Respiratory therapists are specialized healthcare professionals trained to evaluate, treat, and care for individuals experiencing cardiopulmonary disorders and breathing difficulties. They are integral members of critical care teams within hospitals, emergency departments, and other clinical settings. Respiratory therapists are authorized and skilled to perform intubation in many healthcare environments and under specific circumstances.
The Respiratory Therapist’s Role in Airway Management
Respiratory therapists play a central role in managing a patient’s airway. Their involvement often begins with assessing a patient’s respiratory status to determine if intubation is necessary, considering factors like respiratory failure, airway obstruction, or a decreased level of consciousness. This assessment also includes preparing all necessary equipment for the procedure.
RTs frequently assist physicians during intubation by providing support. After an endotracheal tube is placed, RTs manage the airway, including suctioning secretions to maintain patency and connecting the patient to a mechanical ventilator. Their understanding of the respiratory system makes them contributors to maintaining a stable airway and optimizing breathing support for patients.
Performing Intubation: RT Responsibilities
Respiratory therapists perform intubation in various clinical scenarios, often in emergencies or as part of rapid response teams where immediate airway control is necessary. This includes situations such as cardiac arrest, severe respiratory distress, or when a patient cannot protect their airway due to a low level of consciousness. RTs are also involved in intubations for planned surgeries.
During the intubation procedure, the respiratory therapist follows a sequence of steps to establish a secure airway. They position the patient and use a laryngoscope to visualize the vocal cords. The endotracheal tube is then guided through the vocal cords into the trachea. Once the tube is in place, the RT inflates a cuff to secure the tube and ensures proper placement by listening for breath sounds and checking for exhaled carbon dioxide. In emergency cases, RTs may utilize rapid sequence induction (RSI) to minimize risks like aspiration.
Training and Credentialing for Intubation
The ability of respiratory therapists to perform intubation is supported by education and specialized credentialing. RTs earn an associate or bachelor’s degree in respiratory therapy and must pass a national board certifying examination to become certified or registered respiratory therapists. Their training includes knowledge of anatomy, physiology, and hands-on experience in airway management techniques.
Many respiratory therapists hold Advanced Cardiac Life Support (ACLS) certification, which equips them with skills for managing cardiopulmonary emergencies, including airway management. The specific scope of practice for RTs, including the authority to perform intubation, can vary depending on state regulations and the policies of individual healthcare institutions.
Beyond Intubation: Comprehensive Respiratory Care
Beyond intubation, respiratory therapists provide a broad spectrum of care for patients with breathing disorders. They manage mechanical ventilation, setting up and adjusting ventilators to optimize oxygenation and carbon dioxide removal for patients unable to breathe independently. This includes continuous monitoring of patient response and making necessary adjustments to ventilator settings.
Respiratory therapists also play a role in ventilator weaning protocols, assessing a patient’s readiness to be removed from mechanical support and guiding them through breathing on their own. Their responsibilities extend to administering aerosolized medications, performing chest physiotherapy to clear airways, and providing tracheostomy care. These duties contribute to patient recovery and respiratory health.