Activities	Evaluate, treat, and care for people who have breathing or other cardiopulmonary disorders. Have major responsibility for all respiratory care approaches, including the supervision of respiratory therapy technicians. Start and carry out therapeutic procedures, maintain patient records, and select, assemble, check, and operate equipment.
Outlook	Faster-than-average-job growth
Median Income	$54,280 per year in 2010
Work Context & Conditions	Respiratory therapists generally work between 35 and 40 hours a week. Because hospitals operate around the clock, therapists may work evenings, nights, or weekends.
Minimum Education Requirements	Associate's Degree
Skills	Monitoring, Critical Thinking, Instructing, Active Listening, Time Management, Reading Comprehension, Speaking
Abilities	Oral Expression, Speech Recognition, Problem Sensitivity, Speech Clarity, Oral Comprehension
Interviews	Dennis Brown Kevilin Prah

Job Category		Healthcare Practitioners & Technical
Job Description		Respiratory therapists and respiratory therapy technicians—also known as respiratory care practitioners—evaluate, treat, and care for patients with breathing or other cardiopulmonary disorders. Practicing under the direction of a physician, respiratory therapists assume primary responsibility for all respiratory care therapeutic treatments and diagnostic procedures, including the supervision of respiratory therapy technicians. Respiratory therapy technicians follow specific, well-defined respiratory care procedures under the direction of respiratory therapists and physicians. In clinical practice, many of the daily duties of therapists and technicians overlap; furthermore, the two have the same education and training requirements. However, therapists generally have greater responsibility than technicians. For example, respiratory therapists will consult with physicians and other health care staff to help develop and modify individual patient care plans. Respiratory therapists also are more likely to provide complex therapy requiring considerable independent judgment, such as caring for patients on life support in intensive-care units of hospitals. In this Handbook statement, the term respiratory therapists includes both respiratory therapists and respiratory therapy technicians. Respiratory therapists evaluate and treat all types of patients, ranging from premature infants whose lungs are not fully developed to elderly people whose lungs are diseased. Respiratory therapists provide temporary relief to patients with chronic asthma or emphysema, as well as emergency care to patients who are victims of a heart attack, stroke, drowning, or shock. To evaluate patients, respiratory therapists interview them, perform limited physical examinations, and conduct diagnostic tests. For example, respiratory therapists test patients’ breathing capacity and determine the concentration of oxygen and other gases in patients’ blood. They also measure patients’ pH, which indicates the acidity or alkalinity of the blood. To evaluate a patient’s lung capacity, respiratory therapists have the patient breathe into an instrument that measures the volume and flow of oxygen during inhalation and exhalation. By comparing the reading with the norm for the patient’s age, height, weight, and sex, respiratory therapists can provide information that helps determine whether the patient has any lung deficiencies. To analyze oxygen, carbon dioxide, and pH levels, therapists draw an arterial blood sample, place it in a blood gas analyzer, and relay the results to a physician, who then may make treatment decisions. To treat patients, respiratory therapists use oxygen or oxygen mixtures, chest physiotherapy, and aerosol medications. When a patient has difficulty getting enough oxygen into his or her blood, therapists increase the patient’s concentration of oxygen by placing an oxygen mask or nasal cannula on the patient and set the oxygen flow at the level prescribed by a physician. Therapists also connect patients who cannot breathe on their own to ventilators that deliver pressurized oxygen into the lungs. The therapists insert a tube into the patient’s trachea, or windpipe; connect the tube to the ventilator; and set the rate, volume, and oxygen concentration of the oxygen mixture entering the patient’s lungs. Therapists perform regular assessments of patients and equipment. If the patient appears to be having difficulty breathing or if the oxygen, carbon dioxide, or pH level of the blood is abnormal, therapists change the ventilator setting according to the doctor’s orders or check the equipment for mechanical problems. In home care, therapists teach patients and their families to use ventilators and other life-support systems. In addition, therapists visit patients several times a month to inspect and clean equipment and to ensure its proper use. Therapists also make emergency visits if equipment problems arise. Respiratory therapists perform chest physiotherapy on patients to remove mucus from their lungs and make it easier for them to breathe. For example, during surgery, anesthesia depresses respiration, so chest physiotherapy may be prescribed to help get the patient’s lungs back to normal and to prevent congestion. Chest physiotherapy also helps patients suffering from lung diseases, such as cystic fibrosis, that cause mucus to collect in the lungs. Therapists place patients in positions that help drain mucus, and then vibrate the patients’ rib cages and instruct the patients to cough. Respiratory therapists also administer aerosols—liquid medications suspended in a gas that forms a mist which is inhaled—and teach patients how to inhale the aerosol properly to ensure its effectiveness. In some hospitals, therapists perform tasks that fall outside their traditional role. Therapists’ tasks are expanding into areas such as pulmonary rehabilitation, smoking cessation counseling, disease prevention, case management, and polysomnography—the diagnosis of breathing disorders during sleep, such as apnea. Respiratory therapists also increasingly treat critical care patients, either as part of surface and air transport teams or as part of rapid-response teams in hospitals.
