Welcome to BreathSounds




              My name is John D’Urbano, RRT and I’ve been a Respiratory Therapist in the Phoenix area since 1992. I received my education in Respiratory Care at Long Medical Institute, and Gateway Community College in Phoenix, Arizona. I worked my way through that first year of school as a night-shift security patrol supervisor. For the 2 years following I worked nights as a Respiratory Therapy Technician with one of the registries. Like many students I lost a lot of sleep, missed out on a lot of recreational activities, had a bank account that was near empty most of the time, and even had my lights turned off from time to time. There was never a day when I regretted my decision to go to school to become a Respiratory Therapist.






Saturday 3/14/2020

CEU Webinars will present 12 hours
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3 sessions of 4 hours each - $40 per session
Purchase 4, 8 or 12 hours (1, 2, or 3 sessions)
No microphone or camera needed




Hi BreathSounds fans. A friend is working on a thesis toward her Masters degree. Please help her by completing a very brief survey. Read bellow...

Hi all - if you've not yet participated in the survey for my thesis, I would really appreciate it if you would. The Laboratory and the Respiratory Therapy professions have been significantly affected by Medicare changes, automation, etc, resulting in reductions in staff. I think I corrected the issue with not being able to access the survey. Please follow this link.

Managing Stress in a Constantly-Changing Workforce | Online Surveys

AARC-Approved CEUs at

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Expires 12/31/2019

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All Airway Safe-Mask!

This is a Next Generation One-Piece Bag/Valve/Mask that should be the next standard of care for early airway management.

Posted: Tuesday March 19th 2019

Interactive Flu-Map for the 2018/2019 Flu Season

This is an interactive map showing the progression of the flu throughout the United States over the past 3 months. I can't take credit for this. This is NOT my map, this is NOT my code, and none of it came from my servers. This interactive healthmap is from Kinsa. Below is a link to the map. Links to the Kinsa site are provided.

Inter-Active Flu-Map

Smith Seminars is having an awesome sale on CEU's!!

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Buy $60 of any courses use Coupon Code: 10%discount
Coupons Expire 2/28/2019
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Added: Wednesday, February 13th, 2019

               BreathSounds is happy to announce the addition of a new section of the website dedicated to board exam preparation and CEU’s. From the left menu simply click on CEU and Exam Resources. As always, if there are any questions please feel free to drop me a note anytime at

J. D’Urbano, RRT-Retired
Founder / Web Administrator
BreathSounds – Because at the Head of Every Team IS a Respiratory Therapist

Added: Monday, December 3rd 2018

Added: Tuesday, July 10th, 2018

Camp Trach Me Away

Camp Trach Me Away!

This is an awesome, donation supported, program physically located East of Atlanta, Georgia. Their Mission?

Camp Trach Me Away provides a week-long summer camp experience to children with tracheostomies.  It provides opportunities for children with tracheotomies to learn life skills, gain support from their peers and engage in traditional summer camp activities.

PLEASE go check them out, DONATE, get involved andhave fun watching these kids enjoying activities that they were once only able to dream about.

I typically don't publically post reviews of a lot of products and material, but this one I simply can't pass up. Robert Green's book, titled "Green's Respratory Therapy: A Practical and Essential Tutorial of the Core Concepts of Respiratory Care" is, hands down, one of the BEST supplements to Respiratory Care education that I have ever come accross in my long and fairly successful career. If you are a student of Respiratory Care, or even a credentialed Respiratory Therapist looking to "tune up" your already vast world of knowledge, then this IS the supplement for you! I promise you, this is well worth looking in to.

 Green's Respiratory Therapy

NOTICE: BreathSounds is not sponsored by any author or product manufacturer and there is no financial agreement between the author or publisher of this material and BreathSounds, its staff, or any of its affiliates.

 Room Tension

Room tension is exactly what it sounds like. It is what I like to call the triad of chaos. It is the level of stress, noise and confusion in the room during a medical urgency, or emergency. Typically, the more unstable the patients appears the more likely we are to experience this triad of chaos. It is during these scenarios that we are most likely to make mistakes, adding unnecessary risk to your patients’ safety. Read the entire article here... Or you can watch the brief 4 minute video lecture:

Reading Between the Lines

I read a bit, and I write a bit. Most of it is simply a bunch of boring medical stuff, but occasionally I tap out something that is actually kinda kewl. 😊 This is probably not one of those times, but it is a rather important subject that does a little tap-dance on our safety.

