Egan Chapter 1 History of Respiratory Care

respiratory care (respiratory therapy)

health care discipline that specializes in the promotion of optimal cardiopulmonary function and health

RT role in health care

prevent, identify, and treat acute or chronic dysfunction of the cardiopulmonary system

RT areas of employment (6)

hospitals (75%), clinics, physicians' offices, skilled nursing facilities, cardiopulmonary diagnostic labs, public schools

AARC

American Association of Respiratory Care

AARC mission statement

"to encourage and promote professional excellence, advance the science and practice of respiratory care, and serve as an advocate for patients, their families, the public, the profession and the respiratory therapist"

NBRC

National Board for Respiratory Care

NBRC role in respiratory care

credentialing body for respiratory therapists (certification and registry exam)

Name 2 types of RCP credentials

RRT: registered respiratory therapist (advanced level)

CRT: certified respiratory therapist (entry level)

body that oversees accreditation of RC programs

CoARC

CoARC

Committee on Accreditation for Respiratory Care

What were the first respiratory therapists called?

Inhalation therapists

What was the AARC first called?

ITA (Inhalation Therapy Association)

In what ways can an RT function as a PA or physician extender?

applying protocols or guidelines, ventilator adjustments, arterial line insertion and management, intubation, extubation, etc.. Various things that RTs are trained for can minimize cost and unnecessary care where an MD or PA would otherwise be needed

Who is David Pierson?

prominent pulmonary physician

known as the "father of medicine"

Hippocrates

Greek physician living during the 5th and 4th centuries BC

Hippocrates

four essential fluids (Hippocratic medicine)

phlegm, blood, yellow bile, black bile

believed air contained essential substance distributed to body via heart

Hippocrates

physicians are to follow certain ethical principles called this

Hippocratic oath

first great biologist

Aristotle

Developed pneumatic theory of respiration in Egypt

Erasistratus

Anatomist who believed air had a substance vital to life

Galen

Determined sub-atmospheric pressures inflated lungs

Leonardo da Vinci

performed human dissections and experimented with resuscitation

Andreas Vesalius

described properties of CO2

Joseph Black

describes his discovery of oxygen: "dephlogisticated air"

Joseph Priestley

describes relationship between gas temperature and volume

Jacques Charles ("Charles Law")

uses oxygen to treat various condition at Pneumatic Institute

Thomas Beddoes

describes his law of partial pressures

John Dalton

describes relationship between gas, temperature and pressure

Gay-Lussac

describes law of diffusion for gases

Thomas Graham ("Graham's Law")

advances his "germ theory" and suggests that some diseases were result of microorganisms

Louis Pasteur

discovers x-ray and opens door for modern field of radiology

William Roentgen

technicians hauled O2 cylinders and apply 02 delivery devices (when?)

1940s

positive-pressure breathing devices applied to patients (when?)

1950s

formal education programs for inhalation therapists begins (when?)

1960s

ABG

arterial blood gas

designation "respiratory therapist" becomes standard (when?)

1974

globalization of respiratory care

practice of RC originally in US and Canada now expands globally

Respiratory Care Week established nationally to promote profession and importance of good lung health

1980

Development of sophisticated mechanical ventilators expand role of RT (when?)

1960s

Karl von Linde

large-scale production of 02 developed by

oxygen tents first used oxygen tents first used (when?)

1910

O2 masks first used (when?)

1918

O2 therapy widely prescibed (when?)

1940s

Clark electrode first developed (when?)

1960s

allows measurement of arterial PO2

Clark electrode

Ear oximeter invented (when?)

1974

Pulse oximeter invented (when?)

1980s

Venturi mask to deliver specific FIO2 introduced (when?)

1960

delivers specific FIO2

Venturi mask

portable liquid O2 systems for long-term oxygen therapy (LTOT) in home introduced (when?)

1970s

further advances in home oxygen therapy equipment occurred when?

21st century

aerosolized epinephrine introduced as treatment for asthma (when?)

1910

Isoproterenol and Isoetharine introduced as bronchodilaors (when?)

1940s-1950s (1940 and 1951 respectively)

Aerosolized steroids first used to treat acute asthma (when?)

1971

Levalbuterol (Xopenex) introduced (when?)

2000

DPI

dry powder inhalers

SVN

small volume nebulizer

Iron lung introduced by Philip Drinker (when?)

1928

Philip Drinker

inventor of Iron lung

Jack Emersons develops improved version of iron lung used for polio victims (when?)

1940s-1950s

Negative-pressure "wrap" ventilator introduced

1950s

When was positive-pressure ventilation used originally?

during anesthesia

first microprocessor-controlled ventilators developed when?

1980s

Bennett 7200

first microprocessor-controlled ventilator

due to the use of endotracheal tube, mechanical ventilation increases what?

risk for VAP

VAP

ventilator-associated pneumonia

prevents risk of VAP

non-invasive ventilation

William MacEwen successfully applied first endotracheal tube to patient when?

1980

laryngoscope introduced when?

1913

first suction catheter described when?

1941

low pressure cuffs for endotracheal tubes introduced when?

1970s

measurement of lung's residual volume first performed when?

1800

first water-sealed spirometer developed by John Hutchinson when?

1846

rapid arterial blood gas (ABG) becomes available when?

1967

polysomnography becomes routine when?

1980s

ITA to AARC progression

ITA > AAIT > AART > AARC

ITA founded when?

1941

AART became AARC when?

1982

state licensure for RTs begins when?

1980

Who sets minimum educational requirements and determine competence to practice?

state licensing laws

who sets required amount of CEU's required to keep license to practice?

state licensing boards

AARC monthly science journal name

"AARC Times"

How many specialty sections in AARC?

10

When did AARC, NBRC & CoARC formally express support for all RT's to seek and obtain RRT credential?

2002

when was first formal RT program offered and where?

1950, Chicago

programs multiply and become hospital based when?

1960s

minimum educational requirement to practice RC?

Associates degree

When did the AARC formally encourage development of baccalaureate and graduate ed in RC?

2003

What population will increase demand for RC services and RTs?

baby boomers

why will baby boomers need RC?

as they age, more will have asthma, COPD and other cardiopulmonary diseases

What will RTs of the future focus more on? (6)

-prevention

-protocol administration

-care plan development

-disease management and rehabilitation

-family and patient education

-tobacco cessation counseling

Who described what RTs of the future will focus more on?

David Pierson

Aim of "2015 and beyond"

answer 5 questions about future of profession

5 questions about future of profession according to "2015 and beyond"

1) How will patients receive health care services?

2) How will respiratory care services be provided?

3) What knowledge, skills, and attributes are needed by RTs?

4) What education and credentialing systems are necessary?

5) How can the profession transition with little impact on practicing RTs?

7 major competencies need by RTs by 2015

1) diagostics

2) chronic disease state management

3) evidence based medicine and RC protocols

4) patient assessment

5) leadership

6) emergency and critical care

7) therapeutics