Javier Amador-Castaneda, BS, RRT, is a respiratory therapist at Columbia University Irving Medical Center in New York City. He joined the Society of Critical Care Medicine (SCCM) in 2018 and is a member of the Fundamental Critical Care Support (FCCS) Program Committee; Anesthesiology, Internal Medicine, and Respiratory Care sections; and the Global Outreach knowledge education group. You can find Mr. Amador-Castaneda working out and traveling when he is not busy with critical care. Read more about his love of critical care.
How did you get into critical care?
I served in the U.S. Army National Guard, enlisting at 17. My first deployment to Operation Iraqi Freedom in 2008/2009 found me working as a military police officer in a hospital, providing security for healthcare professionals. This experience exposed me to an array of medical roles, ultimately leading me to respiratory therapy. From that moment, I was determined to pursue a career in respiratory care. As I delved into the intensive care unit (ICU), my passion for this profession grew. Embracing every opportunity to learn, I eagerly absorbed knowledge, like a sponge.
My commitment to the field led me to volunteer on various SCCM committees, pushing the boundaries of my capabilities by presenting at conferences and serving as a moderator. I have contributed to the advancement of respiratory care by publishing articles and authoring a book chapter for SCCM. This journey has not only enriched my career but also fueled my unwavering dedication to improving patient care in the realm of respiratory therapy.
What are the top advances in critical care since you started your career?
Low tidal volume ventilation and positive end-expiratory pressure (PEEP) have improved outcomes for patients with acute respiratory distress syndrome and other severe lung injuries. Driving pressures to optimize PEEP, prone positioning ventilation, esophageal manometry for patients with high BMI, and electrical impedance tomography have all advanced the field. Extracorporeal membrane oxygenation (ECMO) has become more accessible, efficient, and safe. High-flow nasal cannula (HFNC) therapy has emerged as an alternative for patients with acute hypoxemic respiratory failure, offering improved oxygenation and comfort. Point-of-care ultrasound (POCUS) has revolutionized bedside diagnostics and monitoring in critical care settings. Finally, recognizing the importance of pulmonary rehabilitation for chronic respiratory diseases has led to the development of comprehensive, multiprofessional programs.
What advice do you have for those starting their critical care careers?
Develop a solid understanding of the core principles of critical care, and pursue additional training to enhance your skills and expertise. Stay up to date with the latest research, advancements, and evidence-based practices through workshops, conferences, and professional organizations, such as SCCM. Seek experienced professionals who can offer guidance, advice, and support as mentors. Prioritize self-care, practice healthy coping mechanisms, and seek support to prevent burnout. Cultivate teamwork and communication skills. Focus on patient- and family-centered care by prioritizing your patients’ and their families’ needs and wishes. Develop strong communication and empathy skills to provide compassionate care. Treat your patients as if they were members of your own family. Participate in research, quality improvement initiatives, and evidence-based practice projects. Lastly, be flexible and adaptable to new technologies, treatments, and approaches.
What is your greatest professional achievement?
I authored a chapter in the forthcoming FCCS book, slated for release in 2024. I attribute my success to the valuable relationships I have forged with remarkable colleagues throughout my career, each of whom has imparted wisdom and influenced my achievements in some capacity. I would like to express my profound gratitude to the pulmonary team at the Hospital of the University of Pennsylvania, where I embarked on my professional journey. I also extend my appreciation to the entire pulmonary team at Columbia University Irving Medical Center, where I continue to evolve as a respiratory care practitioner.
Why do you love being in critical care?
First, critical care allows me to make a significant difference in the lives of critically ill or injured patients. Collaborating with diverse healthcare professionals, including physicians, nurses, pharmacists, and therapists, fosters an environment of shared knowledge and mutual support. The complexity and acuity of the patients I encounter challenge me to stay updated on the latest evidence-based practices and apply them daily. Managing my patients’ mechanical ventilation is an art.
The dynamic nature of critical care means new technologies and treatments are developed regularly, keeping us at the forefront of innovation and allowing for the best care possible. While critical care can be emotionally challenging, it offers a unique sense of fulfillment when our patients improve and recover—reminding us of the value of our work and our impact on the lives of our patients and their families. Furthermore, critical care offers a platform to educate and mentor the next generation of healthcare professionals, shaping the future of critical care medicine.
What do you see as the most challenging issue facing critical care?
Critical care’s most challenging issue is the increasing demand for services along with a shortage of skilled professionals and resources. Key contributing factors include an aging population, health disparities, a rapidly evolving knowledge base, and ethical dilemmas. Addressing these challenges requires investment in education and training, strategies to manage workforce shortages and burnout, promotion of evidence-based practices, optimized resource allocation, and efforts to reduce health disparities. Collaboration among healthcare professionals, policymakers, and researchers is crucial.
What industry trends have you excited about the future?
I am excited about artificial intelligence and machine learning revolutionizing diagnostics and decision-making. The move toward precision medicine enables personalized, targeted therapies based on individual patients’ profiles. Wearable technology and remote monitoring facilitate patient care, while virtual reality enhances medical education. Expanding telemedicine improves access to critical care expertise, particularly in underserved areas. Advancements in 3D printing and bioprinting create patient-specific medical devices and tissues, and ongoing research into immunomodulatory therapies offers innovative treatment options for various respiratory diseases.
What do you love about SCCM membership?
SCCM provides a platform to connect with colleagues, share experiences, and collaborate in a multiprofessional environment. Members have access to a wide range of educational resources, including webcasts, podcasts, and online courses, to help them stay updated with the latest evidence-based practices. The leading critical care journal, Critical Care Medicine, is delivered monthly to members to help them stay informed about the latest research.
Attending SCCM’s annual Critical Care Congress and other events allows members to learn from renowned experts in the field, present their own research, and participate in interactive workshops. As a speaker, moderator, and program committee member, I have personally experienced the benefits of attending these events.
The Society offers career development resources, such as mentorship programs, leadership opportunities, and training programs, which can help members advance their careers and enhance their skills. Additionally, SCCM recognizes the achievements of its members through various awards and honors, celebrating their contributions to the field.
Connect with @Javier Amador-Castaneda on SCCM Connect!