In medical emergencies, the ABCs of resuscitation—Airway, Breathing, and Circulation—serve as critical steps in stabilizing a patient. As part of a multidisciplinary team, respiratory therapists (RTs) work alongside nurses and play a vital role in each of these areas, ensuring that patients receive effective and timely care during a crisis.

A: Airway Management

The first step in resuscitation is ensuring the airway is open and clear. A compromised airway can result from secretions or foreign bodies in the airway, or from severe neurologic impairment.
Role of Respiratory Therapists:

• Airway Assessment: RTs assess the airway using physical examination, pulse oximetry, end tidal carbon dioxide monitoring and arterial blood gas analysis.
• Intubation Support: They are skilled in advanced airway management and assist with intubation when necessary, ensuring that the airway is secured for ventilation.
• Use of Suctioning: RTs utilize suction devices to remove secretions or foreign bodies, maintaining a clear airway.

B: Breathing Support

Once the airway is secure, the next focus is ensuring the patient is adequately ventilated. Effective ventilation is essential for delivering oxygen to the body and removing carbon dioxide.
Role of Respiratory Therapists:

• Ventilation Assistance: RTs can manually ventilate patients using a bag-valve-mask during a life-threatening cardiopulmonary crisis. They are experts in mechanical ventilation, setting up and adjusting ventilators to support patients who cannot breathe independently.
• Supplemental Oxygen: They administer supplemental oxygen as needed, monitor oxygen saturation levels to ensure adequate gas exchange, and titrate the amount of oxygen delivered to the patient.
• Assessment of Lung Function: RTs evaluate breath sounds and respiratory patterns, adjusting interventions based on the patient’s response. They administer nebulized medications such as bronchodilators and mucolytics.

C: Circulation

While airway and breathing are critical, circulation is the final piece of the puzzle in resuscitation. Effective circulation ensures that oxygenated blood reaches vital organs.
Role of Respiratory Therapists:

• Understanding the impact of respiratory function on circulation: RTs recognize how respiratory issues can affect circulation, such as in cases of respiratory failure leading to cardiovascular instability. Additionally, RTs understand that low blood pressure can result from high levels of positive end expiratory pressure (PEEP) in mechanically ventilated patients.
• Assisting with CPR: While RTs are not primarily responsible for performing chest compressions, they contribute by ensuring the airway is secure and providing rescue breaths if required.

Conclusion

As we recognize Respiratory Care Week, let’s honor the dedication and expertise of respiratory therapists. Respiratory therapists are integral to the resuscitation process, contributing their expertise in airway management, breathing support, and collaboration on circulatory concerns. Their involvement helps optimize patient outcomes during critical emergencies, ensuring that every aspect of the ABCs is addressed efficiently. In times of crisis, the skills and knowledge of respiratory therapists make a significant difference in patient survival and recovery.
 

Reference
Johnson S. (2014). Code Blue Calls: Role of Respiratory Therapist. The Journal of Pulmonary and Respiratory Medicine, Vol 4, Issue 4.
DOI: 10.4172/2161-105X.1000e135 

 

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