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Respiratory therapy is categorized as an allied health profession in the United States and Canada. Respiratory therapists (RT) specialize in the assessment and treatment of breathing disorders including chronic lung problems (e.g., asthma, bronchitis, emphysema, COPD), and more acute multi-systemic problems stemming from other pathological conditions such as heart attacks, stroke, or trauma. RTs are specialists in airway management, mechanical ventilation, acid/base balance, and critical care medicine.
Certification, Education, and Training
Registered Respiratory Therapists (RRT) are graduates of a three-year diploma program or a four- or five-year degree program. There are also Master's and PhD degree programs offered by some schools. After graduation, the therapist must then write a national exam administered by the Canadian Society of Respiratory Therapists (CSRT) in Canada and/or the National Board for Respiratory Care (NBRC) in the United States. Only two attempts to pass are permitted, after which further training is required.
In order to be considered for admission to a respiratory therapy program, a strong high school background (typically grades of B+ or higher) in science and math at the senior matriculation level is usually required. The program of study varies from one school to another, but all programs include the following: Courses in anatomy, physiology, pathophysiology, pharmacology, chemistry, physics, microbiology, hemodynamics, mechanical ventilation, statistics, healthcare law, and medical ethics are required. Pass marks are usually set high. These studies relate to all body systems. Extra focus is spent on the respiratory, cardiovascular, neuro and renal systems. Class sizes are usually small and offer classroom as well as clinical "hands-on" experiences. Many applicants already hold science degrees. Traditionally there is a measurable attrition rate due to a student's failure to meet expected performance standards. Most of the schools do not allow multiple rewrites of failed exams. The material from the entire program must be mastered, applied and retained. There is no "cook book" practice. RTs must think quickly under stressful situations and make the proper life-or-death decision, while others may become emotional and unable to react. RTs must function as a patient advocate, as well as a staff, physician and patient resource. RTs function as an indispensable member of the health care team.
Roles and Responsibilities
Airway management is a number-one skill needed by a respiratory therapist as well as vascular access for intravenous lines (IV), an arterial line or arterial blood gas (ABG). Some RTs are specially trained in helping in the operating room (OR), high-risk deliveries, extracorporeal membrane oxygenation (ECMO), chest tube and central line insertion. RRTs may also provide an important role in the homecare environment. Here the RRT's role is different from the hospital role in that there are not a lot of available technical resources available. One must rely more on clinical assessments and experience-related decision-making when evaluating the patient's current condition. This is where the real extent of the RRT's knowledge is truly tested.
The nature of the RT's education allows for easy upgrading to learn more advanced skills and procedures. Respiratory therapists only act on a physician's order, except where there are written protocols or, in the event of an emergency, with no physician present. An example of an existing protocol: Duke University Medical Center utlizes RTs to provide all, out-of-operating-room intubations. Physicians may write an order, "to ventilate according to Respiratory Therapist," or, "Adjust Ventilator" to maintain certain physiological values. These types of orders require the therapist to interpret lab results and assess the patient, then make a decison to adjust or not to adjust life support parameters. As one can see, the wrong choice could result in serious harm or death to the patient. This usually occurs at night or on weekends when the senior medical staff are not in the building. The therapist must be educated and trained well in order to safely complete these tasks.
Regulatory Bodies and Professional Societies in Canada
In the provinces of Alberta, Manitoba, Ontario, and Quebec, respiratory therapy is regulated by provincial legislation, and licensing is handled by the provincial regulatory bodies.
Most of the provinces in Canada also have their own professional associations or societies for RTs. A detailed listing of the regulatory bodies and societies can be found at the Canadian Society of Respiratory Therapists (CSRT).
The procedures that an RT can provide depend on the patient's individual needs and/or the laws in the various states and provinces where they practice.
Remuneration in Canada
Starting salaries in Canada for a staff RRT range from *]40,000 in Prince Edward Island to $65,000 in Alberta. The top-end yearly salary of an RRT staff position in Alberta, Canada is $75,000.00. Typically, RTs are entitled to four weeks of vacation after 1 year plus 11 statutory holidays. Many RTs are making $90,000 to over $100,000 per year with overtime backshift and weekend premium, and/or extra training.
External links
- Canadian Respiratory Therapist Job Profile — analysis of job outlook and wage information for Canada.
- U.S. Respiratory Therapist Job Outlook — analysis of job outlook and wage information for the U.S.
- American Association for Repiratory Care (AARC)
- Canadian Society of Respiratory Therapists (CSRT)
- RT Journal (professional journal)
"Respiratory therapy"