User:Pulmonological/SB Respiratory practitioner

Respiratory Practitioner

Cartoon of clinician ascultating a patient.
Occupation
Names	Respiratory Practitioner Respiratory Therapist Cardiopulmonary Therapist Respiratory Scientist
Occupation type	Specialty
Activity sectors	Medicine, Allied Health
Description
Education required	Associate of Science Bachelor of Science Master of Science
Fields of employment	Hospital, Clinic Sleep clinic
Related jobs	Pulmonologist Physician assistant

A respiratory practitioner is a practitioner who is specialized in pulmonary medicine who typically works with a Pulmonologist. Respiratory practitioners are responsible for the overall respiratory care of their patients. "Respiratory Care" includes all pulmonary and cardiovascular aspects of care.

Regulation

United States

National Board for Respiratory Care

Registered respiratory therapist

The NBRC considers its certification "Registered Respiratory Therapist" (RRT) to be an advanced practitioner, able to work as a mid-level practitioner much like the nurse practitioner or physician assistant. Respiratory practitioners are often utilized similarly under medical control by way of hospital protocols which give the respiratory practitioner who is a registered respiratory therapist the ability to order medications and images, determine therapy and interpret images and laboratory values. The term for protocols which allow respiratory practitioners autonomy is termed "Respiratory Driven Protocols". The requirement to be eligible for the examinations which certify a respiratory practitioner as a registered respiratory therapist are a minimum of Associate of Science in Respiratory Science and have previously passed the certifying examination for the Certified Respiratory Therapist certification. The examination for certification as a registered respiratory therapist is both; the NBRC-WRE the written examination and the NBRC-CSE, the clinical simulation examination. Both of which place the examinee in the role of ordering physician.

Certified respiratory therapist

Formerly titled the "Certified Respiratory Therapy Technician" the certified respiratory therapist (CRT) credential is awarded as an entry level certification. Though in most states the scope of practice is not separated, the NBRC considers the CRT to be subordinate to the advanced practitioner, the registered respiratory therapist (RRT). The requirement to be eligible for the examination which certifies a person as a "certified respiratory therapist" is an Associate of Science in Respiratory Science, or a Bachelor of Science in Respiratory Science degree.

Clinical practice

Respiratory practitioners are found in various sectors of health care. In the hospital setting, Respiratory practitioners evaluate, treat and assist with diagnosis of respiratory/pulmonary diseases. In the United States, Respiratory practitioners with certification as Registered Respiratory Therapists evaluate and treat patients with a great deal of autonomy under the direction of a pulmonologist, and in specialty facilities respiratory therapists are a preferred addition to surface or air transport. In other settings respiratory therapists are found in schools as asthma educators, working with teachers and coachs about childhood symptoms of asthma and how to spot an emergency. In the United States, legislation has been introduced several times to allow Respiratory practitioners certified as asthma specialists with registered respiratory therapist certification to prescribe and manage previously diagnosed respiratory patients in physician clinics. In sleep clinics respiratory practitioners work with physicians in diagnosis of sleep-related illnesses. Respiratory practitioners in the United States are migrating toward a mid-level (or physician extender) role similar to the physician assistant or nurse practitioner.

Advanced training

Respiratory Practitioners are eligible once licensed to take advanced provider courses offered by certification bodies, such as Pediatric Advanced Life Support, Advanced Cardiovascular Life Support, and Advanced Trauma Life Support as a member of the trauma management team.

Specialty areas

Asthma Specialist

Asthma specialist's work with clinics, hospitals and schools as an educator for teachers and practitioners on asthma and allergies. Respiratory Practitioners in the role as an Asthma Educator additionally help diagnose and treat asthma and other respiratory illness. An Asthma Educator is the resource clinician in inpatient and outpatient environments for evaluating and advising physicians on treatment plans and helping facilitate patient understanding and compliance with the plan. In the United States, Certified Asthma Educators (AE-C) are credentialed by the National Asthma Educator Certification Board (NAECB).

