The fans do not work alone. Why respiratory therapists are essential in the treatment of coronaviruses


“If you don’t do it right, the results for patients are different. You need qualified people who have a lot of experience in this area to get good results with these patients, “she said.

Enter the respiratory therapist, who is specially trained to treat people with respiratory problems. In the midst of the coronavirus pandemic, their role as master of the mechanical ventilator brought them a new level of recognition for what has long been an unknown job.

“When I tell people that I am a respiratory therapist, they look at me blankly,” said Lisa Shultis, respiratory therapist and director of respiratory care at the University of Long Island. “Until this time. Now they look at me with fear. “

A ventilator and other hospital equipment are seen in an emergency campaign hospital in Central Park in New York to assist in the response to the Covid-19 pandemic.

Respiratory therapists are those who monitor the oxygen levels of Covid-19 patients, manage their breathing and, if necessary, intubate them and set up a mechanical ventilator.

There are 155,000 licensed respiratory therapists in the United States, according to the American Association for Respiratory Care (AARC). Yet their work remains “virtually unknown,” said Tom Kallstrom, CEO and executive director of ARCA.

“In doctor’s shows (TV), they never really show respiratory therapists,” he said. “They show others what we do. I’m grateful to know that at least people know who we are (now). “

What respiratory therapists do

As the name suggests, respiratory therapists focus on breathing – the problem at the heart of the pandemic.

Respiratory therapists normally treat acute conditions, such as premature babies with underdeveloped lungs or adults with heart attacks, as well as chronic conditions, such as asthma or chronic obstructive pulmonary disease.

Now, however, the coronavirus is in the center. The coronavirus causes Covid-19, which affects the lungs and can cause pneumonia, shortness of breath, and in the worst case, an acute respiratory distress syndrome, called ARDS.

“These patients are so different from any patient we have ever seen before,” said Eason. “We normally have a few patients who are sick at this level. (Now) our intensive care units are full of them. And filled with them. None of them can breathe. “

One treatment for these problems is to provide additional oxygen through a nasal cannula, a device that enters a patient’s nose. If that doesn’t work, a more extreme treatment is to stick a tube into a patient’s throat, known as an intubation, and connect it to a mechanical ventilator that breathes for him. It is often the last best hope for a deteriorating patient.

Respiratory therapists are responsible for monitoring the patient’s oxygen levels and working with doctors to decide if and when to use these treatments.

“It takes a lot of knowledge, experience and skill to be able to advise a doctor on the best way to ventilate,” said Tom Barnes, principal professor and consultant for the master’s program in respiratory science at Northeastern University.

Their work helps to lighten the responsibilities of doctors and nurses.

“None of the parties really have the history and training on mechanical ventilators that a respiratory therapist has,” said Kallstrom. “It really is a three-legged stool. You really need your doctor, nurse, and respiratory therapist to work together continuously. “

Respiratory therapists are sometimes the ones who physically do the intubations. They install and manage the fans. They then work on its controls to adapt to the patient’s needs: the size of the breath, the number of breaths per minute, the oxygen concentration, the airway pressure and more variables. And they set up alarms on the machine so that, in the event of a problem, the fan quickly alerts nearby workers.

Inside an emergency room during the coronavirus epidemic

“It’s like having to sit in the cockpit of an airplane, you don’t know what to do,” said Kallstrom. “I don’t think a fan is as confusing as that, but there are a lot of buttons and modes of operation for a modern fan. “

It can also be dangerous. Because respiratory therapists are sometimes the intubators hovering over the open airways of an infected patient, they are particularly at risk of getting the virus.

“You have to see where you’re going with this tube in the windpipe, not the esophagus. It’s very difficult when you have a mask, glasses, everything, “said Shultis. “The patient has expired in your face. That’s why it’s very dangerous. This is why it is imperative that we have the right one (personal protective equipment) for everyone in the room, but especially for respiratory therapists. “

Shultis, Kallstrom and Barnes said they were frustrated to see officials and the media discussing the need for ventilators without recognizing the role of respiratory therapists.

“They work outside and it’s especially difficult when people don’t recognize them,” said Barnes.

It’s not just national numbers. Shultis said that even inside hospitals, respiratory therapists are often not recognized on an equal footing with other healthcare workers.

“Call us by name. We are not just the people who run the respirators. We are respiratory therapists. We are an important profession in the health care team, “she said.

CNN’s Lauren del Valle and Miguel Marquez contributed to this report.


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