acute lung injury and acute respiratory distress syndrome. Respir Care. 2004 Jul;49(7):793-809.
  34. Kallet RH, Campbell AR, Dicker RA, Katz JA, Mackersie RC. Work of breathing during lung-protective ventilation in patients with acute lung injury and acute respiratory distress syndrome: a comparison between volume and pressure-regulated breathing modes. Respir Care. 2005 Dec;50(12):1623-31.
  35. Kallet RH, Quinn TE. The gastrointestinal tract and ventilator-associated pneumonia. Respir Care. 2005 Jul;50(7):910-21.
  36. Kallet RH, Jasmer RM, Pittet JF, Tang JF, Campbell AR, Dicker R, Hemphill C, Luce JM. Clinical implementation of the ARDS network protocol is associated with reduced hospital mortality compared with historical controls. Crit Care Med. 2005May;33(5):925-9.
  37. Kallet RH, Daniel BM, Garcia O, Matthay MA. Accuracy of physiologic dead space measurements in patients with acute respiratory distress syndrome using volumetric capnography: comparison with the metabolic monitor method. Respir Care. 2005 Apr;50(4):462-7.
  38. Hough CL, Kallet RH, Ranieri VM, Rubenfeld GD, Luce JM, Hudson LD. Intrinsic positive end-expiratory pressure in Acute Respiratory Distress Syndrome (ARDS) Network subjects. Crit Care Med. 2005 Mar;33(3):527-32.
  39. Siobal MS, Kallet RH, Kivett VA, Tang JF. Use of dexmedetomidine to facilitate extubation in surgical intensive-care-unit patients who failed previous weaning attempts following prolonged mechanical ventilation: a pilot study. Respir Care. 2006 May;51(5):492-6.
  40. Kallet RH, Campbell AR, Dicker RA, Katz JA, Mackersie RC. Effects of tidal volume on work of breathing during lung-protective ventilation in patients with acute lung injury and acute respiratory distress syndrome. Crit Care Med. 2006 Jan;34(1):8-14.
  41. Siobal MS. Pulmonary vasodilators. Respir Care. 2007 Jul;52(7):885-99.
  42. Kallet RH, Hemphill JC, Dicker RA, Alonso JA, Campbell AR, Mackersie RC, Katz JA. The spontaneous breathing pattern and work of breathing of patients with acute respiratory distress syndrome and acute lung injury. Respir Care. 2007 Aug;52(8):989-95.
  43. Kallet RH. The role of inhaled opioids and furosemide for the treatment of dyspnea. Respir Care. 2007 Jul;52(7):900-10.
  44. Kacmarek RM, Kallet RH. Respiratory controversies in the critical care setting. Should recruitment maneuvers be used in the management of ALI and ARDS? Respir Care. 2007 May;52(5):622-31.
  45. Kallet RH, Branson RD. Respiratory controversies in the critical care setting. Do the NIH ARDS Clinical Trials Network PEEP/FIO2 tables provide the best evidence-based guide to balancing PEEP and FIO2 settings in adults? Respir Care. 2007 Apr;52(4):461-75.
  46. Fremont RD, Kallet RH, Matthay MA, Ware LB. Post obstructive pulmonary edema: a case for hydrostatic mechanisms. Chest. 2007 Jun;131(6):1742-6.
  47. Kallet RH. Capnography and respiratory care in the 21st century. Respir Care. 2008 Jul;53(7):860-1.
  48. Seeley E, McAuley DF, Eisner M, Miletin M, Matthay MA, Kallet RH. Predictors of mortality in acute lung injury during the era of lung protective ventilation. Thorax. 2008 Nov;63(11):994-8.
  49. Liu KD, Levitt J, Zhuo H, Kallet RH, Brady S, Steingrub J, Tidswell M, Siegel MD, Soto G, Peterson MW, Chesnutt MS, Phillips C, Weinacker A, Thompson BT, Eisner MD, Matthay MA. Randomized clinical trial of activated protein C for the treatment of acute lung injury. Am J Respir Crit Care Med. 2008 Sep15;178(6):618-23.
  50. Davis JL, Morris A, Kallet RH, Powell K, Chi AS, Bensley M, Luce JM, Huang L. Low tidal volume ventilation is associated with reduced mortality in HIV-infected patients with acute lung injury. Thorax. 2008 Nov;63(11):988-93.
  51. Siobal MS. Combining heliox and inhaled nitric oxide as rescue treatment for pulmonary interstitial emphysema. Respir Care. 2009 Jul;54(7):976-7; author reply 977-8.
  52. Lu JP, Knudson MM, Bir N, Kallet R, Atkinson K. Fondaparinux for prevention of venous thromboembolism in high-risk trauma patients: a pilot study. J Am Coll Surg. 2009 Nov;209(5):589-94.
  53. Kallet RH. What is the legacy of the National Institutes of Health Acute Respiratory Distress Syndrome Network? Respir Care. 2009 Jul;54(7):912-24.
  54. Kallet RH, Diaz JV. The physiologic effects of noninvasive ventilation. Respir Care. 2009 Jan;54(1):102-15.
  55. Kallet RH. Noninvasive ventilation in acute care: controversies and emerging concepts. Respir Care. 2009 Feb;54(2):259-63.
  56. Gentile MA, Siobal MS. Are specialized endotracheal tubes and heat-and-moisture exchangers cost-effective in preventing ventilator associated pneumonia? Respir Care. 2010 Feb;55(2):184-96.
  57. Siobal MS, Hess DR. Are inhaled vasodilators useful in acute lung injury and acute respiratory distress syndrome? Respir Care. 2010 Feb;55(2):144-57.
  58. Ong T, McClintock DE, Kallet RH, Ware LB, Matthay MA, Liu KD. Ratio of angiopoietin-2 to angiopoietin-1 as a predictor of mortality in acute lung injury patients. Crit Care Med. 2010 Sep;38(9):1845-51.
  59. Kallet RH, Jasmer RM, Pittet JF. Alveolar dead-space response to activated protein C in acute respiratory distress syndrome. Respir Care. 2010 May;55(5):617-22.
