At some point or another, we’ve all worked with respiratory therapy in the ED. What has your experience been? In this episode, Drew, John, and Andy are joined by guests Matt Pavlichoko, RRT, and Kirk Hinckley, MD to discuss the role Respiratory Therapy (RT) plays in the care of patients in the ED. 

What is the value of Respiratory Therapy?

As EM physicians, we often consider ourselves the masters of resuscitation, however, we aren’t the only airway experts in the hospital. Our RT colleagues are not only well-versed in the airway but can also play an integral role in helping us manage a critical patient, particularly in respiratory distress. They often can be very helpful consultants in identifying patients who may need more respiratory support and the type of support that may be appropriate. 

When it comes to intubation, in many academic centers, the RT is often seen assisting a resident or junior learner with intubation, however, in smaller departments in the community, many RTs intubate fairly regularly. Early on in residency, RTs can be an incredible resource for learning things like intubation techniques and vent management. Additionally, learning early on to ask what the RT you are working with is capable of and comfortable with doing is key when you are in a critical case with that RT. Having an experienced RT who can intubate while you focus on other parts of the resuscitation can be crucial and help you offload tasks when resources are limited. 

One interesting thing for EM physicians to remember about RTs and visa versa is that, while RTs are airway experts, they are not often specialized for the ED. This is important because often what is important in the ED in the first 60-90 minutes of managing that patient is often different from what will be important to remember when managing that patient in the ICU from a respiratory standpoint. As with all members of the team, the most important step to teamwork is making sure we are checking out egos at the door and remembering that it’s about the patient. 

Take-Home Points:
  • RTs can be an extremely valuable airway and respiratory consultant
  • Many RTs can intubate and can help to offload tasks in critical patient scenarios
  • RTs are not often specialized in emergency medicine, but by working together we can pool our expertise to take fantastic care of our patients

Post by Patricia Capone, DO PGY-2


About Our Guests:

Matt Pavlichoko, RRT-NPS
Respiratory Therapist and co-host of RT Sidebar podcast

Kirk Hinckley, MD
Full-time EM Physician and Director of Education with Vapotherm

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The Value of RT’s

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