Working Conditions		Respiratory therapists generally work between 35 and 40 hours a week. Because hospitals operate around the clock, therapists may work evenings, nights, or weekends. They spend long periods standing and walking between patients’ rooms. In an emergency, therapists work under a great deal of stress. Respiratory therapists employed in home health care must travel frequently to the homes of patients. Respiratory therapists are trained to work with hazardous gases stored under pressure. Adherence to safety precautions and regular maintenance and testing of equipment minimize the risk of injury. As in many other health occupations, respiratory therapists run the risk of catching an infectious disease, but carefully following proper procedures minimizes this risk.
Salary Range		The median annual wage of respiratory therapists was $54,280 in May 2010. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $39,990, and the top 10 percent earned more than $73,410.

Education Required		Formal training is necessary for entry into this field. Training is offered at the postsecondary level by colleges and universities, medical schools, vocational-technical institutes, and the Armed Forces. An associate degree has become the general requirement for entry into this field. Most programs award associate or bachelor’s degrees and prepare graduates for jobs as advanced respiratory therapists. Other programs award associate degrees or certificates and lead to jobs as entry-level respiratory therapists. According to the Commission on Accreditation of Allied Health Education Programs (CAAHEP), in 2008 there were 31 entry-level and 346 advanced respiratory therapy programs presently accredited in the United States. Areas of study in respiratory therapy programs include human anatomy and physiology, pathophysiology, chemistry, physics, microbiology, pharmacology, and mathematics. Other courses deal with therapeutic and diagnostic procedures and tests, equipment, patient assessment, cardiopulmonary resuscitation, application of clinical practice guidelines, patient care outside of hospitals, cardiac and pulmonary rehabilitation, respiratory health promotion and disease prevention, and medical recordkeeping and reimbursement. High school students interested in a career in respiratory care should take courses in health, biology, mathematics, chemistry, and physics. Respiratory care involves basic mathematical problem solving and an understanding of chemical and physical principles. For example, respiratory care workers must be able to compute medication dosages and calculate gas concentrations. Respiratory therapists advance in clinical practice by moving from care of general to critical patients who have significant problems in other organ systems, such as the heart or kidneys. Respiratory therapists, especially those with 4-year degrees, may also advance to supervisory or managerial positions in a respiratory therapy department. Respiratory therapists in home care and equipment rental firms may become branch managers. Some respiratory therapists advance by moving into teaching positions.
