Respiratory therapy

From Wikipedia, the free encyclopedia

Respiratory Therapy is an allied health profession in the United States and Canada. In the United States there are currently two levels of respiratory therapist, the Certified Respiratory Therapist (CRT) and the Registered Respiratory Therapist (RRT), both credentials offered by the National Board for Respiratory Care (NBRC). Both of which fall under the title Respiratory Care Practitioner

Contents 1 History of Respiratory Therapy 1.1 Work Environment 1.2 Regulation of practice 2 References 3 External links 4 See also

[edit] History of Respiratory Therapy

Since 1946 the field of Respiratory Therapy has grown exponentially. Some oxygen tank technicians began meeting with doctors concerned with lung disease in Chicago, Illinois in the 1940s. This group named itself the Inhalational Therapy Association ("ITA") in 1946. They gradually put together a series of classes for people administering medical gases to patients. In December, 1950, 31 members of the Association were issued certificates for attending 16 lectures. This was the first certification of "inhalation therapists." (Burton, pp. 5-6) It was an on-the-job training system for so-called "oxygen jockies". They had little formal education, but did have a desire to do their jobs better and help patients in the process.

In 1953 the American College of Chest Physicians agreed to sponsor the ITA. By this year the ITA was holding an annual convention, with attendees from 14 states and Canada. In 1954 they changed the name to American Association of Inhalation Therapists, electing a board of directors. They elected Sister Borromea as president and appointed Jimmy Young as executive director. By this time the AAIT was putting out a monthly Bulletin, and state chapters began to form. (Burton p. 7)

During the next few years better equipment and more advanced therapy techniques were introduced. Those practicing in the profession began to adopt the title "inhalation therapist." Their main function was to ensure safe oxygen use, to administer intermittent positive pressure breathing (IPPB) treatments, to perform cardiopulmonary resuscitation (CPR), and to operate negative pressure (iron lung) ventilators.

Alvin Barach, a leader in discovering the role oxygen therapy played in breathing and health, led a group in publishing in 1950 "Minimum Standards for Inhalation Therapy." In 1957 the New York delegation to the AMA's House of Delegates introduced a resolution to develop schools of inhalation therapy, and soon after some schools were set up. In 1960 Articles of Incorporation were filed with the State of Illinois for the American Registry of Inhalation Therapists. Twelve examinees were registered in 1961. In 1972 the Association changed its name to the American Association of Respiratory Therapy, and this was later changed to the American Association of Respiratory Care. By 1983 about 16,000 respiratory therapists had been registered. (Burton, pp. 9-10). About 1969 the organization devised a system for credentialing entry-level practitioners, which became the National Board of Respiratory Care's system of certifying technicians.

With the advent of positive pressure mechanical ventilators, the more widespread hospital provision of neonatal and pediatric care, more sophisticated pulmonary function testing (PFT), a need for thoroughly trained clinical practitioners presented itself.

Over the years "respiratory technicians" have evolved to being college and University trained clinicians. Respiratory therapy skills and procedures include (but are not limited to): managing mechanical ventilation (invasive and non-invasive), intubation and placement of other airways, arterial line insertion, cardiac catheter advancement, tracheostomy recannulation, nasotracheal suction, drawing and interpreting arterial blood gases, pulmonary waveform analysis, inhaled medication delivery, oxygen delivery (via nasal canula and various mask devices), managing a variety of aerosol therapy devices, performing pulmonary function tests.

[edit] Work Environment

Respiratory Therapists are most commonly found in ICU/CCU,CVICU,PICU,NICU,ER,and OR,as well as other critical care areas within the hospital setting. Respiratory Therapists treat virtually every patient population, and most often the most critically ill patients in the hospital. The Respiratory Therapist duties include but are not limited to: Delivering Aerosolized Drugs, Management and Initiation of Life Support, Withdrawal of life support in an either Terminal (known as "terminal weaning")or general weaning capacity, Respiratory Therapists are also a critical part of the Crash Team and are responsible for Cardiopulmonary Resuscitation of the patient, as well as establishing a patent airway (known as intubation). Respiratory Therapist also administer cardiac testing as well as place Arterial Lines and draw Arterial Blood Gasses (ABG) for Pulmonary Function analysis. Respiratory Therapists are also found in Sleep Diagnostic facilities, Cardiac Cath labs, Cardiac Stress Labs and Pulmonary Function Testing labs.

