Respiratory Therapists and COVID-19: An Overview (2024)

The COVID-19 pandemic, which swept across the globe in late 2019 and beyond, introduced unprecedented challenges to the healthcare community.

Among the various professionals grappling with the pandemic’s toll, respiratory therapists found themselves in an especially critical position.

As the coronavirus primarily affects the respiratory system, leading to complications such as pneumonia, acute respiratory distress syndrome (ARDS), and other severe pulmonary conditions, the expertise of respiratory therapists became indispensable.

This article offers an overview of the integral role played by respiratory therapists during the height of the COVID-19 crisis.

What is a Respiratory Therapist?

A respiratory therapist is a specialized healthcare professional trained to evaluate, treat, and manage patients with respiratory disorders and other cardiopulmonary conditions.

These individuals play a crucial role in the care of patients with a wide variety of conditions, from asthma to life-threatening issues like respiratory failure.

Here’s a breakdown of what a respiratory therapist might do on the job:

• Patient Assessment: They evaluate patients with breathing or cardiopulmonary disorders, and they also review patient information, conduct exams, and perform diagnostic tests such as measuring lung capacity.
• Treatment: Based on the assessments, RTs provide treatments that can include chest physiotherapy, aerosol medications, and managing ventilators. They work with doctors to develop patient care plans and suggest treatments.
• Emergency Response: Respiratory therapists respond to emergency situations like cardiopulmonary resuscitation (CPR) or other urgent care scenarios. They are often a part of hospital “code” teams which respond to immediate life-threatening situations.
• Ventilator Management: For patients who can’t breathe on their own, RTs set up and manage life-supporting machines. They make adjustments to ensure the patient is receiving the right amount of oxygen at the right pressure.
• Patient Education: Educating patients and their families is a key role. RTs might teach patients how to use treatments or strategies to cope with conditions like asthma or chronic obstructive pulmonary disease (COPD).
• Pulmonary Rehabilitation: This can help patients improve lung function and quality of life. RTs might guide patients through exercises or help them adapt to using oxygen.
• Neonatal and Pediatric Care: Some RTs specialize in the treatment of infants in the neonatal intensive care unit (NICU) or children with conditions like premature birth or cystic fibrosis.
• Sleep Disorders: Some Respiratory therapists specialize in evaluating and treating sleep-related disorders, including conditions like sleep apnea.

Note: Respiratory Therapists work in a variety of settings, including hospitals, long-term care facilities, home healthcare settings, and specialized clinics. To become an RT, one typically completes an associate’s or bachelor’s degree program in respiratory therapy and obtains a professional license. Licensing requirements may vary by location but often include passing a national examination and fulfilling continuing education requirements.

What is COVID-19?

COVID-19 is an infectious disease caused by a novel coronavirus, named SARS-CoV-2. The “CO” stands for corona, the “VI” for virus, the “D” for disease, and “19” refers to the year it was discovered, 2019.

COVID-19 is a respiratory illness with symptoms ranging from mild cold-like to severe pneumonia-like, leading to hospitalizations or death, especially in older adults and those with underlying conditions.

The virus spreads primarily through respiratory droplets, leading to global pandemics. Governments worldwide implemented measures like social distancing, mask mandates, and lockdowns to curb its spread.

Signs and Symptoms

COVID-19 symptoms can range from mild to severe, and some individuals can be asymptomatic (showing no symptoms).

Here’s a list of common symptoms:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• Loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

Note: The presence or absence of any specific symptom isn’t conclusive proof of infection. Testing is crucial for a definitive diagnosis. Additionally, as our understanding of the virus has grown, the list of recognized symptoms has expanded and may continue to change.

Risk Factors

Risk factors increase an individual’s chance of developing severe illness from COVID-19. While anyone can get infected and become ill, certain groups are more likely to experience severe symptoms or complications.

Here are the identified risk factors for severe COVID-19:

• Age: Older adults, especially those over 65, face a higher risk of severe illness or death.
• Underlying Medical Conditions: Several chronic conditions increase the risk, including heart conditions, chronic lung diseases, obesity, diabetes, chronic kidney disease, liver diseases, and those in an immunocompromised state.
• Race and Ethnicity: Certain racial and ethnic groups, such as Black, Hispanic, and Native American populations, have been observed to have a higher risk of severe illness. This disparity is not due to genetic factors but is likely influenced by socioeconomic status, access to healthcare, exposure risks related to occupation, and underlying health conditions.
• Living Conditions: People living in congregate settings (like nursing homes or long-term care facilities) are more vulnerable because the virus spreads more easily in close quarters.
• Occupational Exposure: Frontline workers, healthcare personnel, and those in essential roles might be exposed more frequently to the virus.
• Pregnancy: Pregnant individuals seem to have the same risk as adults who are not pregnant. However, pregnant people are at an increased risk for severe illness and might also be at an increased risk for adverse outcomes, like preterm birth.
• Smoking: Current and former smokers might be at an increased risk of severe illness from COVID-19.
• Other Factors: Other conditions or factors might also increase the risk, and research is ongoing. For example, certain genetic factors or other health conditions not yet identified might play a role.

