Monday, April 18, 2016

Respiratory Therapist;more than just Breathing Treatments


Is a Respiratory Therapist (RT) more than just a breathing treatment provider?

So I have had experience in nursing for over 20 years and have specialized in Infusion Therapy for over 6 years.  Recently, I was teaching an IV class in which the facility was using a Respiratory Therapist to insert and maintain their PICC's.  I was a little taken aback by this discovery as I have never heard of such a thing.



Well I contacted the California Board for Respiratory Therapist and they responded back fairly quick and the following was their response;

"Good afternoon Mr. Stansbury.

The Respiratory Care Board of California (Board) often receives inquiries related to PICC and central line insertion.   In its responses the Board has stated that that licensed respiratory care practitioners are authorized to insert and care for PICC lines, so long as appropriate training, guidelines, and competencies are provided/documented by the licensed health care facility to ensure these services are conducted in a safe and competent manner when administered to the public.

With regard to central line placement, the respiratory care scope of practice was amended in 2004 to allow for the insertion of central lines, "in whole or in part, to provide ventilatory or oxygenating support."  Provided the insertion of a CVC is for the purpose, in whole or in part, to provide ventilatory or oxygenating support, it is within an RCP's scope of practice.  Having said that, the Board would caution any facility allowing an RCP to perform this function to tread cautiously.  The RCP should be well trained and skilled in this function.  Failure to perform the procedure correctly could easily be life threatening.  Further, because a common repercussion of this procedure is pneumothorax, it is especially important that qualified personnel are IMMEDIATELY available to address this situation, since treating a pneumothorax requires cutting the tissues and RCPs are clearly not authorized to do this.  The facility should ensure emergency procedures are in place as a matter of patient safety.

For your reference, below please  find links to the pertinent sections of law.  Please let me know if you require additional information.  Thank you for your inquiry.

http://www.rcb.ca.gov/applicants/lawsregs_bp3700.shtml#3702
http://www.rcb.ca.gov/applicants/lawsregs_bp3700.shtml#3702.7"




I also checked around and Arizona is another state that allows RT's to insert PICC lines. RT's in California are not only authorized to start PICC's but peripheral IV's as well. Let me know your thoughts in regards to this discovery and how we have progressed and moved many practitioners along in their scope of practice.  Is the RT not an important part of a multidisciplinary team?
Email me at: kstansbury@morethancpr.com or respond to this blog on our Facebook page.