1998 OPEN FORUM Abstracts
Respiratory Therapists Should Perform Intubation
Susan Rinaldo-Gallo MEd, RRT
Respiratory Care Practitioners (RCPs) are well qualified to provide airway management and Endotracheal Intubation (EI). It is within their scope of practice, as indicated by the NBRC (exam content outlines) and the AARC, Clinical Practice Guidelines (RC 1995;40(7):749-760). Following successful completion of training and demonstration of competency, the Registered Respiratory Therapist should provide these services.
RCPs can be readily available, within seconds, of all areas of the hospital and can respond quickly to minimize delays and ensure patient safety. Physicians and other health care providers, such as Nurse Anesthetists, may not be available on off shifts and week ends, or may be involved in other duties, which are difficult to leave immediately. In addition, many hospitals are decreasing the numbers of residents and physicians on staff and/or available around the clock. This increases the need for RCPs to provide safe, and timely care of airway emergencies.
Respiratory Care Departments should provide formal, well-documented training programs for EI. Training should include didactic and hands on aspects with cognitive and practical competency assurance. ACLS and/or PALS should also be obtained to put RCPs on the same skill level as other members of the resuscitation team. Skills maintenance of EI needs to be considered and policies should be established to assure skills are maintained.
It is cost effective for RCPs to provide EI services. RCPs have traditionally provided resuscitation and ventilation to patients. Their presence is required at cardiac and respiratory arrests and therefore there is no additional cost assumed by RCPs being present to intubate. RCPs can be further utilized to provide and maintain the airway management equipment, centralizing this will further help decrease costs.
Several examples of RCPs providing successful EI services, with greater than 90% success rates, have been documented and will be presented.
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.