Cystic fibrosis

Respiratory Practitioners work with people suffering from cystic fibrosis in clinics and hospitals by educating them about their disease and working with them on a treatment plan. While admitted to a hospital, patients with cystic fibrosis have their treatment schedule modified and maintained by respiratory Practitioners. Maintaining a healthy schedule for pharmokonetic and physical therapeutic airway clearance typically more frequent than home treatment plans because admissions are usually due to an increased need for therapy during the stay.

Cardiovascular perfusionist

Respiratory practitioners are able to fullfill the role of Perfusionist with appropriate training. The perfusionist is a highly trained member of the cardiothoracic surgical team which consists of cardiac surgeons, anesthesiologists, physician assistants, surgical technicians, other respiratory practitioners, and nurses. The perfusionist's main responsibility is to support the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, unbeating heart. Perfusionist certifications are maintained and awarded by The American Academy of Cardiovascular Perfusion.

Extracorporeal Membrane Oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass technique used for the treatment of life threatening cardiac or respiratory failure. An ECMO Clinical Specialist is a technical specialist trained to manage the ECMO system including blood pump, tubing, artificial oxygenator, and related equipment. The ECMO Specialist, under qualified medical direction and supervision, is also responsible for the clinical needs of the patient on ECMO which may include bedside management of oxygenation and carbon dioxide removal, maintenance of normal acid-base balance, administration of medications, blood and blood products, and maintenance of appropriate anticoagulation therapies for the blood. This ECMO Clinical Specialist may be the bedside critical care nurse specifically trained in ECMO patient and circuit management, or the ECMO system may be primarily managed by a registered respiratory therapist, or physicians with training as ECMO clinical specialists.

Intensive care

Intensive Care is one of the mainstays of respiratory therapy. Respiratory Practitioners are taking an increased clinical role in recent years related to intensive care. Ventilatory support is usually the largest criteria for being placed into an intensive care setting which is maintained entirely by Respiratory Practitioners and Cardiopulmonary specialists. Mechanical Ventilation is a rapidly expanding science and has been recognized as a complex technology by the respiratory therapy credentialing agency (NBRC) who in 2011 added the speciality credential called the "Adult Critical Care Specialist", available only to the registered respiratory therapist (RRT-ACCS).

Neonatal & Pediatric Intensive Care

Much like adult intensivist Practitioners neonatal and pediatric specialists deal primarily with monitoring ventilation and perfusion. The NPS practitioner is trained extensively in antenatal and intrapartum patients and family. Neonatal assessment and laboratory studies. The practitioner is also a specialist in ventilatory support and cardio-pulmonary therapy of neonatal and pediatric patients. In the United States NPS credentialing is available to both the certified respiratory therapist (CRT-NPS) and the registered respiratory therapist (RRT-NPS) however the registered respiratory therapist (RRT-NPS) is preferred by most organizations.

Sleep Disorder Specialist

See also: Sleep disorder specialist

The Sleep Disorder Specialist is a Registered Respiratory Therapist (RRT-SDS) whom performs sleep disorders testing and therapeutic intervention along with diagnosis of sleep related disease such as Obstructive Sleep Apnea or Central Apnea. The role is very similar to the Polysomnographic Technologist.

Case Management

See also: Certified Case Manager

Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human services needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Eligibility and certification is maintained by the Commission for Case Management Certification, a body certifying healthcare professionals in the United States.

Scientific Research

Respiratory scientists are specialists in pulmonary function. Respiratory therapists work with Pulmonologists in both clinical and general research of the respiratory system, ranging from the anatomy of the respiratory epithelium to the most effective treatment of pulmonary hypertension in pediatrics. Scientific research also takes place to look for causes and possible treatment in diseases such as asthma and lung cancer.

Surface & Air Transport

See also: Air medical services

Respiratory Practitioners work with nurses, physicians, and paramedics in emergency flight and ground transport. They are a vital practitioner delivering care inside helicopters, air ambulance or ground ambulance working to pick up a patient and move them to a facility that has what they need. In the United States certification for transport (C-NPT) is currently awarded by The National Certification Corporation. The NREMT has included Respiratory Practitioners as qualifing for the advanced credentialing as a critical care paramedic CCEMT-P.