You can’t always believe what you read. Not in a literal sense anyway. This is especially true when it comes to medical information found on the internet. I know, I know… Please, just humor me for a few minutes. Yes, there are numerous sites on the internet offering a ton of useful and useless information on countless conditions, disorders, diseases, injuries, etc.… Much of that information is good, and some – not so much. Do you really believe you can tell the difference? Yes, that was a trick question.

Even those very reputable sites with tons of articles written especially for the non-medical professional, or the lay-person, come with risks to the very health or life of that lay-person. The reason is actually quite simple. The average lay-person does not have the educational background AND the bedside clinical experience to actually read between the lines. Medical literature is one of the few places in the literary world that truly has a TON of information between the lines. If you don’t know to look for it, and don’t know how to interpret it, then you really are missing some VERY important information, and just might be putting your very safety at risk.

Adding to the problem is the “Direct to Consumer Advertising” of medical procedures, devices, and medications promising effective treatments for everything from hangnails to hat hair. This type of advertising is intentionally misleading and intriguing to the lay person. The interesting part about this is medical direct to consumer advertising is illegal in every country in the world except for 2.

Unfortunately, the United States is one of them.
I’ll give you a few examples to ponder. Interstitial Lung Disease. There are approximately 15 separate recognizable diseases that fall under this umbrella diagnosis. The signs and symptoms are almost identical for all of them, vague and non-specific, but the effective treatments for each are very different and condition specific.

Here’s a common complaint. Shortness of breath, non-specific, may also have a little local chest pain or not. There are roughly 100 different conditions that can cause symptoms as vague as this. Some of them can be fatal, and a few of them can be fatal pretty quickly. Don’t research it. Go to the urgent care or ER of your choice.

It boils down to this. For every set of symptoms there are numerous conditions that can explain them. Trying to research them on your own before you visit a Physician can either cause you to underestimate that problem, putting you at great risk, or overestimate the problem, perhaps causing you to panic unnecessarily. Either way the real problem will not be treated correctly and that is NEVER a good idea.

If you are having symptoms of any kind, PLEASE go see your Physician BEFORE you research. They have the education, they have the clinical experience, and they’ve already done the research. Think smart, and be safe…

Asthma Treatment Education: As Important as the Treatment Itself

 Staying current in medical education is an important part of the healthcare professionals’ world, especially in light of the advanced medical technology and education of today. Thoroughly educating patients on the “proper” use of asthma treatment medications and devices is just as important.

Dr. Charles Vega, Clinical Professor of Family Medicine at the University of California in Irvine, along with Dr. Sandra Adams, Professor of Medicine and Pulmonary & Critical Care Specialist at the University of Texas in San Antonio, discuss just that.

Dr. Adams is also the Founder and CEO of The Wipe Diseases Foundation, a not-for-profit foundation dedicated to the education of respiratory diseases for patients as wel as healthcare professionals.

According to the current research approximately 45% of asthma patients practice improper use of asthma medications and devices. This contributes to a significantly increased number of emergency department and urgent care visits throughout the United States. The data is near identical in adults as well as pediatrics.

It is not as simple as it used to be. Today there are almost as many different devices as there are different medications for the treatment and maintenance of asthma. A short example is the metered dose inhaler (MDI) vs the dry powder inhaler (DPI) and the soft mist inhaler (SMI).

Some medications are short acting beta2 agonist bronchodilators (SABA’s), the long acting beta2 agonist bronchodilators (LABA’s), anticholinergics, and inhaled corticosteroids (ICS).

Most of the time the devices and medications are specific to the circumstances of the condition. Some are for immediate relief of asthma symptoms while others are specific to maintenance of the disease.

This was discussed in more detail by Dr. Vega and Dr. Adams to Medscape Medical News, and the complete discussion can be found at


Wednesday, May 10th, 2017

Happy New Year!!
*** 2017 ***


Throughout my day I often give advice, teach, and even give short unofficial lectures to Respiratory Therapists, Nurses, and even Physicians a wealth of topics. In 2016 this was one of the most popular topics that came up.

Airway Management is a multi-role responsibility, and it is ongoing. Meaning Airway Management doesn’t stop when the tube is in. The distance between the tip of the ET tube is every bit as important as the distance between the top of the ET tube balloon and the vocal chords.


Sunday, January 1st, 2017
J. D'Urbano, RRT


Professional Longevity is an earned skill rarely seen in today's workforce and is the key difference between merely having a job and actually earning a meaningful career...

Saturday, November 12th, 2016
J. D'Urbano, RRT

The staff & Management here at BreathSounds would like to wish all of you a very Happy and SAFE

Respiratory Care Week!!!

Monday, October 24th, 2016
J. D'Urbano, RRT

The E-Cigarette Controversy...  Continues...

