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Winter 2020 Issue 10

An official publication of the Ontario Respiratory Care Society, a section of
The Lung Association – Ontario

Update on Respiratory Health, Research and Education is a publication of the Ontario Respiratory Care Society, a section of The Lung Association. Update is published three times per year and includes peer-reviewed original articles, clinical practice tools, health news, and communications between the ORCS and its membership.



Welcome to 2020! A New Year and a new decade! I hope that everyone had a chance to pause over the holidays, to be in its moments of wonder and reflection, and to consider where we see ourselves as we begin anew. Whether you make resolutions or not, the beginning of the New Year is a key time for setting goals and defining strategies for the year ahead. Read More


Happy New Year! I am grateful for the opportunity to share this message, to remember the past year’s challenges and achievements while looking forward to the promise of a new year and a new beginning. As our editorial team begins the 2020 journey, we will continue our commitment to sharing knowledge and providing education to everyone involved or interested in getting involved in respiratory care. This edition of Update on respiratory health, research & education provides informative articles on current topics of interest for healthcare professionals, students and patients. Read More

Cuts to Ontario’s Out-of-Country Traveler’s Program - What Does this Mean for Ontario Residents?

Submitted by: Jessica Sopher, Policy & Public Affairs Associate, the Ontario Lung Association

The Ontario government has moved forward with their decision to cancel the Ontario Health Insurance Plan’s (OHIP) coverage for emergency health services outside of Canada, becoming the only province or territory who does not offer some form of coverage in this area. Previously, if an Ontario resident had a medical emergency while abroad, OHIP reimbursed the cost of physician services and hospital services. To have been eligible, select criteria would have had to be met including: the treatment was medically necessary, the treatment was performed in a licensed health facility or hospital, and that the illness or condition was acute, unexpected and required immediate attention(1). Read More


Fool Me Once…Fool Me Twice….
The Rise of E-Cigarettes.

Constance Mackenzie MD, MSc, FRCPC
Assistant Professor
Divisions of Respirology / Clinical Pharmacology and Toxicology
Western University, London, ON
Assistant Medical Director
Ontario/Manitoba/Nunavut Poison Centre
Hospital for Sick Children, Toronto, ON

In a few short months, electronic cigarettes (e-cigarettes) and vaping have gone from a promising harm reduction tool for smoking cessation1 to the suspected cause of a massive outbreak of cases of severe lung injury2 focused on, but not isolated to the United States. What is happening? Could the medical community have seen this coming. Read More


Written by Yvonne Drasovean, BSc, RRT, MEd, FCSRT

Motivation, hard work, sincere enthusiasm and passion are some of the many attributes defining great leadership. These same attributes and great leadership also describe Mike Keim.  Read More

Eye On

Telehomecare: Staying healthier at home

Shelley Morris
Senior Business Lead – Digital Self Care

Intensive coaching/remote monitoring program helps patients with chronic obstructive pulmonary disease and/or chronic heart failure

Faced with several chronic conditions, Alberto was worried about daily activities like going for a walk and going to work. He told his family doctor that he felt like the “walls were shutting in” and had many questions about living with chronic obstructive pulmonary disease (COPD).

Read More

Fitness for Breath
Physical Activity is Leading to a Better Quality of Life 

Jody Hamilton BSW, MSW, Patient Engagement and Community Programs Manager
Ontario Lung Association

The Ontario Lung Association is thrilled with the on-going expansion of the Fitness for Breath (FFB) program across Ontario. What started out as a pilot in the fall of 2014 at the Abilities Centre in Whitby, and FFB has now expanded to 21 sites and is still growing. 

