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 Respiratory
therapists and respiratory therapy technicians -- also known as respiratory
care practitioners -- evaluate, treat, and care for patients with breathing
or other cardiopulmonary disorders. Practicing under the direction of a
physician, respiratory therapists assume primary responsibility for all
respiratory care therapeutic treatments and diagnostic procedures,
including the supervision of respiratory therapy technicians. Respiratory
therapy technicians follow specific, well-defined respiratory care
procedures under the direction of respiratory therapists and physicians.
In clinical
practice, many of the daily duties of therapists and technicians overlap.
However, therapists generally have greater responsibility than technicians.
For example, respiratory therapists consult with physicians and other
health care staff to help develop and modify patient care plans.
Respiratory therapists also are more likely to provide complex therapy
requiring considerable independent judgment, such as caring for patients on
life support in intensive-care units of hospitals. The term respiratory
therapist includes both respiratory therapists and respiratory therapy
technicians.
Respiratory therapists evaluate and treat all types of
patients, ranging from premature infants whose lungs are not fully
developed to elderly people whose lungs are diseased. Respiratory
therapists provide temporary relief to patients with chronic asthma or
emphysema, and they give emergency care to patients who are victims of a
heart attack, stroke, drowning, or shock.
To evaluate patients, respiratory therapists interview them,
perform limited physical examinations, and conduct diagnostic tests. For
example, respiratory therapists test a patient's breathing capacity and
determine the concentration of oxygen and other gases in a patient's blood.
They also measure a patient's pH, which indicates the acidity or alkalinity
of the blood. To evaluate a patient's lung capacity, respiratory therapists
have the patient breathe into an instrument that measures the volume and
flow of oxygen during inhalation and exhalation. By comparing the reading
with the norm for the patient's age, height, weight, and sex, respiratory
therapists can provide information that helps determine whether the patient
has any lung deficiencies. To analyze oxygen, carbon dioxide, and blood pH
levels, therapists draw an arterial blood sample, place it in a blood gas
analyzer, and relay the results to a physician, who then makes treatment
decisions.
To treat patients, respiratory therapists use oxygen or oxygen
mixtures, chest physiotherapy, and aerosol medications -- liquid
medications suspended in a gas that forms a mist which is inhaled. They
teach patients how to inhale the aerosol properly to ensure its
effectiveness. When a patient has difficulty getting enough oxygen into his
or her blood, therapists increase the patient's concentration of oxygen by
placing an oxygen mask or nasal cannula on the patient and setting the
oxygen flow at the level prescribed by a physician. Therapists also connect
patients who cannot breathe on their own to ventilators that deliver
pressurized oxygen into the lungs. The therapists insert a tube into the
patient's trachea, or windpipe; connect the tube to the ventilator; and set
the rate, volume, and oxygen concentration of the oxygen mixture entering
the patient's lungs.
Therapists perform regular assessments of patients and
equipment. If a patient appears to be having difficulty breathing or if the
oxygen, carbon dioxide, or pH level of the blood is abnormal, therapists
change the ventilator setting according to the doctor's orders or check the
equipment for mechanical problems.
Respiratory therapists perform chest physiotherapy on
patients to remove mucus from their lungs and make it easier for them to
breathe. Therapists place patients in positions that help drain mucus, and
then vibrate the patients' rib cages, often by tapping on the chest, and
tell the patients to cough. Chest physiotherapy may be needed after
surgery, for example, because anesthesia depresses respiration. As a
result, physiotherapy may be prescribed to help get the patient's lungs
back to normal and to prevent congestion. Chest physiotherapy also helps
patients suffering from lung diseases, such as cystic fibrosis, that cause
mucus to collect in the lungs.
Therapists who work in home care teach patients and their
families to use ventilators and other life-support systems. In addition,
these therapists visit patients in their homes to inspect and clean
equipment, evaluate the home environment, and ensure that patients have
sufficient knowledge of their diseases and the proper use of their
medications and equipment. Therapists also make emergency visits if
equipment problems arise.
In some hospitals, therapists perform tasks that fall
outside their traditional role. Therapists are becoming involved in areas
such as pulmonary rehabilitation, smoking cessation counseling, disease
prevention, case management, and polysomnography -- the diagnosis of
breathing disorders during sleep, such as apnea. Respiratory therapists
also increasingly treat critical care patients, either as part of surface
and air transport teams or as part of rapid-response teams in hospitals.
Note: Some resources in this section are provided by the US
Department of Labor, Bureau of Labor
Statistics.
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