PHARM Podcast 30 : Respiratory Therapy Profession with Sean Marshall

Prehospital and Retrieval Medicine Podcast

This is Sean, a Canadian respiratory therapist. Tune in and learn about his profession!

Hi folks! This interview I talk to Sean Marshall, a respiratory therapist in Ontario, Canada. We do not have this profession in Australia and I believe it is mainly in North America and Canada. So I wanted to learn more about it and the training and daily role these RTs provide.

Things we discuss :

1. RT training
2. RT daily routine and duties
3. RT scope of practice
4. Hypothetical severe asthma case in ED and role of RT within the ED resuscitation team
5. Critical care air transport and RT role
6. The ideal transport ventilator
7. Why RT profession and other non doctor professions may have trouble establishing themselves in Australia

Sean provided some commentary and reference link below:

Hi Minh,

This article may be an appropriate citation, I’ll let you be the judge.

http://www.ncbi.nlm.nih.gov/pubmed/21233157

There are many studies such as this one. They are often used to advocate that ventilator management by a Respiratory Therapist following a protocol achieves better success than physician’s managing the ventilator. I support this view but feel it is a bit of an extrapolation from the actual findings of the studies to say one group of professionals does a better job than another.

Although I can’t seem to find a good reference, I would also make the following pitch for RTs: During a night shift in hospital, it is often a single physician responsible for the medicine wards. It may be a Resident or specialist Attending that does not have a great deal of experience with critical care and airway management. I feel that especially at times of day when staffing is less, that a Respiratory Therapist brings experience and confidence to airway management and ventilation, allowing the physician to step back and lead the whole team through a resuscitation. I feel this is a safer model of care than requiring the MD to simultaneously take in all the facts and lead an effective resuscitation while at the same time searching for vocal cords to pass a tube or initiating mechanical ventilation. And if you staff multiple physicians to address that situation, RTs can fill the need more cost-effectively.

I understand it’s political, but I felt compelled to advocate for my profession.

Thanks again,

Sean

Minh here – Sean, I agree with you. Its not about egos in airway management and frankly I dont really care who sticks the plastic past the cords as long as they do it safely and defend oxygenation at all times. The lone wolf attitude to critical care airway procedures and ventilation must be culturally displaced and a team approach adopted where the doctor maybe best utilised as a team leader if appropriately skilled and confident to act in such a role. Operational silos of clinical practice do not help patient safety and quality of care and we should all be sharing skills, knowledge and experience rather than defending professional territories.Rant ends

enjoy the podcast

Minh

Now on to the Podcast

http://media.blubrry.com/prehospitalpodcast/content.blubrry.com/prehospitalpodcast/sean_marshall_interview.mp3

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