Fitness for Breath is a relatively new model for exercise maintenance designed specifically for people living with chronic lung diseases such as: COPD, severe asthma and pulmonary fibrosis. Fitness for Breath is intended for people who have attended a pulmonary rehabilitation (PR) program, however, since many people do not have access to a PR program in their community, they join FFB programs by self-referral and the signed consent of their physician. FFB is intended to ensure the continuation of pulmonary rehabilitation, allowing the participants to continue their exercise routine in their communities.Read More


Review by Elizabeth Gartner

Gordon CS, Waller JW; hDCook RM; Cavalera SL, Lim WT,Osadnik CR, . Effects of Pulmonary Rehabilitation on Symptoms of Anxiety and Depression in COPD A Systematic Review and Meta- Analysis. Chest. 2019 July;156(1):80-91. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31034818

This paper describes a review of randomized control studies evaluating the effectiveness of pulmonary rehabilitation (PR) on anxiety and depression symptoms in COPD. Studies included compared PR, programs lasting longer than 4 weeks, to usual care. A subgroup analysis was also done comparing less than 8 weeks vs greater than 8 weeks of rehabilitation. The working definition of PR was exercise training with a minimum of 8 sessions with or without education and psychological support.  In comparison, usual care was defined as the absence of formal intervention. Studies had to have outcomes related to anxiety and/or depression, two common comorbidities with COPD. Read More


Review by Shirley Quach:  HBsc, RRT

Bourbeau J, Bhutani M, Hernandez P, Aaron SD, Balter M, Beauchesne MF, D’Urzo A, Goldstein R, Kaplan A, Maltais F, Sin DD, Marciniuk DD. Canadian Thoracic Society Clinical Practice Guideline on pharmacotherapy in patients with COPD – 2019 update of evidence. Canadian J of Respiratory, critical care and sleep medicine [internet]. 2019 Oct [cited 2019 Nov]; 3(4): 210-232. Available from: https://www.tandfonline.com/doi/full/10.1080/24745332.2019.1668652 DOI 1 0.1080/24745332.2019.1668652

The Canadian Thoracic Society (CTS) position statement serves as a guide for clinicians to use to personalize and optimize pharmacotherapies for patients living with chronic obstructive pulmonary disease (COPD). In light of recent research studies and clinical evidence, the recommendations in the CTS clinical practice guideline were updated in October 2019. Read More


Review by Lily Spanjevic, RN, BScN, MN, GNC(C), CRN(C), CMSN(C)

Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage:  a prospective, multicenter, single-blinded, randomized, controlled trial

Xie He, G., Li, N., Ren, L., Shen, H.H., Liao, N., Wen, J.J., Xu, Y. M., Wang, J., & Yun Li, Q.  (2019)  Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage:  a prospective, multicenter, single-blinded, randomized, controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 2091: 14:  2291-2304. Available from: https://www.dovepress.com/benefits-of-different-intensities-of-pulmonary-rehabilitation-for-pati-peer-reviewed-article-COPD

It is well known that Pulmonary Rehabilitation (PR) is essential in managing patients with COPD.  PR includes exercise training, counseling, instructional training and behavioral change tailored to each patient.  However, there is a lack of research data that identifies specific frequency, intensity of exercise, the degree of supervision, and the appropriate duration of PR exercise. Read More


Ontario Respiratory Care Society (ORCS) Committees

Joining an ORCS Committee is a great way to get involved! 

Provincial Committee
The Provincial Committee provides leadership to the ORCS and is comprised of the ORCS Chair, a Chair-Elect or Past Chair in alternate years, the Chairs of the five standing committees, the Chairs of the regional planning committees and a member of The Lung Association Board of Directors.

Editorial Board
Produce an electronic publication for the Ontario Respiratory Care Society (ORCS) members; provide academic content for the publication.

Respiratory Health Educators Interest Group (RHEIG)
Provide respiratory education and a half-day session at the Better Breathing Conference; provide patient education content for the ORCS publication.

Education Committee
Session planning for the Better Breathing Conference.

Research and Fellowship Committee
Manage the funding process including Grant and Fellowship application review and funding allocation.

Regional Planning Committees
Regional Planning Committees plan educational events in their respective regions. The Regions include:
Northeastern Region
Northwestern Region
Eastern Region
Central Region
Western Region

To find out more, or to join one of these committees, contact the OTS/ORCS Coordinator,
Natalie Bennett, nbennett@lungontario.ca


With so many amazing perks to save you money this year… Membership is a MUST!

The ORCS is proud to be partnering with JD Smith to offer Liability Membership for RT members! 2M Liability packages start at $130.00 THIS PRICE INCLUDES YOUR $40 MEMBERSHIP!

