Lecture 2: Historical Roots of Respiratory Care

Dalton

describes law of partial pressure, in 1801 and atomic theory in 1808.

Gay-lussac

describes the relationship between gas pressure and temperature in 1808

Graham

Described law of diffusion for gases 1831

Luis Pastuer

in 1865 advanced his germ theory of disease. 

Asphexia and drowning recovery

Oxygen was used to revive these individuals, on the belief that t could reanimate unconscious patients

Pneumonia and respiratory infections

in early 1900’s begain using oxygen to treat these, especially during outbreaks.

Carbon monoxide poisoning

Used to displace this from hemoglobin, helping to restore effective oxygen transport in affected individuals. 

When was oxygen first used for therapeutic administration

1798.

Neonatal resuscitation

by the mid 20th century, oxygen therapy became a key part of caring for these people in distress.

Chronic Obstructive pulmonary disease (COPD)

in early 20th century, physicians began using oxygen intermittently to relieve these patients. 

Anesthesia support and surgical procedures.

Supplemental oxygen administered during and post, to improve issue oxygenation and reduce complications

WWII

Increased demand for oxygen therapy and airway managment in battlefield medicine. positive pressure breathing for high-altitude pilots.  Oxygen Technicians.

1950’s

delivering aerosol medications, expanding the role of the oxygen technicians. 

Inhalation therapist

began training in 1950’s, and formal education began in 1960’s. provided oxygen therapy in H cylinders

Polio Epidemic

Thousands of patients suffered respiratory muscle paralysis and deformities. Created urgent need for mechanical ventilation (negative pressure ventilators =Iron lung)

Ventilator development

1950; introduction of positive-pressure ventilators (bird and bennett)  

High-Flow Nasal Cannula (HFNC) Therapy

•Became a first-line treatment for hypoxemia before mechanical ventilation.

•Helped reduce the need for intubation in many patients with COVID-related pneumonia.

Awake Proning

• Encouraged patients who were not intubated to lie on their stomachs to improve oxygenation.

•Simple, non-invasive, and highly effective in many cases.

. Telehealth & Remote Monitoring

•RTs began monitoring oxygen levels, symptoms, and even ventilator data remotely.

Expanded access to care—especially for patients in quarantine or in rural areas.

AI-Assisted Ventilator Management

•Some ICUs used AI tools to adjust ventilator settings or predict patient deterioration.

•Helped optimize care with limited staff.

Expanded Use of Point-of-Care Ultrasound (POCUS)

•Used by RTs and physicians to assess lung function and identify complications like fluid buildup.

Cross-Training and Flexibility

•RTs were trained to work in new environments like emergency departments or COVID wards.

•Fostered stronger collaboration with nurses and physicians in crisis situations.

Focus on PPE and Infection Control

•Led to stricter respiratory protection protocols and improved safety standards for aerosol-generating procedures.

Data-Driven Protocols and Real-Time Decision Making

•Facilities began using shared dashboards and patient data to standardize RT care across shifts.

Roles and responsibilities of RTs

Clinical tasks, educator and advocate roles and interdisciplinary team involvement

Clinical tasks

• O2 therapy

• Mechanical ventilation management

• ABG

• Airway managment

• Medication delivery

• Pulmonary function testing

• Cardiopulmonary monitoring

• Emergency and code resposne

Educator role

• Teach patients use of equipment and meds

• Provide disease ed.

• Train RT students and new staff

• Educate interdisciplinary teams during rounds and care planning

• Promote health literacy and preventive strategies.

Advocate role

• Speak up for patients’ respiratory care needs and safety

• Ensure access to appropriate therapy and equip.

• Represent the RT profession in healthcare teams and public forums

• Support public health initiatives

• Engage with professional organization to advance the field.

Interdisciplinary team involvement. 

• Collaborates with other disciplins.

• Participate in ICU and discharge planning rounds

• Provide input on ventilator management and weaning protocols

• Communicate respiratory status updates to the care team

• Support continuity of care across setting.