Note: It’s essential to understand that having one or more risk factors doesn’t mean someone will necessarily have a severe outcome with COVID-19, but it does increase their chances. Conversely, some people without clear risk factors have experienced severe illness. Preventative measures, like vaccination and practicing good hygiene, can help mitigate these risks.

Role of Respiratory Therapists in Treating and Preventing COVID-19

Given that COVID-19 primarily impacts the respiratory system, the expertise of respiratory therapists has been crucial in managing and treating patients with this disease.

Here’s an outline of their role:

• Ventilator Management: One of the most critical roles of RTs during the COVID-19 pandemic has been the management of patients receiving mechanical ventilation. They determine the appropriate settings for ventilators, make adjustments as necessary, and monitor patients’ responses to ensure optimal oxygenation and ventilation. They also assist in the intubation and extubation processes in the ICU.
• Oxygen Therapy: Many COVID-19 patients experience varying levels of respiratory distress and require supplemental oxygen. RTs evaluate patients to determine the right amount of oxygen and the best delivery method, whether it’s through nasal cannula, face mask, high-flow nasal cannula, or other devices.
• Airway Clearance: For patients with thick mucus or secretions, RTs employ techniques and interventions to help clear the airways. This can include percussion, postural drainage, and the use of devices that aid in secretion removal.
• Patient Assessment: RTs regularly assess patients’ respiratory status by listening to lung sounds, measuring blood oxygen levels, analyzing blood gases, and noting other vital signs. Based on their assessments, they might adjust treatment strategies or collaborate with other healthcare professionals to ensure optimal patient care.
• Aerosolized Medication Administration: Some COVID-19 patients may benefit from inhaled medications that reduce inflammation or open up the airways. RTs are responsible for administering these aerosolized drugs and ensuring they are delivered effectively.
• Breathing Exercises and Rehabilitation: RTs guide patients through breathing exercises to enhance lung function and promote better oxygenation. For patients recovering from severe COVID-19, RTs may also be involved in pulmonary rehabilitation to improve lung function and overall stamina.
• Education: RTs educate patients and their families about the disease, the importance of specific interventions, and self-care techniques for home. They also play a role in training other healthcare professionals about respiratory equipment and interventions specific to COVID-19 patients.
• Safety and Infection Control: Given the contagious nature of the virus, RTs follow stringent infection control protocols, ensuring that respiratory equipment is sanitized and safe for patient use. They also use personal protective equipment (PPE) to safeguard themselves and reduce the spread of the virus.

Respiratory therapists have been on the frontline of the Covid response, providing critical care and expertise to manage the respiratory complications associated with the virus.

Their role has been invaluable in improving patient outcomes and navigating the challenges of this global health crisis.

FAQs About Respiratory Therapists and COVID-19

Who are the Frontline Medical Workers?

Frontline medical workers refer to the healthcare professionals directly involved in diagnosing, treating, and caring for patients with confirmed or suspected COVID-19.

This group includes but is not limited to, doctors (especially pulmonologists and emergency medicine specialists), nurses, respiratory therapists, paramedics, and medical lab technicians.

These professionals are at the highest risk of exposure due to their close, frequent contact with patients.

What Do Respiratory Therapists Do to Treat COVID-19?

Respiratory therapists play an essential role in addressing the respiratory complications associated with COVID-19. They are at the forefront of operating and adjusting mechanical ventilators to ensure patients are optimally oxygenated.

In addition to this, they administer supplemental oxygen using various devices tailored to the individual needs of each patient. A significant aspect of their job is to help patients clear mucus or secretions from their airways, ensuring unobstructed breathing.

Continuous evaluation of a patient’s respiratory status is crucial, and respiratory therapists adjust treatments based on these regular assessments.

They also deliver inhaled medications designed to reduce inflammation or open up the airways.

Furthermore, to help patients regain their lung function and strength, respiratory therapists guide them through specific breathing exercises and rehabilitation programs.

