How Does the Respiration Process Work?

Respiratory therapist is a new medical profession whose job is to diagnose, treat and care for patients with cardiopulmonary insufficiency or abnormality under the guidance of a doctor. Specifically, it provides a variety of ventilation and oxygen therapy for acutely critical patients; the use and monitoring of various medical gases; the treatment and monitoring of various aerosols and aerosols; the use and maintenance of cardiopulmonary resuscitation and its equipment; pulmonary rehabilitation treatment; other Technical operations, such as blood gas analysis, pulmonary function monitoring, hyperbaric oxygen chamber treatment, etc.

Respiratory therapist

Respiratory therapist is a new medical profession whose job is to diagnose, treat and care for patients with cardiopulmonary insufficiency or abnormality under the guidance of a doctor. This includes providing a variety of ventilation

Respiratory therapy originated in the United States and has a history of more than fifty years. There are already more than 100,000 respiratory therapy practitioners in the United States, located in various medical institutions and communities, families, and medical device companies. Some developed countries and regions in North America and Asia have basically followed the American model and formed a team of professional respiratory therapists of a certain size, but this industry in China has only just begun to take off. In 1994, Shao Yifu Hospital in Zhejiang Province took the lead in accordance with the American model Established a department of respiratory therapy; in 1997, the West China Medical College of Sichuan University opened a major in respiratory therapy in accordance with the American education model for respiratory therapy. This is also the only institution of higher learning in China offering undergraduate education in respiratory therapy.

The formal establishment of the American Association for Respiratory Care (AARC) in 1947 marked the beginning of the establishment of the discipline of respiratory therapy, and the establishment of the National Board for Respiratory Care (NBRC) in 1956 marked the gradual establishment of the respiratory treatment practice Standardization. The formal establishment of the American Joint Review Committee for Respiratory Therapy Education (JCRTE) in 1970 marked the gradual improvement of the American respiratory therapy education system. In 1964, Canada established the Canadian Society of Respiratory Therapist (CSRT) after the United States. Some hospitals in Taiwan have established respiratory therapy departments since 1973, and established the respiratory therapy society in 1990. They are regions with more complete Asian organizations, sound systems, and mature subject development. In addition, Singapore, the Philippines and some Central American countries have basically established respiratory therapy disciplines in accordance with the American model.

Internationally, RT can perform the following tasks under the guidance of a written doctor's order, an oral doctor's order, or an approved protocol:

(1) Monitoring and effect evaluation of respiratory therapy.

(2) Respiratory physiological monitoring.

(3) Mechanical ventilation, including self-checking and debugging of the ventilator before use, adjustment of modes and parameters, prevention and treatment of ventilator-related complications such as ventilator-related lung injury, ventilator-related pneumonia, and mechanical ventilation evacuation.

(4) Hemodynamic monitoring, circulatory system maintenance, Extracorporeal Membrane Oxygenators (ECMO), etc.

(5) Assist the doctor in the establishment of artificial airways, including nasal and oral tracheal intubation, tracheotomy, and can be operated independently in emergency situations.

(6) Management of artificial airway, including management of catheter position, management of airbag of artificial airway, temperature and humidity of artificial airway, removal of artificial airway, etc.

(7) Oxygen therapy, including adjustment of oxygen concentration, selection and use of oxygen therapy devices, and evaluation of the effects of oxygen therapy.

(8) Use of special medical gases, such as N0 inhalation therapy.

(9) Atomization treatment, including selection of aerosolized drugs and devices, use of atomization devices, monitoring of the atomization process, and evaluation of atomization effects.

(10) Chest physical therapy, including postural drainage, chest sputum excretion, guided cough, suction of sputum through the nose, mouth, and artificial airway negative pressure, and treatment of lung dilatation.

(11) Respiratory rehabilitation exercises, including controlled breathing techniques and respiratory muscle training.

(12) Central venous catheter and arterial catheter.

(13) Bronchoscopy.

(14) Pulmonary function test.

(15) Collection of sputum specimens.

(16) Gas metabolism analysis.

(17) Arterial blood gas analysis.

(18) In-hospital / out-of-hospital transport of mechanically ventilated patients.

(19) Participate in cardiopulmonary resuscitation and master the use of simple respirators and electric defibrillators.

(20) Hyperbaric oxygen chamber treatment.

(21) Sleep apnea monitoring.

(22) Management of respiratory therapy related equipment, including cleaning, disinfection and performance testing of the ventilator; cleaning, disinfection and installation of the ventilator's pipeline; nebulization device, heating and humidifying device, bronchoscope, vibration sputum discharge machine , Maintenance of negative pressure sputum suction, electric defibrillator, blood gas analyzer.

(23) For home treatment, RT should instruct patients and their families to use and maintain the ventilator and related respiratory therapy equipment to ensure its safe and effective use, and guide patients to aerosol inhalation therapy, respiratory rehabilitation exercises, etc.

(24) Quit smoking instruction.

(25) Health education.

(In the days when SARS was raging in 2003, the department's respiratory therapists relied on strong professional skills to fight on the front line of SARS, and made great contributions to the overall victory of SARS in Zhejiang Province);

In 1997, the West China Medical University Clinical Medical College (now the West China Clinical Medical College of Sichuan University), a key institution under the Ministry of Health, was promoted by Dr. Sawyer, the former chairman of CMB, and assisted by respiratory education experts such as UAB and Loma Linda University in the United States. Established a professional laboratory in April 1996 in accordance with the American respiratory therapy teaching model. In 1997, the Ministry of Health approved the establishment of a respiratory therapy major. In the same year, it enrolled a 5-year undergraduate student in respiratory therapy and was assigned to first-class hospitals, including Peking Union Medical College Hospital. Respiratory or ICU. In order to train a true respiratory therapist, West China Medical Center of Sichuan University has enrolled four-year undergraduate students since 2000 and awarded a bachelor of science degree after graduation. Sichuan University is also the only university in China that offers respiratory therapy.

