Introduction To Respiratory Technology :
A Respiratory Therapist is a specialized healthcare practitioner who has graduated from a college or a university. Respiratory therapists work under the general supervision of a physician most often in intensive care and also in outpatient clinics and wards under pulmonologist.
Respiratory therapists are specialists and educators in pulmonology. Respiratory therapists are also advanced-practice clinicians in airway management; establishing and maintaining the airway during management of trauma, intensive care.
Respiratory therapists often are in charge of initiating and managing life support for people in intensive care units and emergency departments, stabilizing, treating and managing pre-hospital and hospital-to-hospital patient transport by ambulance.
In the outpatient setting Respiratory Therapists are often educators in asthma clinics, pediatric clinics, and in sleep-clinics.
The Respiratory Care Technology curriculum prepares students as advanced practitioners in respiratory care technology. Students learn diagnostic and therapeutic procedures applicable to pulmonary care. Therapeutic procedures include administration of oxygen and other medical gases, aerosolization of drugs for inhalation, set up and maintenance of mechanical ventilators (to assist or control ventilation), non-invasive ventilation, performance of chest physical therapy maneuvers, airway maintenance in emergency situations and certification in cardiopulmonary resuscitation. Respiratory care Technologists perform diagnostic procedures such as Pulmonary Function Studies including diffusion studies and arterial blood gas analysis. Respiratory Care Technologists are also involved in rehabilitation of the patient with cardiopulmonary abnormalities.
Qualification of Respiratory Care Technologist:
Batchelor’s degree or Mastersdegree [fulltime]in Respiratory Care Technology/Therapy or its equivalent from a recognised institution.
Subjects covered in Respiratory Care Technology:
Applied anatomy, physiology, Pharmacology and pathology related to respiratory care technology. artificial airway, airway care, oxygen therapy, chest physiotherapy and mechanical ventilation are also included in the syllabus.
Posting Areas: Chest Ward and Chest OPD, Medical ICU, Cardiac ICU, Neonatal & ICU, Bronchoscopy & Thoracoscopy Room.
Role of Respiratory Technologist/ Job Description:
Provide emergency airway care (intubation, tracheal suctioning, etc.,) according to approved protocols
Perform invasive and non-invasive physiologic procedures such as blood gas analysis, TcM, EtCo2, etc.
Provide direct assistance to the physician and Code Team in cardiac/respiratory arrest with primary responsibilities being patient airway and blood gas analysis.
Assists with pulmonary diagnostic procedures as necessary.
Performs respiratory care procedures such as medical gas therapy, bland/medicated aerosol therapies, bronchopulmonary hygiene procedures.Monitors patient responses and modifies therapies on clinical/physiologic assessments in consultation with physicians.
Applies mechanical ventilator support of patients and monitors patient’s response as per physicians orders. Modifies ventilator management to meet patient needs, based on clinical assessment, physiologic monitoring, laboratory date and consultation with the physician.
Role as Physician Assistant:
Assisting Physician in basic assessment of Patient’s respiratory status including Vital Signs, Evaluating the patients history.
Provides direct assistance to the physician in Fibre-optic Bronchoscopy, Thoracoscopy, Broncho-alveolar lavage, Ultrasound guided aspiration and biopsy, Intercostal drainage, Patient education, etc.
Role in Intensive Care Units:
To check intubation tray appropriately.
Perform/assist with endotracheal intubation &extubation.
Understand the variety of nasotracheal, orotracheal tubes, sizes and utilization.
Initiate, maintain and wean patients on ventilators. Provide ventilatory support and care.
Initiate, adjust and maintain Oxygen therapy.
Understand and perform the rationale of various modes of chest physical therapy including percussion, postural drainage, Deep Breathing and Coughing techniques.
Assess patients periodically, evaluate pulmonary status and perform broncho-pulmonary toileting.
Obtain arterial blood samples, perform blood gas analysis and be able to give basic interpretation of the same.