  60. Kallet RH, Siobal MS. Measuring dead space: does it really matter? or, What are we waiting for? Respir Care. 2010 Mar;55(3):350-2.
  61. Matthay MA, Kallet RH. Prognostic value of pulmonary dead space in patients with the acute respiratory distress syndrome. Crit Care. 2011;15(5):185.
  62. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Matthay MA, Brower RG, Carson S, Douglas IS, Eisner M, Hite D, Holets S, Kallet RH, Liu KD, MacIntyre N, Moss M, Schoenfeld D, Steingrub J, Thompson BT. Randomized, placebo-controlled clinical trial of an aerosolized β₂-agonist for treatment of acute lung injury. Am J Respir Crit Care Med. 2011 Sep 1;184(5):561-8.
  63. Seeley EJ, McAuley DF, Eisner M, Miletin M, Zhuo H, Matthay MA, Kallet RH. Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury. Respir Res. 2011 Apr 22;12:52.
  64. Kallet RH. Patient-ventilator interaction during acute lung injury, and the role of spontaneous breathing: part 2: airway pressure release ventilation. Respir Care. 2011 Feb;56(2):190-203.
  65. Kallet RH. Patient-ventilator interaction during acute lung injury, and the role of spontaneous breathing: part 1: respiratory muscle function during critical illness. Respir Care. 2011 Feb;56(2):181-9.
  66. Brown LM, Kallet RH, Matthay MA, Dicker RA. The influence of race on the development of acute lung injury in trauma patients. Am J Surg. 2011 Apr;201(4):486-91
  67. Kallet RH. Measuring dead-space in acute lung injury. Minerva Anestesiol. 2012 Nov;78(11):1297-305.
  68. Kallet RH, Alonso JA, Matthay MA. Quantifying the severity of acute lung injury using dead-space ventilation: should the lung injury score be updated? Respir Care. 2012 Mar;57(3):477-9.
  69. Kallet RH. Accuracy and reliability of extubation decisions by intensivists. Respir Care. 2012 Feb;57(2):328.
  70. Kallet RH. Adjunct therapies during mechanical ventilation: airway clearance techniques, therapeutic aerosols, and gases. Respir Care. 2013 Jun;58(6):1053-73.
  71. Kallet RH, Volsko TA, Hess DR. Respiratory Care year in review 2012: invasive mechanical ventilation, noninvasive ventilation, and cystic fibrosis. Respir Care. 2013 Apr;58(4):702-11.
  72. Kallet RH, Matthay MA. Hyperoxic acute lung injury. Respir Care. 2013 Jan;58(1):123-41.
  73. Siobal MS, Ong H, Valdes J, Tang J. Calculation of physiologic dead space: comparison of ventilator volumetric capnography to measurements by metabolic analyzer and volumetric CO2 monitor. Respir Care. 2013 Jul;58(7):1143-51.
  74. Kallet RH, Zhuo H, Liu KD, Calfee CS, Matthay MA; National Heart Lung and Blood Institute ARDS Network Investigators. The association between physiologic dead-space fraction and mortality in subjects with ARDS enrolled in a prospective multi-center clinical trial. Respir Care. 2014 Nov;59(11):1611-8.
  75. Kallet RH. A Comprehensive Review of Prone Position in ARDS. Respir Care. 2015 Nov;60(11):1660-87.
  76. Kallet RH. The Vexing Problem of Ventilator-Associated Pneumonia: Observations on Pathophysiology, Public Policy, and Clinical Science. Respir Care. 2015 Oct;60(10):1495-508.
  77. Kallet RH. The complexity of interpreting plateau pressure in ARDS. Respir Care. 2015 Jan;60(1):147-9.
  78. Siobal MS. Transnasal Aerosol Delivery to Pediatric Patients: Jet Versus Vibrating Mesh. Respir Care. 2015 Oct;60(10):e168.
  79. Siobal MS. Monitoring Exhaled Carbon Dioxide. Respir Care. 2016 Oct;61(10):1397-416.
  80. Chatburn RL, Kallet RH, Sasidhar M. Airway Pressure Release Ventilation May Result in Occult Atelectrauma in Severe ARDS. Respir Care. 2016 Sep;61(9):1278-80.
  81. Kallet RH. Should PEEP Titration Be Based on Chest Mechanics in Patients With ARDS? Respir Care. 2016 Jun;61(6):876-90.
  82. Kallet RH, Branson RD. Should Oxygen Therapy Be Tightly Regulated to Minimize Hyperoxia in Critically Ill Patients? Respir Care. 2016 Jun;61(6):801-17.
  83. Bhattacharya M, Kallet RH, Ware LB, Matthay MA. Negative-Pressure Pulmonary Edema. Chest. 2016 Oct;150(4):927-933.
  84. Siobal MS. A Shout Instead of a Whisper: Let's Get the Graphics Right-Reply. Respir Care. 2017 Feb;62(2):257.
  85. Phillips JS, Pangilinan LP, Mangalindan ER, Booze JL, Kallet RH. A Comparison of Different Techniques for Interfacing Capnography With Adult and Pediatric Supplemental Oxygen Masks. Respir Care. 2017 Jan;62(1):78-85.
  86. Kallet RH, Burns G, Zhuo H, Ho K, Phillips JS, Pangilinan LP, Yip V, Gomez A, Lipnick MS. Severity of Hypoxemia and Other Factors That Influence the Response to Aerosolized Prostacyclin in ARDS. Respir Care. 2017 Aug;62(8):1014-1022.
  87. Kallet RH, Zhuo H, Ho K, Lipnick MS, Gomez A, Matthay MA. Lung Injury Etiology and Other Factors Influencing the Relationship Between Dead-Space Fraction and Mortality in ARDS. Respir Care. 2017 Jun 13.
  88. Kallet RH, Zhou H, Yip V, Gomez A, Lipnick MS. Spontaneous breathing trials and conservative sedation practices reduce mechanical ventilation duration in patients with acute respiratory distress syndrome. Respir Care 2017;62(12): in press.
Technical

