"The notion of someone other than a respiratory therapist providing care to patients with breathing problems is preposterous."

This is one line out of a story about threats to Respiratory Therapists and their jobs.  The gist of the story is that while RT's have been worried about Nurses taking doing the RT function & taking away their jobs, it's actually the EMT that they need to be worried about.

Another quote:

At that moment, a man with severe asthma stumbled through the door. Blue—and barely able to breathe—the man managed to whisper three words to the nurse before he plopped down in the chair. Exhausted, he said, "I can't breathe!"

The nurse knew immediately who to call—Brian, who had bailed her out hundreds of times before with respiratory patients. He saw that if he did not get this patient started on some heavy-duty bronchodilators, the prognosis would not be good.

Calmly, Brian put the patient into a wheelchair and took him back to the examination room. He stabilized the patient with a 7.5 mg dose of albuterol and approached the physician with the suggestion of starting the patient on IV steroids to aid in his recovery. After 45 minutes of aggressive therapy, a trip to radiology for a chest film, and thorough education on the management of asthma, the patient was discharged and sent home. Had it not been for the skill and expertise of Brian, the patient's outcome could have been a lot worse.

RTs face similar situations in EDs across the country; and therapists across the globe have been in Brian's shoes before and have taken great pride in knowing that when it comes to patients with cardiopulmonary deficiencies, they are the most qualified clinicians to provide care. RTs are the experts—a fact with which it is difficult to argue. Unfortunately, in this particular scenario, Brian is not an RT and not a nurse; he is, rather, an emergency medical technician (EMT).

Unfortunately?  UNFORTUNATELY???  WTF!  While the article does give credit where credit is due, and states that 'Brian' is skillful and expert, (here comes the 'but'), it sure slams him for not being a RT.  I'd also like to point out that 'Brian' did not do the care all by himself.  He had nurses & a physician to help/guide him - just as a RT would - it's that whole team thing.  I don't see anyone - EMT, RT or RN doing all of that on his/her own, without some guidance or oversite.  Maybe in some places, but not most.

You should read this article yourself.  Obviously I have some biases.  I like RT's, and enjoy working next to them.  We all bring something to the table (or to the patient's bed, in this case).  Why can't we all just get along?

Another quote:

Instead of a cross-functional EMT, imagine a "Super RT" who would perform hybrid-like responsibilities of a respiratory therapist, nurse, and physician.

Uhm, excuse me.  I think that's what a Paramedic does now.

The article discusses the importance of airway therapy.  It mentions that the standard practice of 'most EMTs' is to insert a LMA.  Wait a minute.  No, it's not.  "Most EMT's" I know hate the damn things, especially in an emergency setting.  The article quotes a study that shows EMT's have a 50% success rate with endotracheal intubation.  Can't argue with that - perhaps it shows that they need more training, experience, or it shows that preferably Paramedics should be intubating.  The study itself is about rural EMT-Basics. 

Airway is #1 - among RT's & Medics.  The article notes a disadvantage to being a "jack of all trades, master of none".  Yes, a typical Paramedic has to be proficient, fluent even, in many different aspects of the job.  Yes, we may not have as much mastery of the airway as an anesthesiologist, but I'll step out onto a limb and say that most RT's don't either.  That's why the docs perform the intubations (and sometimes the Paramedics) around here & most places I've been to.

When we got our transport ventilators about a year ago, I approached the RT's in one of our local hospitals to get some information.  I was greeted with hostility and the comment that "it took them 2 years to learn how to operate a vent" and how were we supposed to learn it in 2 hours?  We ended up getting the training from another RT from another hospital.  We don't have them on vents for more than 2 hours, and the vents we use are not nearly as fancy as those in the hospital, so frankly, I don't need 2 years of experience to use them.

OK, off my rant.  Read the article.  Discuss amongst yourselves.  I'd like to hear your thoughts.

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