On-Line registration will be open February 1st, 2020!!


For more information please email: societies@lungontario.ca

Your $40 Membership includes:

  • Discounts on Home, Auto, Travel and Health Insurance for all ORCS Members
  • Big Discounts with Park N’ Fly
  • Shopping, Entertainment perks and more… FREE through Perkopolis with your ORCS membership.
  • Discount at Stethoscope.ca. This includes free engraving and 1/2 price cases.
  • 15% off all purchases at scrubscanada.ca
  • 10% coupon from Dell.ca to help with your business and personal computing needs.
  • Discounts on Professional Development ($175 off the cost of registration to the Better Breathing Conference 2020)
  • Discounts of up to 40% off GoodLife fitness memberships for ORCS members and their families. Rates
  • Volunteer with the ORCS by joining a committee, writing an article for one of our Publications, or becoming a member of our Speaker’s Bureau.  
  • Discounts to Education Seminars and Workshops and The Annual Better Breathing Conference!


January 22-23, 2020
10th Annual Respiratory Health Forum for primary care practitioners – Free Registration
Location: Marriott Downtown at CF Toronto Eaton Centre
For more information, visit: lungontario.ca/rhf

January 24 & 25, 2020
Better Breathing Conference 2020
Location: Marriott Downtown at CF Toronto Eaton Centre
For more information, visit:  betterbreathing.ca

January 25, 2020
Digital Health Forum I   12:00 PM – 1:30 PM EST
Location: Marriott Downtown at CF Toronto Eaton Centre
For more information, visit: https://tladigitalhealthforum.eventbrite.ca

February 11, 2020 I  11 am – 12 pm EST 
COPD and its management – KOTM/OTN Series -Part one
Presented by: Diane Feldman, RRT, CRE
Webcast link: http://webcast.otn.ca/mywebcast/?id=157009352 
OTN Event ID #: 157009352

Date: March 5, 2020
Location: The Michener Institute, Toronto, Ontario
An educational evening for Healthcare Professionals and Students brought to you by the Ontario Respiratory Care Society – Central Ontario Region. Dr. Roger Goldstein will present on The Magic of Pulmonary Rehabilitation, followed by an interactive session on Facilitating Collaborative Practice in Pulmonary Rehab.
Register at https://bit.ly/39REpD2

March 10, 2020 I  11 am – 12 pm EST 
COPD and its management – KOTM/OTN Series -Part two
Presented by: Diane Feldman, RRT, CRE and Sara Han, RRT, CRE
Webcast link: http://webcast.otn.ca/mywebcast/?id=157050804
OTN Event ID #: 157050804 

For more information or to set up a workshop in your area for your healthcare team or organization please contact us at pep@lungontario.ca


Yvonne Drasovean, RRT
Lorelei Samis, BScPT

Jocelyn Carr, BScPT, MSc
Julie Duff Cloutier, RN, MSc, CAE
Yvonne Drasovean, RRT
Elizabeth Gartner, BScOT
Lawrence Jackson, BScPhm
Rachel McLay, HBSc (Kinesiology)
Shirley Quach, HBsc, RRT
Priscila Robles, BScPT, MSc, PhD
Lily Spanjevic, RN, BScN, MN, GNC(C), CRN(C), CMSN(C)

Miriam Freymond Turnbull, MBA, RRT, COPD Ed.
Vice President  & GM | ProResp Inc.

George Habib, BA, BEd, CAE

Christina Sperling, MScCH, BKin, RRT

Jennifer Noble

Natalie Bennett

Roline Mennigke

An official publication of the Ontario Respiratory Care Society, a section of
The Lung Association – Ontario.

RHEIG Committee

Jane Lindsay, BScPT
Lorelei Samis, BScPT

Aisha Balasubramaniam, MPH, BSc, RRT, CRE
Geetika Bhargava, BHSc, RRT, CRE
Rose-Marie Dolinar, RN(EC), MScN, PhD student
Kitty Seager, CRE, CTE, RPN
Sylvia Sirarajahkumar, HBSc, BScPharm, ACPR
Maria Willms, RN, CRE