Respiratory therapist
A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respiratory therapists graduate from a college or university with a degree in respiratory therapy and have passed a national board certifying examination. The NBRC (National Board for Respiratory Care) is responsible for credentialing as a CRT (certified respiratory therapist), or RRT (registered respiratory therapist),
"Respiratory Care" redirects here. For the medical journal, see Respiratory Care (journal).Occupation
- Respiratory Therapist
- Respiratory Practitioner
- Respiratory Care Practitioner (RCP)
- Licensed Respiratory Therapist
- Associates in Applied Science or Technology (depending on the college) and a certificate in Respiratory Therapy or an Associate of Science in Respiratory Care
- Bachelor of Science in Respiratory Care
- Master of Science in Respiratory Care
- Hospital,
- Clinic
- Laboratory
- Sleep clinic
- DME or Durable Medical Equipment
- LTAC Long Term Acute Care hospital
Flight Transport, Air Ambulance
Teaching or nursing home
The specialty certifications of respiratory therapy include: CPFT and RPFT (Certified or Registered Pulmonary Function Technologist), ACCS (Adult Critical Care Specialist), NPS (Neonatal/Pediatric Specialist), and SDS (Sleep Disorder Specialist).
Respiratory therapists work in hospitals in the intensive care units (Adult, Pediatric, and Neonatal), on hospital floors, in emergency departments, in pulmonary functioning laboratories (PFTs), are able to intubate patients, work in sleep labs (polysomnography) (PSG) labs, and in home care specifically DME (durable medical equipment) and home oxygen.
Respiratory therapists are specialists and educators in many areas including cardiology, pulmonology, and sleep therapy. Respiratory therapists are clinicians trained in advanced airway management; establishing and maintaining the airway during management of trauma, and intensive care.
Respiratory therapists initiate and manage life support for people in intensive care units and emergency departments, stabilizing, treating and managing pre-hospital and hospital-to-hospital patient transport by air or ground ambulance.
In the outpatient setting respiratory therapists work as educators in asthma clinics, ancillary clinical staff in pediatric clinics, and sleep-disorder diagnosticians in sleep-clinics, they also serve as clinical providers in cardiology clinics and cath-labs, as well as working in pulmonary rehabilitation.
Credentialing and licensure[edit]
United States and Canada[edit]
In the United States and Canada, respiratory therapists are healthcare practitioners who, after receiving their education, complete a credentialing process and become a certified respiratory therapists (CRT) or registered respiratory therapists (RRTs).
After satisfactorily completing the required examinations and being added to a registry, the practitioner is then eligible to apply for a license to practice in the region governed by their respective licensing body.
In the United States, specialist respiratory therapists are clinicians who hold National Board for Respiratory Care specialty credentials, which may include neonatal/pediatric specialist (CRT-NPS or RRT-NPS), adult critical care specialist (RRT-ACCS), sleep disorder specialist (CRT-SDS or RRT-SDS), and pulmonary function technologist (CPFT or RPFT). The NBRC's RRT-ACCS examination is the newest NBRC examination: it was introduced in 2012.
In the United States, one must obtain a degree in Respiratory Care and must then sit for the board exams to become a RRT. RRT is issued by the National Board for Respiratory Care after passing the Therapist Multiple-Choice Examination NBRC-TMC and Clinical Simulation Examination NBRC-CSE examinations.[8] Eligibility for the NBRC-CSE examination is based on scoring high enough on the NBRC-TMC, and holding at least an Associate of Science in Respiratory Care. Professional credentials denoted as a Certified Asthma Educator (AE-C) may also be earned by passing the National Asthma Educator Certification Board [9](NAECB) exam.
In some parts of Canada, one may practice as a provisional respiratory therapist after graduating, until writing and passing the CBRC exam. The RRT certification is granted by examination from the Canadian Society of Respiratory Therapists.
History of respiratory care[edit]
The profession of respiratory care was officially established in the United States c. 1930;[22] and respiratory research has officially existed since the early 1900s.[62] During the early years, respiratory therapists were referred to as "oxygen technicians", and most of their activities involved moving cylinders of compressed gas and administering oxygen via nasal catheter or oxygen tent.[63] Most oxygen technicians were trained on the job, although brief training programs began to appear in the late 1940s and 1950s.[64][65]
Today the profession hardly resembles what it was in the 1940s. Respiratory therapists provide direct care, patient education, and care coordination. They are academically trained in respiratory nursing and respiratory medicine. They practice in acute care facilities, long-term acute care facilities, skilled nursing facilities, assisted-living centers, subacute care units, rehabilitation centers, diagnostics units, and in the home.[66] Respiratory therapist training has also dramatically changed. Current accreditation standards require Respiratory therapists to have, at minimum, an Associate of Science in Respiratory Care degree from an accredited program.[67] Legal requirements to practice respiratory therapy have also dramatically changed. 49 states now legally recognize respiratory therapists.[68] Limited permits or state licenses are now required in all states except Alaska, which has no statutory authority over the practice of respiratory care. All states that have licensure requirements also require continuing education.
In 2007 the American Association for Respiratory Care (AARC) began developing recommendations for the promotion of the field of respiratory care in the United States[22] in response to increased concern regarding licensure and credentialing issues as well as international recognition of those practicing in the United States.[6] The task force decided to recommend that by 2015 the minimum education requirement for licensure and certification as a respiratory therapist be a bachelor of science in respiratory therapy (BSRT).[69] The AARC task force also recommended the American Respiratory Care Foundation change its scholarship policies and only award assistance and grants to those working toward a bachelor's degree. The Committee on Accreditation for Respiratory Care (CoARC) was asked by the AARC task force to change its accreditation standards and no longer accredit associates level respiratory care programs.[69] The CoARC replied by a press release rejecting the recommendation.[70] In 2011 legislation introduced by the AARC will help improve the use of respiratory therapists in clinical applications by allowing them to manage patients with asthma and COPD seeing a clinic for routine checkups.[71] Similar bills have been introduced before and have died in committee.[4][5][72]