Registered Respiratory Therapist: From Air to Ground
In the spring of 1992, I was working as a Life Flight Registered Respiratory Therapist/Paramedic and enjoying every minute. I even liked flights in the cold or smothering heat. The hospital that sponsored the air medical program had taken an unconventional approach in determining the qualifications of the medical crew. The administration was concerned with the potential for “downtime” of the crew, which was the polite way of saying they didn’t want to pay people to sit around. With this edict in mind, the administration decided the crew would be comprised of a nurse and a respiratory therapist (RRT). When the crew was not involved in flight(s) or flight activity, the crew members could be utilized throughout the hospital. For the flight therapist/paramedic, that meant being assigned to the emergency department (ER), the intensive care unit (ICU) and the code blue team . . . life was exciting!
My day started like many other days had, with a code in the ER. At the conclusion of the code, I overheard two of the ER physicians discussing the increasing patient volume and need for additional staff in the Hyperbaric Medicine Program. The HBO program was relatively new, less than one year old, and was the only facility within 150 miles capable of providing emergent, critical care 24/7 365. Subscribing to the theory that you can’t hear no if you don’t ask, I politely interrupted the conversation and asked if they had considered utilizing a registered respiratory therapist. To my surprise, they were open to the idea, and my venture into the field of hyperbaric oxygen therapy began.
In 1992, based on UHMS statistics, fewer than 300 hyperbaric facilities existed. Our program was comprised of registered nurses and one registered respiratory therapist (myself). The entire team had a vast amount of critical care experience, which was necessary. I felt very fortunate to be part of a program dedicated to critical care and also felt fortunate to have been given the opportunity that I assumed few, if any other, RRT had been given. However, this was not the case. Numerous programs were utilizing RRTs.
It is incredible how fast twenty-five years have gone by and how the field has changed. As I mentioned, we were the only 24/7 facility within a 150-mile radius, and we were the only facility. Fast-forward twenty-five years, the city (Kansas City) that once had only one hyperbaric program, now had seventeen (17) hyperbaric centers. Over that period, there have been many changes, some good and others not so good. We have seen the number of programs grow by some projections to over 2,100 centers nationally with the majority also providing wound care services.
When I look back at my days as a flight therapist/paramedic and the concern and ultimately the decision the hospital administration made to develop a versatile, multidiscipline team, it is eerily similar to what we utilize in wound care and HBO today. I have the opportunity to consult with wound care and hyperbaric centers throughout the country and have noticed a commonality among centers that function efficiently while providing the highest level of care. That commonality is a multidiscipline team utilizing the unique skill set of each professional, while staying within their scope of practice (licensure). They are dedicated to training, obtaining additional qualification(s) or certification and maintaining competency. Is this an unconventional approach? Perhaps, but motivated, qualified and versatile team members is what we all strive to be.