The Department of Anesthesia and Respiratory Care Services utilize cutting edge simulation technology in training and evaluation. The recent addition to the RCS department of the ASL 5000 Active Servo Lung along with the RespiSim Patient Ventilator Interface enables state of the art ventilator management training and bench testing to evaluate new technologies on site. 

 

Events

Since 1993, ZSFG Respiratory Care Services has been presenting an annual all day, 5 CEU seminar on Selected Topics in Intensive Respiratory Care. 

The seminar always offers a very diverse range of topics, from the latest trends in Respiratory Care to hot topics of more general interest, such as Hospital Disaster Preparedness and Response in the Post-Katrina Era Civilian Hospital Response to Mass Casualty Events: The Israeli Experience Four Women From Whom Life-Sustaining Therapy Was Withdrawn, Medical Management of Biochemical Weapons Casualties. 

During the height of the SARS outbreak in 2002, we interrupted and extended the seminar so that we could show the live feed of the first CDC SARS webcast about the epidemic and CDC's recommendations. 

Recent Seminars:

2006
2005
2004 

Careers

Worklife

Job Satisfaction
The one trait that characterizes practitioners at ZSFG is their very high skill level, their dedication to their job and unstinting work ethic. The staff turnover ratio is extremely low. Therapists come here and stay - the median length of service is 15 years. Internal and external promotional opportunities are encouraged. 

New Hire Orientation 
Only Registered Respiratory Care Practitioners are eligible for employment with ZSFG RCS. All newly hired therapists will complete a 12-week orientation and a six month probationary period. Two weeks before the employees first day, a pre employment packet of confidentially agreements, health screening and computer log-on forms must be returned to the department. 

