Respiratory Therapy—Taking a closer look into this high-demand field
Breathing. Could there be a more essential facet of life than being able to breath properly? For those who have experienced illness or trauma that prevented proper breathing, they know that panic and fear set in quickly. A function of the body that is often not even given a second thought, breathing, is no longer taken for granted when it is obstructed or restricted.
Respiratory therapists, commonly referred to as RTs, are health care professionals who assist people with acute and chronic breathing problems during their time of need. Whether a patient is suffering from a chronic illness such as asthma, has had chest trauma from a car accident, or is a neonate whose whole body fits in the palm of a hand, it is the job of the respiratory therapist to offer the necessary help to get these individuals breathing comfortably. Let’s explore this exciting and complex profession further.
What types of patients do respiratory therapists work with?
A respiratory therapist may work with a wide variety of patients with pulmonary problems from the neonate to geriatric and terminally ill patients. However, these professionals do more than just care for patients with lung disease. They also care for patients with more complicated problems, like cancer, congested heart failure, heart attacks, and even respiratory failure. Other examples of respiratory patients include those who have been diagnosed with cystic fibrosis, neuromuscular disorders, brain injuries, near drowning victims, quadriplegic/paraplegic patients and trauma patients. Below more information is provided on specific types of patients a respiratory therapist sees:
Because the lungs are the last organ to develop in a fetus, when babies are born prematurely, respiratory therapists are often needed. RTs may administer different modes of breathing treatments, oxygen, mechanical ventilation, noninvasive ventilation, and airway clearance. Also, surfactant is a drug administered by a respiratory therapist, after being ordered by a physician, to neonates to assist the lungs in the breathing process. Surfactant is naturally produced in babies’ lungs to help them mature but oftentimes neonates do not produce enough natural surfactant so it must be administered artificially.
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- Respiratory Distress Syndrome patients
There are two types of this syndrome, Adult Respiratory Distress Syndrome (ARDS) and Infant Respiratory Distress Syndrome (IRDS). Both involve the stiffening of the lungs, which makes it difficult for these individuals to ventilate. In infants it is treated with surfactant and a high frequency oscillator (HFOV). In adults it is treated with mechanical ventilation or a jet ventilator. This syndrome is extremely difficult to manage and has a high mortality rate.
- Hospice patients/Palliative Care Patients
Hospice units care for the terminally ill patient who has chosen comfort measures only. The care for these patients is concentrated on comfort until their final day. Respiratory therapists assist nurses in palliative care for the patient. RTs may apply oxygen or perform breathing treatments to provide relief and make the patient as comfortable as possible. Depending on the patient’s wishes, respiratory therapists may also have to withdraw life support.
- Chronic Obstructive Pulmonary Disease patients
Chronic Obstructive Pulmonary Disease (COPD), which is a classification that includes asthma, chronic bronchitis, and emphysema, is the fourth leading cause of death in the United States and is on the rise. Patients with emphysema can be treated with long-term oxygen therapy (LTOT), nebulizer therapy, and with corticosteroids for maintenance. The physician may also order an oral steroid, such as prednisone, to decrease the inflammation in the airways. Patients with asthma are also treated with bronchodilators, corticosteroids, and other drugs for maintenance. Asthmatics are educated on the disease process and offered maintenance regimens and rescue treatments. Patients with the diagnosis of COPD can be educated on breathing techniques and exercises through pulmonary rehabilitation.
- Lung Disease patients
These patients are educated about the specific disease and offered treatments.
- Car accident or trauma patients
Respiratory therapists are involved in all traumas within a hospital that include intubation, bagging, and ventilator management.
- Cardiac patients
Respiratory therapists are involved in all codes within a hospital that include intubation, bagging, and ventilator management.
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- Sleep Disorder Patients
Some respiratory therapists work in sleep labs where they are involved in the diagnosing, titrating, and treating of sleep disorders such as sleep apnea.
- Patients suffering an allergic reaction from a bee sting
This involves respiratory therapists managing the airway of the patient and monitoring for anaphylactic shock. Once these patients are aware of their allergy they can carry an epinephrine (“epi”) pen and are educated on how to use that in case of future emergencies.
- Patients in need of hyperbaric oxygen therapy (HBOT)
Patients who may need hyperbaric oxygen therapy include whose who are suffering from diabetic wounds, carbon monoxide poisoning, skin infections, and osteoradionarcosis which is delayed bone damage as a complication of radiation therapy. In addition, scuba divers, miners, tunnel builders, or fighter pilots can develop decompression sickness commonly referred to as “the bends”. This is brought on by surfacing too quickly whether it be in the air or water. The HBOT process involves breathing in pure oxygen while in a sealed chamber that is pressurized 1 ½ to 3 times the normal atmospheric pressure. Many describe these treatments as the feeling of diving without getting wet.