Advanced Directives

A legal document describing medical interventions or medical situations that are acceptable or unacceptable to a patient should they be unable to speak for themselves due to critical illness. 

This document provides the health care team, family, and significant others with direction to develop and plan of care in accordance with the patient's wishes and values.

Advanced Directives may be highly specific and situational, or describe a more general set of wishes that can help guide care choices.

Breath Stacking

Breathing stacking is a physician prescribed procedure, so instruction from your health care provider is essential before you perform it.

This procedure involving hyper inflating the lungs over a defined time period to help recruit the base of the lungs for improved gas exchange.   It is typically performed twice daily.

Breath stacking may be ordered as a preventative treatement or as an acute treatment in the event of chest infection. 

Please click here for a printable brochure about breath stacking.

Chronic Alveolar Hypoventilation (CAH)

Patients who under breathe with respect to their needs.

Chronically Critically Ill (CCI)

Patients who experience a prolonged recovery time in the Intensive Care Unit to recover from an acute illness. 

Patients often require weeks to months to wean from mechanical ventilation.  Some patients will not be able to wean from mechanical ventilation.

Critical Illness Recovery Program

Bay 6 of the Medical-Surgical Intensive Care Unit is dedicated to the care and rehabilitation of patients who are chronically critically ill with an anticipated or established need for prolonged mechanical ventilation (PMV), or those known to need long term ventilation (LTV). 

Goals of care may include improving mobility and independence, reduction and management of long term ventilation, maximizing nutrition, promoting psychological recovery, and reducing monitoring needs until a patient is safe to transfer to another facility.

Invasive Ventilation

Provision of mechanical ventilation through an endotracheal tube inserted in the patient's airway through the nose or mouth, or through a tracheostomy.  A tracheostomy is a breathing tube inserted directly into the trachea through the neck.

Long Term Ventilation

When a patient needs mechanical ventilation that is expected to last a lifetime. Ventilation may be non-invasive or invasive.

Non-Invasive Ventilation (NIV)

Provision of mechanical ventilation by positive airway pressure support using a mask placed over the nose, or nose and mouth.

Plan of Care

A plan used by patients and their health care providers to establish health goals and the means to achieve them.

Prolonged Mechanical Ventilation (PMV)

Invasive mechanical ventilation in an ICU for more than 21 days, and more than 6 hours per day. 

Registered Respiratory Therapist (RRT)

A registered health care provider who specializes in caring for patients with respiratory health problems. RRTs work within acute care hospitals as well as in the community, and help manage home oxygen use, as well as non-invasive and invasive ventilation devices.


A physician who has specialized in the respiratory system. The respirologist can diagnose and treat both acute and chronic respiratory issues.

Secretion Clearance

Physiotherapy techniques and devices designed to help a patient clear secretions in the absence of an effective cough.