This position is responsible for respiratory care for patients of all age groups, who are diagnosed with cardio-pulmonary dysfunction. Services are provided throughout the Tufts Medical Center are complex. This includes the ICUs, in-patient rooms, the Emergency Room, and outpatient clinics. A request for service originates from the medical staff of Tufts Medical Center. It may be written or verbal and can be communicated to the therapist by direct telephone conversation and/or beeper page. The patient’s nurse or unit secretary conveys the order.
All patients are assessed for their needs initially and on an on-going basis until no longer required. Documentation of services provided is recorded in the Respiratory Therapy Progress Notes section located on the department flow sheet. A copy of this document is filed in the patient Medical Record.
A list of the specific practices available by this department is noted below. A Respiratory Therapist is under the direction of the Director and Assistant Director of Respiratory Care. Patient services are available 24 hours/day, 365 days/year. Services are provided in accordance to policies and procedures agreed upon by the Medical Directors of the department. Clinical Practice Guidelines have and continue to evolve as the framework of clinical respiratory care practice. These practices are well referenced and sponsored by the American Association for Respiratory Care.
Neonatal and pediatric training
Advanced certifications: ACLS, NRP, PALS
Incentive career ladder supporting expanded skillsets
Participation in neonatal and pediatric transport program
Extracorporeal Membrane Oxygenation (ECMO) training
Participation in orientation of new employees, primary preceptor opportunities
Quality and Safety initiatives: participating in composing and maintaining clinical practice guidelines and protocols
Participation in various departmental and critical care research opportunities
Initiates patients on invasive and non-invasive mechanical ventilation; routinely checks and maintains proper function of ventilator in conjunction with the physician order.
Abides with infection control guideline for invasive and non-invasive equipment per departmental policy. Changes and adjusts ventilator parameters based on clinical assessment and blood gas analysis in accordance with physician orders.
Weans patients from mechanical ventilation and other therapies through patient assessment and adjusting parameters within prescribed protocols.
Administer inhaled medications in accordance with institutional guidelines derived from the department of respiratory care and pharmacy.
Administers oxygen using low flow, high flow, open and closed circuits.
Embodies patient and family centered care. Explains procedures to patients and family.
Provides services to analyze blood specimens for blood gases, glucose and electrolytes in neonatal and pediatric intensive care units.
Administers Positive Pressure Breathing, (e.g. CPAP or BiPAP), which consists of the application of positive pressure to the upper airway to promote better lung inflation and aerosol distribution.
Routinely assists in the transport of patients requiring life-support to and from referral hospitals.
Provides in-house transport of mechanically ventilated and other high-risk patients.
Provides non-traditional therapies, e.g. Nitric Oxide gas administration, as ordered.
Provides resuscitation and support services at all high-risk deliveries.
Monitors effectiveness of therapy using non-invasive techniques such as pulse oximetry, end tidal CO2 and transcutaneous PO2/PCO2, in addition to invasive techniques such as arterial blood gas sampling.
Analyzes inspired oxygen concentration using various oxygen analyzers.
Calibrates monitors and maintains Transcutaneous Oxygen Monitors, End Tidal CO2 and pulse Oximetry monitors.
Assists in Cardio-Pulmonary Resuscitation as part of Code Team primarily providing airway management and manual resuscitation. Commonly administers drugs via the endotracheal tube during cardiopulmonary rescue e.g. Lidocaine, Atropine Sulfate and Epinephrine.
Documents therapy, patient assessment, and interventions performed and test results in the progress notes of the medical record in a concise, accurate, and thorough manner.
Transcribe a detailed shift note for all patient’s cared for during the shift.
Responsible for acknowledging the proper assembly of all respiratory therapy equipment prior to and during patient use.
Performs daily rounds and fairly bills patients for services rendered.
Attend rounds daily with the intensive care unit critical care team and is an active participant in the patient’s care.
Assists with development of in-service programs for departmental personnel.
Assists the Associate Director with the orientation of new employees; acts as a preceptor for new employees and is utilized as a clinical instructor for students enrolled in local universities.
Administers therapeutic agents such as Heliox, Surfactant, Tobramycin, Ribavirin and Pentamidine in accordance with established Departmental procedure.
Provides services for new clinical programs as research protocols are developed.