[edit] Regulation of practice

All RTs are required to complete at least an Associate's Degree program supported by one of the following: the Committee on Accreditation for Respiratory Care (CoARC), its predecessor the Joint Review Committee for Respiratory Therapy Education (JRCRTE), the Commission on Accreditation of Allied Health Education Programs (CAAHEP), or in Canada by the Council o­n Accreditation for Respiratory Therapy Education (CoARTE). There are four and five year Bachelor's degree programs as well as Master's degree programs. A Therapist holding a Bachelor's Degree can go on to earn a Master's degree in health related fields such as MPH, as well as Doctoral degrees such as a PhD, or EdD. After graduation, the therapist must then take a national exam and obtain proper licensure for their state or province .

Canada
In Canada, credentialing is governed by the Canadian Board for Respiratory Care (CBRC), also known as Le Conseil Canadien Des Soins Respiratoires (CCSR). Therapists obtain the Registered Respiratory Therapist (RRT) credential by successfully completing the written Canadian Society of Respiratory Therapists (CSRT) Certification Examination.

United States
In the US, a two-tiered system exists that is administered by the National Board for Respiratory Care (NBRC). Passing the primary certification exam makes the practitioner a Certified Respiratory Therapist (CRT). Subsequently, a written registry exam and a separate clinical simulation exam must be taken. All graduates as of 2005 are required to pass both the written and clinical simulation portions of the registry exam, becoming an RRT. A further examination for Neonatal/Pediatric Specialist may be taken, allowing RTs to be designated Neonatal-Pediatric Specialists (CRT-NPS or RRT-NPS). CRT status with one year experience in Neonatal or Pediatric Respiratory Care following Certification, or RRT status, is required for eligibility to take the NPS exam.[1] Other exams that RTs are eligible to take include Certified Pulmonary Function Technologist (CPFT) and Registered Pulmonary Function Technologist (RPFT). Some RTs become sleep study technicians and obtain the credential of Registered Polysomnographic Sleep Technologist (RPSGT), which is governed by the Board of Registered Polysomnographic Technologists (BRPT).

[edit] References

[edit] External links

• American Association for Repiratory Care (AARC)
• National Board for Respiratory Care (NBRC)
• Canadian Society of Respiratory Therapists (CSRT)

[edit] See also

• Advance for Respiratory Care Practitioners
• Advance for Managers of Respiratory Care
• RT Space, Global Community for Respiratory Therapist
• Respiratory Care & sleep disorder
• Canadian Respiratory Therapist Job Profile — analysis of job outlook and wage information for Canada.
• Critical Care News is a peer-to-peer forum for intensive care clinicians throughout the world to share experiences in ventilation therapies with each other.
• United States Occupational Outlook Handbook for Respiratory Therapists — Job outlook and wage information for The United States
• RT Magazine (bimonthly professional publication)
• RT Corner (Educational Site for RT's and Nurses)
• RESPIRATORY CARE: The Science Journal of the American Association for Respiratory Care (AARC)
• Respiratory Care Forum

v • d • e Respiratory & Pulmonary Care Credentials Certified Pulmonary Function Technologist • Registered Pulmonary Function Technologist  • Certified Respiratory Therapist • Registered Respiratory Therapist • Neonatal/Pediatric Respiratory Care Specialist  • Sleep Disorders Testing and Therapeutic Intervention Respiratory Care Specialist Degrees Diploma in Respiratory Care • Associate of Science in Respiratory Therapy • Bachelor of Science in Respiratory Therapy • Master of Science in Respiratory Therapy • Doctorate in Philosophy of Respiratory Therapy Specialties (not comprehensive) Neonatal/Pediatric • Critical Care • Emergency • Sleep Disorder • Emergency Flight Therapy Other CRT Examination • RRT Examination • Respiratory Therapist practice • Respiratory Therapist process • Respiratory Therapist school • Respiratory Therapy theory • Timeline of Respiratory Therapy History See also Health care