What is the Treatment for COVID-19?

The treatment for COVID-19 varies based on the severity of the symptoms and the patient’s overall health. Common treatments include:

• Mild Symptoms: Home isolation, rest, hydration, and over-the-counter pain relievers.
• Moderate to Severe Symptoms: Hospitalization may be required, with treatments including supplemental oxygen, antiviral medications, and in some cases, the use of mechanical ventilators.
• Supportive Care: Regardless of symptom severity, patients are given supportive care to manage symptoms, such as pain relievers, cough suppressants, and fever reducers.
• Monoclonal Antibodies and Antivirals: Some patients may benefit from recently developed treatments like monoclonal antibodies or antiviral drugs that target the virus directly.

How to Prevent COVID-19?

Some methods to potentially prevent COVID-19 include:

• Vaccination: Get vaccinated as it significantly reduces the risk of infection, complications, and severe outcomes.
• Face Masks: Wear a mask, especially in crowded or enclosed spaces.
• Hand Hygiene: Frequently wash hands with soap and water for at least 20 seconds or use hand sanitizers with at least 60% alcohol.
• Social Distancing: Maintain a distance of at least 6 feet from others, especially if they are coughing, sneezing, or not wearing a mask.
• Avoid Touching Face: Refrain from touching your eyes, nose, and mouth with unwashed hands.
• Clean and Disinfect: Regularly clean and disinfect frequently touched objects and surfaces.
• Stay Informed: Keep up with the latest guidelines and advice from health organizations and local health departments.

Are Respiratory Therapists Trained to Operate Ventilators?

Yes, respiratory therapists are extensively trained to operate, manage, and troubleshoot mechanical ventilators. This training is a core component of their education and clinical practice.

They not only set up and adjust these life-supporting machines but also continuously monitor patients on ventilators, ensuring they receive the right amount of oxygen and ventilation.

Additionally, they collaborate closely with medical teams, providing insights and expertise on respiratory care to optimize patient outcomes.

Is There a Shortage of Respiratory Therapists?

During the peak periods of the COVID-19 pandemic, many healthcare systems worldwide experienced a heightened demand for respiratory therapists due to the surge in patients with respiratory distress.

This surge sometimes led to shortages or strained resources in certain areas.

Factors such as regional COVID-19 case numbers, pre-existing staffing levels, and the capacity of healthcare infrastructure determined the extent of these shortages.

While efforts have been made to bolster the ranks of respiratory therapists through accelerated training and recruitment, some regions still face challenges in meeting the high demand.

Is Burnout High Among Respiratory Therapists?

The COVID-19 pandemic has placed enormous pressure on healthcare workers, and respiratory therapists, being on the frontline, are no exception.

Dealing with critically ill patients, long working hours, witnessing high mortality rates, and the constant risk of exposure has led to increased stress and burnout among many respiratory therapists.

Emotional and physical exhaustion, combined with the challenges of keeping up with the pandemic’s evolving nature, has underscored the need for adequate support and mental health resources for these crucial healthcare professionals.

When to See a Doctor for COVID-19?

Individuals should consider seeing a doctor for COVID-19 if they exhibit symptoms consistent with the virus, such as fever, persistent cough, shortness of breath, or loss of taste or smell.

It’s especially crucial to seek immediate medical attention if symptoms are severe or rapidly worsening, including difficulty breathing, persistent chest pain, confusion, inability to stay awake, or bluish lips or face.

Moreover, individuals in high-risk groups, such as the elderly or those with underlying health conditions, should consult with healthcare professionals even with milder symptoms to ensure prompt and appropriate care.

Disclaimer: The information provided in this article is based on data available as of the last update and is intended for general informational purposes only. The situation surrounding COVID-19 is rapidly evolving, and guidelines may change as new information becomes available. For the most current and comprehensive information, readers are strongly encouraged to visit the official website of the Centers for Disease Control and Prevention (CDC) or consult with a medical professional. Always rely on authoritative sources to make informed decisions about your health and safety.

Final Thoughts

In reflecting upon the challenges that the COVID-19 pandemic presented to the global healthcare community, the significance of respiratory therapists cannot be overstated.

Their skill set, tailored to the very organ system this virus aggressively targets, placed them in a pivotal position to influence patient outcomes.

As we navigate the aftermath and potential subsequent waves of this virus, the lessons learned from RTs’ experiences will undoubtedly shape future respiratory care, emphasizing the continuous need for their expertise in the ever-evolving landscape of healthcare.