The first week of orientation (five 8 hour days) is spent with the Technical Director, Education Coordinator and Clinical Specialists to review policies and procedures and department treatment protocols. The employee will be issued three sets of RCS specific scrubs, assigned a mailbox and locker. There are one day hospital orientations for both UCSF and ZSFG that the employee must attend during their orientation period. During the clinical portion of orientation, orientees are scheduled three twelve hour shifts per week and rotate through all ICU's and care areas of the hospital with a preceptor. Orientation will consist of time on both day and night shifts and with multiple preceptors. 

Scheduling The standard clinical work week is 36 hours - three 12 hour shifts per week; Clinical shifts are from 7 – 7. Other roles and opportunities offer other job hours. 

Staff meetings General staff meetings are held every month rotating between 7:30 am and 7:30 pm and conference call participation is available. 

Operations Meetings Operations meeting for managers, supervisors, and education coordinators are held every month. 

Campus Life Services has a mission to strengthen the bonds that make us a strong UCSF community by providing recreational, artistic, social programs. Giants Ballgames, Yosemite Adventures, Family picnics, fun days at Great America park, and noon concerts are just a sampling of the events planned for the UCSF employees. 

The Bakar Fitness center at the Mission Bay campus near ZSFG is a brand new full featured recreational facility - two pools, one indoor and one rooftop, a full featured gym with the latest equipment, courts, ping pong. Workout, get a massage, swim in a rooftop pool, climb a wall, then relax at the cafe. It's a pretty exciting place. 

So why work at Zuckerberg San Francisco General? 
1. You will use all your skill sets and be respected. 
2. You will be on the cutting edge of medicine, so your knowledge base will always be expanding. 
3. You will enjoy an especially collegial relationship with world class physicians and nurses that have a high regard for our department and your specific skills. 
4. You will work with a very knowledgeable, supportive patient orientated staff. 
5. You will be in one of the most beautiful and exciting cities in the country. 
6. The experience you gain at ZSFG will considerably enhance your resume.

Employment
Alumni

Pathways to Success Beyond SFGH 
Respiratory Care Services encourages each employee to develop their talents to their fullest potential. That sometimes means we lose our best employees as they grow into other positions with greater responsibilities elsewhere. The experience therapists have gained at San Francisco General Hospital has helped them obtain positions in management, education, and research.

The experience therapists have gained at San Francisco General Hospital has helped them land high level management positions in private industry

ZSFG RCS Alumni at various times have held these positions 
Presidents - US
Hamilton Medical
Airon Corporation 

Vice Presidents - International
Medibuy Iconomed

Directors - International
NCI (Japan)
Urologix (AsiaPacific)

Regional Managers - US
Datex Ohmeda
Respironics
Nellcor PuritanBennett

Regional Managers - International
Newport Medical (Asia Pacific) 

ZSFG RCS Alumni in Private Sector Research

  • Inhale Therapeutic Systems
  • Nellcor-NCI – Asia/Pacific
  • Nellcor - US 
  • Genentech

Former therapists have been able to land positions in these categories: 

  • Hospital Administrator
  • Directors, Respiratory Care Services
  • Education Coordinators
  • Instructors and Program coordinators at RC Programs
Contact Us

Phone: 415-206-5736
Fax: 415-206-5735
Email: jkelly@sfghsom.ucsf.edu

Mailing Address:
1001 Potrero Ave
San Francisco, Ca. 94110
GA2 
UC mailbox 1371

 

For the Staff
Education

Research 
A listing of relevant publications within the department and a useful guide on how to write the methods section of a research paper. 

Miscellaneous Publications
NIH Asthma Guidelines
NIH Respiratory Publications
Edwards Hemodynamics
DiBlassi Chap-19 (2).pdf
DiBlassi_Chapter 22.pdf

Halogen 

Reference Info Resources
SFGH Library
UCSF Library
MELVYL
AARC CPGs
SFGH Abbreviation List
Language Translator
O2 Tank Equipment Calculator 

Professional Agencies
AARC
CSRC

Licensure & Exams
NBRC
AMP(NBRC)
Kettering
RCB

CEUs / Training
UCSF Training Courses

Clinical Tools
Mixing concentrations for Continuous Albuterol
Aerogen Placement Guide
SFGH Formulary

Medical Gas Backups
Loading Dock Tanks
N2O - Liquid O2 Pads
Pending: O2 Supply Shutoff
Pending: O2 Supply Backups
Pending: Disaster Equipment 

Orientees

Equipment

Mech Vents
Gas Delivery
Measurement Devices
Clinical Supplies
Patient Education
Computer Help

For Password problems, see table below for who to contact. For computer problems, contact Service Now at (415) 514-4100. 
This person can work with you to determine the problem, and who should be contacted for further assistance. You can also open a help request online at: Service Now.

View Table