Initiate, administer, adjust and maintain BiPAP/CPAP as per physician orders.
Responsible for basic infection control and self-protection.
To provide health education to family and patient if required.
Responsible for transport requirements within the campus with primary responsibility being airway management and ventilation.
Role in PFT Lab:Responsible to perform Pre & post spirometry studies, performing bedside PFT. DLCO: Responsible to perform diffusion studies.Responsible to perform and maintain calibration, log book and quality assurance of the PFT Lab.
Role in Continuous Therapies: Provide health education to patients and family on breathing exercises, MDI/DPI & spacer technique, Incentive Spirometer, Instructions on home care usage of BiPAP/CPAP, nebulizer, O2 concentrator, etc.
Pulmonary rehabilitation may be initiated as a treatment as a source for continuity of improvement after a hospital stay or as a therapeutic way to increase quality of life. Pulmonary rehabilitation is intended to educate the patient, the family, and improve the overall quality of life and prognosis for the patient.Inpatients with COPD, bronchial asthma with utilization of chest physical therapy procedures like percussion, vibration, Deep Breathing & Coughing techniques, application of BiPAP, CPAP, etc.
Role in Special Procedures: Provide assistance during Fibre-optic bronchoscopy procedure. Maintain Bronchoscope room and instruments, administer pre anaesthetic medications and prepare the patient for the procedure. Monitor the vitals during the procedure and after the procedure.
Role in Sleep Studies:
Respiratory Therapists monitor, interpret and diagnose findings from a sleep study, as well as the medical history and physical exam to make the diagnosis.
Importance of Respiratory Care Technologist to the Society:
Without breath, there is no life. Respiratory therapists are among the first to be at the bedside during emergency health situations to provide direct care and assist the physicians. Respiratory therapists are often working at the forefront of many of health care’s most important goals and challenge. Lung diseases and pulmonary complications are on the rise in the world due to environmental pollution and increased aged population.
Career Avenues for Respiratory Technologists :
- Physician Assistant
- In PFT Laboratory with diffusion studies.
- In Chest Wards
- In Continuous Therapies and in Special Procedures
- In Intensive Care Units:
- As Clinical specialist, Coordinator etc
- Teaching, Research etc
Placement of Respiratory Technologist:
Our passed out students are well placed as a Respiratory Physiologist in United Kingdom, Australia & Newzealand. In United states of America & Middle-East countries they are employed as Respiratory Therapists.
There are two recognized governing bodies in the United States; the State Board of Respiratory Care in the state in which a Respiratory Therapist is licensed to practice and the other is the National Board for Respiratory Care (NBRC) a non-profit organization which regulates two levels of certification along with some additional specialist certifications, the Certified Respiratory Therapist (CRT) and the Registered Respiratory Therapist (RRT). The CRT is the certification given after successfully passing the entry-level examination NBRC-ELE; The RRT certification is given after first becoming a CRT and then passing the NBRC-WRE and NBRC-CSE
In multi-speciality hospitals, tertiary hospitals with Intensive Care Unit facility hospitals and clinics with PFT lab, as a physician assistant to the pulmonologists and anaesthetists etc.
Higher Education for Respiratory Care Technologist:
Very soon our institution is planning to implement Masters program in the field of Respiratory Care Technology. Other options of higher education in our institution would include M.Sc., Anatomy/Physiology, Biotechnology, Human Genetics, MBA in Hospital Administration, etc.
Research and Respiratory Technologist:
Respiratory Therapists work with Pulmonologists in both clinical and research studies of the respiratory system.
Future of Respiratory Technologist:
Opportunities will remain good in the foreseeable future because of the substantial projected growth of the middle-aged and elderly population. As this population grows, the incidence of lung disease will also increase requiring more services from respiratory therapists. Many therapists can still expect to work in the hospital setting. However, opportunities outside the hospital will continue to grow in respiratory therapy clinics, diagnostic clinics, physician offices, nursing homes, and patient homes.