In 2004, the first batch of domestic (11) undergraduate respiratory therapists graduated, two of them (Li Jie and Luo Zujin) started respiratory therapy at Beijing Chaoyang Hospital RICU. In 2005, two more graduates of this specialty ( Xia Jingen, Yao Xiuli) came to our hospital. Under the care of President Wang Chen and the careful guidance of Huang Kewu, Dai Huaping, Tong Zhaohui, Deputy Chief Physician and Deputy Chief Physician of RICU Zhan Qingyuan, the work of the respiratory therapists working together has been recognized and praised by colleagues at home and abroad many times, of which Li Jie He also won the 51st International Respiratory Therapy International Scholarship Scholarship to visit the United States for three weeks in November 2005. Luo Zujin also won this honor and will soon visit the United States for study.

Up to now, there are only more than 40 graduates of this major, all of whom work in large-scale teaching hospitals in China. Most of the hospital's respiratory therapy work is still mainly undertaken by clinical medical staff. How this part of the work is completed, how the respiratory therapist's status and needs in the country, and whether the job duties and content are consistent with the United States, etc., are the concerns of American colleagues. The problem. At the exchange meeting, Li Jie, a respiratory therapist, combined with a large-scale questionnaire survey completed in China, made a report on "The Current Status of Chinese Respiratory Therapy", introduced the development of the domestic respiratory therapy profession and the current status of the domestic ICU respiratory therapy work. It is pointed out that the respiratory therapy work lacks a unified standard. ICU has a high demand for respiratory therapy expertise and training. However, there are bottlenecks that limit its development, such as lack of a respiratory therapist license, and many clinical respiratory therapy operations cannot be charged. The positive response of the United States, in particular Professor Janet M. Boehm, the former president of the American Association of Respiratory Therapy (AARC), put forward many practical solutions based on his many years of professional development experience. In addition, on the issue of how respiratory therapists work in Beijing Chaoyang Hospital, Luo Zujin introduced in detail the clinical work projects, research and teaching tasks completed, several published papers, etc., among which the respiratory therapists They also introduced their counterparts in the United States to how they took over the work of existing medical staff, standardized and expanded their work, and how to coordinate the division of labor. Their experience was recognized and appreciated by their peers. Deputy Director Huang Kewu, Chief Quan Jingyu, and Dr. Zhan Qingyuan introduced the status and role of respiratory therapists in their eyes, and how the respiratory therapy profession was supported and developed in Chaoyang Hospital. In the delegation, Professor Michael E. Donnellan also sent several emails after the visit, saying that the respiratory therapy work of Beijing Chaoyang Hospital is indeed at the forefront of the country. They were surprised by the rapid development. This is similar to the young respiratory therapists. The continuous efforts and progress of the company are also inseparable from Beijing Chaoyang Hospital's fertile soil that advocates academics and encourages professional development.

In 1947, the United States established the American Association of Respiratory Therapy (AARC). In North America, the Middle East, and Latin America, including Taiwan, China, many medical schools and medical technology colleges have respiratory therapy majors, and many hospitals have respiratory therapy specialized departments. , Specializing in respiratory therapy, respiratory therapy has played a huge role in the treatment of critically ill patients and respiratory diseases. The training in respiratory therapy has developed into a self-contained higher education program.

1993,

Due to the over-emphasis on clinical medical education in China for a long time, the training of medical related professionals has been neglected. In recent years, national medical colleges and universities have mostly operated in accordance with the traditional system, with limited professional settings and lack of market sensitivity and diversification. Respiratory therapist training is limited to specialized orientation training for respiratory clinicians in individual hospitals in coastal provinces. Respiratory therapy teams have been in an undifferentiated state. Most medical schools and hospitals have not established respiratory therapy majors. Respiratory therapy work is mainly undertaken by doctors engaged in breathing and ICU and specially trained nursing staff. Most of them acquire respiratory therapy skills through self-study and short-term special training without formal learning. With the development of medical diagnosis and treatment technology in China, many hospitals have gradually built intensive care units, equipped with ventilator, defibrillator, heart monitor and other equipment. Diagnosis and treatment level. The main problems today are lack of standardized respiratory monitoring, treatment and management models, and lack of systematic teaching and training programs.

The "Outline of China's Medical Education Reform and Development" (2001 2015) clearly states that "it is necessary to" adjust and reduce the number of medical specialties and actively develop medical related specialties ". The "Outline" determined: "Higher vocational and technical education and secondary education mainly set up medical-related majors." By 2015, it is necessary to "form a medical talent training system that combines medical general education with medical vocational and technical education, a clear division of labor, mutual communication, and interconnection." With the improvement of the treatment of critically ill patients, the aging of the population, and diseases such as SARS Threats to human health, respiratory therapy is increasingly showing its importance, and human demand for respiratory therapy is growing. As a specialized medical technology discipline, in November 2003, the major of respiratory therapy technology was formally listed in the "Special Catalogue of General Colleges and Universities" of the Ministry of Education. Respiratory therapy will become one of the hot topics in medical schools in the future. Respiratory therapy will be improved to a new level in China.