The abbreviation “RT” appears frequently in medical settings, and while it can have a few different meanings, one primary role dominates in direct patient care: the Respiratory Therapist. This clinician focuses on the diagnosis, treatment, and management of patients experiencing issues with their heart and lungs. Understanding the responsibilities and training of the Respiratory Therapist is key to understanding their role within the modern hospital environment.
The Primary Meaning: Respiratory Therapist
A Respiratory Therapist (RT) is a trained medical professional who applies scientific knowledge to the clinical problems of respiratory care. They work with patients across the entire lifespan, from premature infants to elderly individuals suffering from chronic cardiopulmonary disorders. RTs are experts in cardio-pulmonary medicine, evaluating, treating, and managing patients who have difficulty breathing.
RTs are a consistent presence in hospital settings, working with physicians and nurses to implement treatment plans. Their core purpose is to optimize a patient’s respiratory function, helping them breathe more easily across various settings such as intensive care units, emergency departments, and general wards.
Core Clinical Responsibilities of an RT
Mechanical Ventilation and Airway Management
A primary daily responsibility for an RT is the management of mechanical ventilation, overseeing life support for patients who cannot breathe adequately. This involves setting up, calibrating, and adjusting ventilator settings to ensure optimal oxygenation and ventilation while continuously monitoring the patient’s response. RTs are also trained in advanced airway management techniques, which are essential for establishing and maintaining a patient’s airway during acute distress or trauma.
Therapeutic Interventions
Respiratory Therapists administer inhaled medications, commonly through nebulizers or metered-dose inhalers, to deliver aerosolized drugs directly to the lungs for conditions like asthma or Chronic Obstructive Pulmonary Disease (COPD). They also perform chest physiotherapy, using specialized techniques to help clear mucus and secretions from the lungs. Furthermore, RTs are members of the rapid response or “Code Blue” team, where their training in cardiopulmonary resuscitation (CPR) and airway intervention is essential for managing emergencies and assisting with intubation.
Diagnostic Procedures
The RT engages in diagnostic procedures to assess a patient’s respiratory status, which is foundational to creating an effective treatment plan. They perform arterial blood gas (ABG) sampling and analysis to measure the oxygen and carbon dioxide levels in the blood, providing immediate data on lung function.
Specialized Areas of Respiratory Care
Beyond general floor care, RTs frequently specialize in high-acuity environments such as the Intensive Care Unit (ICU). In these settings, the RT manages complex oxygenation and ventilation disorders, utilizing advanced techniques like specialized gas administration or assisting with bronchoscopies. The Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) are other specializations, where RTs treat premature infants and children with conditions such as undeveloped lungs or cystic fibrosis.
RTs also work in diagnostic applications outside of acute care, such as in Pulmonary Function Testing (PFT) laboratories. They conduct tests like spirometry to measure lung capacity and flow, helping physicians diagnose and monitor pulmonary diseases. Another specialization is Sleep Medicine, where RTs conduct polysomnography (sleep studies) and manage treatment devices like continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP).
Credentials and Training for Respiratory Therapists
Becoming a Respiratory Therapist requires completing a degree program accredited by the Commission on Accreditation for Respiratory Care (CoARC). The minimum requirement is typically an Associate’s Degree, though many pursue a Bachelor’s Degree for enhanced career opportunities. Programs cover human anatomy, physiology, and respiratory care techniques, preparing students for clinical practice.
Upon graduation, aspiring RTs must pass examinations administered by the National Board for Respiratory Care (NBRC) to earn professional credentials. The first level of certification is the Certified Respiratory Therapist (CRT), achieved by passing the Therapist Multiple-Choice (TMC) Examination. A state license is also mandatory to practice in many states, with the CRT being the minimum requirement.
The higher standard is the Registered Respiratory Therapist (RRT) credential. To achieve the RRT, the therapist must achieve a higher score on the TMC examination and subsequently pass the Clinical Simulation Examination (CSE). The RRT signifies advanced expertise and competency, often opening doors to leadership roles and advanced specializations like Neonatal/Pediatric Specialist (NPS) or Adult Critical Care Specialist (ACCS).
Other Meanings of RT in a Hospital Setting
While Respiratory Therapist is the most common meaning in direct patient care, “RT” can refer to other roles or procedures. In oncology centers, RT frequently stands for Radiation Therapy. This treatment uses high-energy radiation to shrink tumors and destroy cancer cells, requiring specialized equipment and practitioners.
Another application is Recreational Therapy, a service in rehabilitation or long-term care facilities. Recreational Therapists use play and activities to help patients recover from or adjust to illness, disability, or injury. Finally, “RT” is occasionally used to refer to a Radiology Technologist, the professional responsible for operating imaging equipment like X-ray machines.