Recommended High School Courses		Biology, Mathematics, Chemistry, Health, Physics
Postsecondary Instructional Programs		Law, Government and Jurisprudence, Education and Training, English Language, Psychology, Personnel and Human Resources, Administration and Management, Public Safety and Security, Mathematics, Therapy and Counseling, Physics, Engineering and Technology, Chemistry, Biology, Customer and Personal Service, Computers and Electronics, Mechanical, Medicine and Dentistry, Clerical
Certification and Licensing		Respiratory therapists are licensed in all states except Alaska, although requirements vary by state. Licensure requirements in most states include completing a state or professional certification exam. For specific state requirements, contact your state’s health board. Many employers prefer to hire respiratory therapists who have certification. Certification is not always required, but it is widely respected throughout the occupation. Certification usually requires graduating from an accredited program and passing a certification exam and is often required in order to get a state license. The National Board for Respiratory Care (NBRC) is the main certifying body for respiratory therapists. The Board offers two levels of certification: the Certified Respiratory Therapist (CRT) and the Registered Respiratory Therapist (RRT). The first-level certification available from NBRC for respiratory therapists is the CRT certification. Applicants must have earned an associate’s degree from an accredited respiratory therapy program, or completed the equivalent coursework in a bachelor’s degree program, and pass an exam. The second-level certification available from NBRC is the RRT certification. Applicants must have a CRT certification, meet other education or experience requirements, and pass an exam.

Interest Area		Investigative Involves working with ideas and requires an extensive amount of thinking.
Work Values		Achievement Get a feeling of accomplishment. Social Service Do things for other people. Ability Utilization Make use of individual abilities. Co-workers Have co-workers who are easy to get along with.
Skills		Monitoring Assess how well someone is doing when learning or doing something. Critical Thinking Use logic and analysis to identify the strengths and weaknesses of different approaches. Instructing Teach others how to do something. Active Listening Listen to what other people are saying and ask questions as appropriate. Time Management Manage one's own time and the time of others. Reading Comprehension Understand written sentences and paragraphs in work-related documents. Speaking Talk to others to effectively convey information.
Abilities		Oral Expression Able to convey information and ideas through speech in ways that others will understand. Speech Recognition Identify and understand the speech of another person Problem Sensitivity Able to tell when something is wrong or likely to go wrong. This doesn't involve solving the problem, just recognizing that there is a problem. Speech Clarity Able to speak clearly so listeners understand. Oral Comprehension Able to listen to and understand information and ideas presented through spoken words and sentences.

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Job Outlook		Job opportunities are expected to be very good, especially for respiratory therapists with cardiopulmonary care skills or experience working with infants. Employment of respiratory therapists is expected to increase faster than average for all occupations through the year 2020, because of substantial growth in the numbers of the middle-aged and elderly population—a development that will heighten the incidence of cardiopulmonary disease—and because of the expanding role of respiratory therapists in the early detection of pulmonary disorders, case management, disease prevention, and emergency care. Older Americans suffer most from respiratory ailments and cardiopulmonary diseases such as pneumonia, chronic bronchitis, emphysema, and heart disease. As their numbers increase, the need for respiratory therapists will increase as well. In addition, advances in inhalable medications and in the treatment of lung transplant patients, heart attack and accident victims, and premature infants (many of whom are dependent on a ventilator during part of their treatment) will increase the demand for the services of respiratory care practitioners. Although hospitals will continue to employ the vast majority of therapists, a growing number can expect to work outside of hospitals in home health care services, offices of physicians or other health practitioners, or consumer-goods rental firms. Respiratory therapists held about 112,700 jobs in 2010. Most respiratory therapists work in hospitals. Others may work in nursing care facilities or travel to patients’ homes. Respiratory therapists are on their feet for long periods and may need to lift or turn disabled patients. Like other healthcare workers, respiratory therapists may be exposed to infectious diseases..
More Information		American Association for Respiratory Care, National Board for Respiratory Care, Inc., Committee on Accreditation for Respiratory Care, American Medical Association - Health Care Careers
References		Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2012-13 Edition, Respiratory Therapists, on the Internet at http://www.bls.gov/ooh/healthcare/respiratory-therapists.htm O*NET online, on the Internet at http://online.onetcenter.org/link/summary/29-1126.00