Expanding Scope of Practice for RTs

The role of respiratory therapists (RTs) in the hospital setting is increasingly important as they provide potentially life-saving care to trauma patients. Also responsibly for treating people with health care issues which affect the cardiopulmonary system, these healthcare professionals are prepared to treat a variety of conditions including asthma, emphysema, pneumonia, cardiovascular disorders and trauma.

“Traditionally, Respiratory Therapist role in acute care hospital settings was providing medication, oxygen therapy and ventilator support,” explained Khaja Khan, RCP, president of Aerovu Technologies, Inc. in San Rafael, Calif. “That has changed in recent years, they now also provide services to patients in need of sleep medicine utilizing CPAP and Bipap machines that are non-invasive devices that are critical in their care.”

Line of Work

Respiratory therapists may be found in acute-care hospital settings, including the emergency room, the intensive care unit, the newborn or pediatric intensive care unit, or the pulmonary diagnostics laboratory. They work with patients of all ages, from premature infants with underdeveloped lungs, to senior citizens with advanced chronic obstructive pulmonary disease (COPD).

Always practiced under medical direction, RTs additionally focus their efforts on the development and implementation of treatment plans and protocols, health promotion activities and programs, disease prevention, disease management, clinical decision-making and patient education.

SEE ALSO: The Expanding Role of RCPs

A common life-saving intervention in the emergency department, respiratory therapists are also expanding their scope of practice through vent management techniques. Traditionally, RTs receive a patient in the ICU and place them on this intubation. They then practice institutionally specific settings and therapies, can use albuterol and mucomyst treatments and provide aggressive recruitment or maintenance breaths.

“Disease management is another area that RT’s have expanded into, to insure readmissions by Asthma and COPD are minimized due to the stiff penalties that providers may face from the recently passed affordable care act,” further explained Khan. “In the ICU Rt’s are playing a more active role in determining ideal parameters to insure optimum ventilator support and engaging with physician and nurse team for improved outcomes.”

Dealing with ventilator needs in patients is extremely challenging because demand tends to constantly outpace supply and due to many patients not being eligible to be a donor. Furthermore, a prolonged decision by families can decrease organ availability, especially in the case of lungs.


Within hospitals, the RTs provide care and life support to patients in the emergency room, intensive care units, general hospital areas, the pulmonary diagnostics laboratory and other specialty areas such as rehabilitation. Also, because there are over 100,000 candidates waiting for transplants to date, RTs must work to maintain, use, and manage many types of equipment and administer a variety of necessary medications

Other demanding responsibilities related to patient care include managing life support mechanical ventilation systems, administering aerosol-based medications, monitoring equipment related to cardiopulmonary therapy and analyzing blood samples to determine levels of oxygen and other gases.

Tasks such as managing artificial airways, assessing lung capacity to determine impairment, analyzing chest x-rays and sputum specimens, evaluating vital signs, performing tests and studies related to the cardiopulmonary system, conducting rehabilitation activities, counseling and consulting patients are also imperative of RTs, according to Respiratory Therapist License, a site detailing the specific licensing requirements enforced by each state’s Board of Respiratory Care (http://www.respiratorytherapistlicense.com/what-is-a-respiratory-therapist/).

Due to such high demand, partially due to an aging population, RT departments are being called upon to continuing bringing their value and profound impacts into the hospital setting. On the rise, addressing lung disease and pulmonary diagnostics are at the forefront of many of health care’s most important goals and challenges.

Lindsey Nolen is a staff writer. Contact: lnolen@advanceweb.com.

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