When Loren Johnson, manager of Allina HOME Clinical Services Department, was researching healthcare careers, respiratory therapy appealed to him for one big reason: equipment. Back then, the emphasis was on big equipment. Ventilators were big, oxygen tanks were big. There was something called an Ohio Mist Tent that was a huge compressor that blew cool, moist air into a big sheath around a baby's bed," Johnson says.
Today, he notes, a small nebulizer has replaced the large compressor, and portable oxygen concentrators run on batteries. Hospital ventilators, once 200 pounds and four feet tall, have been replaced by eight-pound home ventilators that "do things the big ones couldn't do," Johnson says. Still, an interest in equipment -- and increasing levels of technology -- is crucial for a career in respiratory therapy.
Take the new, compact ventilators, for example. They use a spinning turbine to create a rapid flow of air. Valves inside the ventilator, controlled by microprocessors, create different modes of pressure and volume of air.
The registered respiratory therapist gets a doctor's order that specifies the mode of delivery. The mode might be defined by the volume of air or the amount of air pressure to be delivered with each breath. The doctor also orders the number of breaths per minute and a positive end expiratory pressure - the amount of air to be left in the lungs between breaths. The RRT sets the mode and also makes sure that alarms are functioning to let attendants know if the ventilator gets disconnected or if the patient needs a tracheal suction.
All of those settings have to be done precisely according to the doctor's orders. In addition, the therapist can work with patients to adjust the speed of each breath for their personal comfort.
The smaller equipment means that RRTs work with patients in their own homes, group homes or assisted-living facilities as well as in hospitals and clinics. In addition, many of the tasks formerly performed by RRTs are now handled by respiratory technicians who are hired and trained by companies like Allina HOME Clinical Services Department.
Some technicians specialize in delivering liquid oxygen. "It's almost like a milk route," Johnson says. Technicians will make up to 20 stops a day, refilling patients' liquid oxygen tanks from a large reservoir in the truck. Technicians can also help set up phototherapy devices for infants born with yellow jaundice or hyperbilirubinemia.
Technicians get a chance to observe what respiratory therapists do and sometimes opt to take training to become a registered respiratory therapist, Johnson says. Training is currently two years, although four years of training will soon become the norm, Johnson believes.
While equipment is far more technologically advanced than it was 20 years ago, Johnson says that many circuits and accessories are now disposable, pre-packaged, custom-ordered and complete. "We used to have to assemble parts and pieces and send them to be sterilized between uses. It's now simpler in that regard."
For more on the St. Paul College program in respiratory therapy, go to www.saintpaul.edu.
Laura French is principal of Words Into Action, Inc., and is a freelance writer from Roseville.