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Introduction of RESPIRATORY therapy

Introduction of RESPIRATORY therapy. Development of the Respiratory Care Profession. In the 1940s, technicians were used to haul O 2 cylinders and apply O 2 delivery devices. In the 1950s, positive-pressure breathing devices were applied to patients.

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Introduction of RESPIRATORY therapy

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  1. Introduction of RESPIRATORY therapy

  2. Development of the Respiratory Care Profession • In the 1940s, technicians were used to haul O2 cylinders and apply O2 delivery devices. • In the 1950s, positive-pressure breathing devices were applied to patients. • Formal education programs for inhalation therapists began in the 1960s.

  3. The development of sophisticated mechanical ventilators in the 1960s expanded the role of the respiratory therapist (RT). • RTs were soon responsible for arterial blood gas and pulmonary function laboratories. In 1974, the designation “respiratory therapist” became standard. Oxygen Therapy • Large-scale production of O2 was developed in 1907 by Karl von Linde. • Oxygen tents were first used in 1910, and O2 masks, in 1918. • O2 therapy was widely prescribed in the 1940s

  4. The Clark electrode was first developed in the 1960s and allow measurement of arterial PO2. • The ear oximeter was invented in 1974, and pulse oximeter, in the 1980s. • The Venti mask to deliver a specific FIO2 was introduced in 1960. • Portable liquid O2 systems were introduced in the1970s.

  5. Aerosol Medications • In 1910, aerosolized epinephrine was introduced as a treatment for asthma. • Later, isoproterenol (1940) and isoetharine (1951) were introduced as bronchodilators. • Aerosolized steroids first used in the 1970s to treat acute asthma.

  6. Mechanical Ventilation • The iron lung was introduced in 1928 by Philip Drinker. • Jack Emerson developed an improved version of the iron lung that was used for polio victims in the 1940s and 1950s. • A negative-pressure “wrap” ventilator was introduced in the 1950s. • Originally, positive-pressure ventilation was used during anesthesia. • The DragerPulmotor (1911), the Spiropulsator (1934), the Bennett TV-2P (1948) and Bird Mark 7 (1958) were positive-pressure ventilators. • The Bennett MA-1, Ohio 560, and Engstrom 300 were introduced in the 1960s as volume-cycled ventilators.

  7. ventilation /ven·ti·la·tion/ (ven″tĭ-la´shun) • 1. breathing; the exchange of air between the lungs and the environment, including inhalation and exhalation. • 2. circulation, replacement, or purification of the air or other gas in a space. • 3. the equipment with which this is done. • negative pressure ventilationmechanical ventilation in which negative pressure is generated on the outside of the patient's chest and transmitted to the interior to expand the lungs and allow air to flow in; used with weak or paralyzed patients. • positive pressure ventilationmechanical ventilation in which air is delivered into the airways and lungs under positive pressure, usually via an endotracheal tube, producing positive airway pressure during inspiration. • pulmonary ventilationa measure of the rate of ventilation, referring to the total exchange of air between the lungs and the ambient air.

  8. More advanced volume ventilators became available in the 1970s: Servo 900, Bourns Bear I and II, and MA II. • The first microprocessor-controlled ventilators were developed in the 1980s (Bennett 7200). • Ventilators with the capability of applying advanced modes of ventilation became available in the 21st century

  9. Airway Management • William MacEwen in 1880 applied the first endotracheal tube to a patient successfully. • In 1913, the laryngoscope was introduced. • The first suction catheter was described in 1941. • Low-pressure cuffs for endotracheal tubes were introduced in the 1970s.

  10. Cardiopulmonary Diagnostics • Measurement of the lung’s residual volume was first done in 1800. • In 1846, the first water-sealed spirometer was developed by John Hutchinson. • In 1967, rapid arterial blood gas analysis became available. • Polysomnography became routine in the 1980s

  11. Professional Organizations • The Inhalation Therapy Association was founded in 1947. • The ITA became the American Association for Inhalation Therapists in 1954. • The AAIT became the American Association for Respiratory Therapy in 1973. • The AART became the American Association for Respiratory Care in 1982. • During the 1980s, state licensure for RTs started. • State licensure is based on RTs passing the entry level exam offered by the National Board for Respiratory Care. • The NBRC offers a certification and registry examination for RTs.

  12. Respiratory Care Education • The first formal RT program was offered in Chicago in 1950. • RT schools grew in the 1960s; many programs were hospital based. • Today, RT programs are offered mostly at colleges and universities. • In 2006, about 350 formal RT education programs exist in the United States.

  13. Breathing with problem:-Those people include patients with chronic lung problems, such as asthma, bronchitis and emphysema, yet may also include heart attack and accident victims; and premature infants. • Respiratory therapists work with physicians and allied health professionals to diagnose and treat patients with disorders associated with the respiratory and cardiovascular systems. Therapists may be required to exercise considerable independent clinical judgment under the direct or indirect supervision of a physician. They are trained to act as technical resource persons for both physicians and other health care professionals. Respiratory therapists are members of the response teams that handle patient emergencies in the hospital.

  14. Diagnostic Procedures • Draw and analyze blood samples to determine the levels of oxygen and carbon dioxide and other gases in order to assess the best course of treatment for a patient • Measure the capacity and efficiency of a patient's lungs to determine if there is impaired function. • Perform stress tests and other studies of the cardiopulmonary system. • Study disorders of people with disruptive sleep patterns. • Obtain and analyze sputum and breath specimens. • Read and analyze chest x-rays and electrocardiograms

  15. Treatment: • Operate and maintain various types of highly sophisticated equipment to administer oxygen or to assist with breathing. • Employ mechanical ventilation for treating patients who cannot breathe adequately on their own. • Monitor and manage therapy that will help a patient recover lung function. • Administer medications in aerosol form to help alleviate breathing problems and to help prevent respiratory infections. • Monitor equipment and patient response to therapy • Conduct rehabilitation activities, such as low-impact aerobic exercise classes to help patients who suffer from chronic lung problems. • Maintain a patient's artificial airway, one that may be in place to help the patient who can not breathe through normal means. • Stand by in labor and delivery rooms to monitor and treat pre-mature infants who have difficulty in breathing on their own • Conduct smoking cessation programs for the hospital patients and other patients in the community who want to kick the tobacco habit. (Young teens to adult to elderly population.)

  16. The practice of respiratory care requires extensive knowledge of many technical and physiological concepts. • 1-Therapists administer many medical gases and cardiopulmonary medications. • 2-Respiratory care practitioners are often responsible for the evaluation of patients and assist in the development of the respiratory care plan. • 3- Respiratory therapists are trained to perform and evaluate the results of diagnostic tests such as arterial blood gases and pulmonary function studies. • 4-The maintenance of mechanical ventilation for critically ill patients is a major task the therapist is expected to perform. • 5- Therapists often assist physicians with procedures such as bronchoscopies, arterial cannula insertions, and heart catheterizations

  17. Respiratory Therapists At Work • Many respiratory therapists work in hospitals, which operate 24 hours a day, seven days a week and 365 days a year. Most therapists work in intensive care units, where they treat critically ill infants, children, or adults or in the general care areas of the hospital giving basic respiratory care. However, there are career opportunities in nursing homes, home health agencies, pulmonary rehabilitation, sleep study centers, flight transport, medical equipment supply companies and in physician offices. Other therapists work in diagnostic laboratories performing pulmonary function tests, cardiovascular studies, and some neurological diagnostic procedures.

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