Respiratory Therapy: revolutionary ways to Help people speak and breath

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Elliot Spiro RRT board certified registered respiratory      therapist, licensed to practice in the state of New York. From 1981 through 1983 he received his start as a staff therapist at Jacobi Medical Center, where he received excellent experience and a foundation of respiratory care. From 1983 through 2001, He was employed by Maimonides Medical Center as a Lead therapist covering areas such as the ER, ICU’s Open Heart Unit and Neonatal ICU. He was instrumental in in servicing the physicians and nursing staff in respiratory and ventilator care. . In 1991,He started the first ventilator unit in the state of New York at Silver Lake Specialized Care Center (SLSCC), where he is Director of Respiratory Therapy services at Silver Lake for the past 22 years.  At Silver Lake Specialized Care Center, he was instrumental in starting the first Blood Gases and pH laboratory in the state of New York outside a hospital setting and wrote the first policy and procedure manual for long term ventilator units in New York State. He is married with three children and currently residing in Staten Island.

Elliot Spiro, Respiratory Director at Silver Lake Specialized Care Center. We talked about how smoking can affect patients who are on ventilators (a ventilator is a device used for maintaining artificial respiration). He said that “many smokers end up on ventilators because their lungs are so damaged that they can no longer breathe on their own.” Elliot Spiro demonstrated how anyone can experience how a patient with emphysema breathes: First, take a deep breath, maximizing all the air pressure in your lungs. Then, take small breaths on top of that air pressure without exhaling all your air. When I tried to breathe this way, I remember struggling to get air into my body. These patients also cannot breathe out and have a sigh of relief. It is unfortunate to see people suffering this way because of a habit they could not quit. This is why I am so passionate about my platform. If I can give children the confidence to say “No” to smoking, then I can help prevent them from ending up like some of these patients who are now on a ventilator, unable to experience the simple action of breathing


In 1991, Silver Lake Specialized Care Center worked hand in hand with New York State Department of Health to develop the first Ventilator Unit that provided care for patients in a Skilled Nursing Facility in the State of New York. It began on November 8, 1991 and continues to be a leader and resource for new and current ventilator residents. Silver Lake’s commitment and goal is to rehabilitate each patient to their maximum potential. They have determined through years of experience that the Passy Muir® Valve has been a conduit in facilitation of both weaning, swallowing and improvement of quality of life. They utilize the team approach with emphasis on a natural way of rehabilitation. The rehab team includes Respiratory Therapy, Speech Therapy, Physical Therapy, Occupational Therapy, Social Work, Nutritional Support, and Pulmonary Medicine. The Silver Lake Team believes that the resident must have a strong foundation prior to commencement of weaning/decannulation. The rehabilitation team developed a regiment of set goals in the areas of Nutrition, Speech, Physical and Occupational Therapy; Psychological services and recreation. Once set goals are achieved, weaning commences. Their high level of communication between staff members allows us to successfully achieve these goals.

Silver Lake’s first resident utilized the Passy-Muir Valve in December 1993. This man had been hospitalized for six months prior and was unable to verbalize. What a surprise when he called his wife on the telephone. She did not recognize his voice since she had not heard it for 6 months. She hung up the phone thinking it was a prank call. Our speech therapist called her to advise her that it was her husband. She was overwhelmed with joy. Eventually the resident was weaned from the ventilator and went home. At that point, they knew that the Passy-Muir Valve was a valuable tool to facilitate speaking, swallowing, breathing and weaning. They also realized that the Passy-Muir Valve was the tool to improve his quality of life. Silver Lake has learned over the years that the Passy-Muir Valve is an integral tool to determine whether or not a person can commence with weaning.

The clinicians at Silver Lake strongly support the use of this valve. They hope that through education other facilities will utilize the Passy-Muir Valve to get the same positive results that they have seen.


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