The subject of electronic cigarettes is fluid. A very dynamic topic that is just as volatile as it was when the device was first introduced into the United States in 2007. Even in light of everything that has been learned there are still unanswered questions, and even a few new ones. Are they safer than conventional tobacco cigarettes? Are they safe at all? Is it a tobacco product or a drug delivery system? A safe smoking alternative or a new tool to aid in smoking cessation? Wrapping up its first decade in the United States the controversy continues. Is it a clever new tool to aid in smoking cessation, or is the electronic cigarette just another "wolf in sheep's clothing"?

Saturday, August 27th, 2016
J. D'Urbano, RRT



Respiratory Care Books:

For over 25 years I have been purchasing these books. I was still in college whenh I bought the blue Pocket Guide for Respiratory Care. With the exception of my text books this was the first piece of Respirat Care literature I bought. Bought it with my text books, and I've bought every update since. About ten years ago I bought their Critical Care Pack, and I've been buying them since. An amazing pack that I actually to help improve my practice.

Click on the ad below and please don't forget to tell them BreathSounds sent you.


Tuesday, August 9th, 2016
J. D'Urbano, RRT

E-Cigarettes to Quit Smoking? The Results are Disappointing...

At 3 to 6 months e-cigarettes vs placebo showed an insignificant incidence of smoking abstinence. This was presented at the American Thoracic Society 2015 International Conference by Dr Matthew Stanbrook of the University of Toronto. Dr Stanbrook and his team of investigators reviewed 297 articles from MEDLINE and EMBASE.

It appears that e-cigarette use did decrease the number of tobacco cigarettes smoked in a significant number of participants. This may be partly due to behavior, meaning that many regular users of e-cigarettes also smoke conventional tobacco cigarettes. They use e-cigarettes as a substitute for tobacco cigarettes when they are in an area where smoking is not permitted. Those who use e-cigarettes and conventional tobacco cigarettes may be doubling their risk of adverse effects from nicotine, the highly addictive and toxic ingredient in tobacco and e-juice, as well as other ingredients that are known to be harmful.

Some Physicians would like to endorse e-cigarettes for smoking abstinence if there was better results and they were better regulated. The U.S. Food & Drug Administration finally has some regulations on the manufacturing and sale of all Electronic Nicotine Delivery Systems (ENDS) but more research and work needs to be done. There is still limited data on the use and long term effects of e-cigarettes and the inhalation of their ingredients.

Friday, May 20th, 2016
J. D'Urbano, RRT

From the Staff & Management Here at BreathSounds: May we ALL have a Happy and SAFE Respiratory Care Week...  (Monday, October 26th 2015 - Friday, October 30th)

BreathSounds is undergoing some minor redesigning and reconstruction. Nothing big. Just enough to make it a bit easier to navigate around and find what you're looking for. Yes, I am trying to make it a little more user-friendly. Thank you for the comments thus far. As always, drop me a note with your comments, suggestions, etc...


            A Respiratory Therapist is a highly trained specialist who cares for patients with disorders, diseases, and injuries that affect the respiratory and cardiopulmonary systems. In ALL healthcare settings a Respiratory Therapist is a vital part of the healthcare team. They are leaders by nature, and masters of their trade. As specialists in respiratory therapy, airway management, ventilator management, and acid/base balance they perform a broad range of basic and advanced skills. They include patient assessment, inhaled medication delivery, arterial puncture, arterial line placement, airway management, endotracheal intubation, ventilator management, and many others. Respiratory Therapists participate in direct patient care in virtually all areas of the hospital – general and telemetry floors, critical care, cardiac cath and special procedure labs, nuclear medicine, and operating rooms, etc...

          Welcome to BreathSounds, an internet community created for Respiratory Therapists by Respiratory Therapists actively working in the medical community. The internet is a vast world and within it there are many resources for Respiratory Care. At BreathSounds we do NOT want to compete with them. We want to join them by sharing information in terms that all can undersatand, and filling in the gaps with information that might be difficult to find.


"Because at the Head of Every Team is a Respiratory Therapist..."




NOTICE from the Author:

No Medical Advice: These writings are my own personal words based solely on my own personal clinical experiences, education, and research. I am NOT a Physician and therefore DO NOT give out medical advice under any circumstance. The writings within BreathSounds, BreathSounds Media, and BreathSounds.Org are in no way intended to be taken as medical advice of any kind.

Copyright NOTICE:

© 2009-2010 – J. D’Urbano – BreathSounds. Unauthorized use and/or duplication of this material without express written permission from the author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to J. D’Urbano and BreathSounds with appropriate and specific direction to the original content.