History of Respiratory Care: Overview and Practice Questions

Respiratory care is a specialized healthcare discipline focused on the assessment, management, and treatment of patients with respiratory disorders.

Originating in the early 20th century as a modest initiative to administer basic oxygen therapy, the field has evolved dramatically, encompassing a range of diagnostic and therapeutic services.

Today, respiratory therapists engage in complex activities ranging from mechanical ventilation to pulmonary rehabilitation, playing a critical role in the management of acute and chronic respiratory conditions.

Understanding the history of respiratory care is essential for appreciating its current complexities and anticipating its future trajectory.

What is the History of Respiratory Care?

The history of respiratory care traces back to the early 20th century, evolving from basic oxygen delivery systems to a specialized healthcare discipline. Advances in technology and medical knowledge have expanded the role of respiratory therapists to include mechanical ventilation, pulmonary rehabilitation, and complex airway management, making them integral in treating a range of acute and chronic respiratory disorders.

Significant Historical Events in Respiratory Care

Understanding the evolution of respiratory care requires a look at the significant milestones that have shaped this critical medical specialty.

From its inception, advances in technology, medical research, and healthcare policies have marked pivotal points in the profession’s development.

Below are some key historical events that have significantly impacted the field of respiratory care:

• 1909 – Oral intubation was introduced
• 1913 – Laryngoscope was developed
• 1918 – Oxygen mask was used
• 1928 – Iron Lung was developed
• 1947 – Inhalation Therapy Association (ITA) was formed
• 1948 – Positive-pressure ventilator was introduced
• 1954 – ITA becomes the American Association for Inhalation Therapists (AAIT)
• 1958 – Bird Mark 7 was introduced
• 1967 – Rapid blood gas analysis was introduced
• 1968 – Fiberoptic bronchoscope was introduced
• 1971 – CPAP was introduced
• 1973 – AAIT becomes the American Association for Respiratory Therapists (AART)
• 1974 – National Board for Respiratory Therapy (NBRT) was founded
• 1983 – NBRT becomes the National Board for Respiratory Care (NBRC)
• 1983 – Respiratory Care Week was nationally proclaimed by Ronald Reagan
• 1984 – AART becomes the American Association for Respiratory Care (AARC)
• 1994 – CDC published guidelines for ventilator-associated pneumonia prevention
• 1998 – Committee on Accreditation for Respiratory Care (CoARC) was formed
• 2000 – RESPIRATORY CARE journal is accepted into Index Medicus
• 2003 – Lung Health Day was launched by the AARC
• 2011 – NBRC creates the Adult Critical Care Specialty credential (RRT-ACCS)

Note: These milestones mark not just technological advancements but also shifts in healthcare policy and education that have collectively elevated respiratory care to its current standard. As we look ahead, the field is poised to integrate even more sophisticated technologies and methodologies, continually evolving to meet the ever-changing healthcare landscape.

History of Respiratory Disease Management

The management of respiratory diseases has undergone significant transformation over the past century.

Initially limited to basic oxygen therapy and manual ventilation techniques, advances in technology and medical research have broadened the scope of treatments available.

The 1950s saw the advent of mechanical ventilators, replacing iron lungs for polio patients and setting the stage for intensive care units.

The introduction of pulmonary function tests in the 1960s and 1970s enabled more accurate diagnoses and individualized treatment plans.

The late 20th and early 21st centuries ushered in non-invasive ventilation techniques like CPAP and BiPAP for sleep apnea and chronic obstructive pulmonary disease (COPD).

Advances in telemedicine and remote monitoring technologies now offer even more comprehensive disease management opportunities, expanding access and improving outcomes.

Practice Questions About the History of Respiratory Care

1. What is the national professional association for respiratory care?
AARC

2. What is the health care discipline that specializes in the promotion of optimal cardiopulmonary health?
Respiratory therapy

3. What name suggests increased involvement in respiratory disease prevention and management?
Respiratory care

23. Which Greek physician is known as the “father of medicine?”
Hippocrates

5. What was prescribed in hospitals in the 1940s and is still a mainstay of respiratory care?
Oxygen therapy

6. What organization is responsible for the respiratory credentialing examination?
The NBRC

7. The iron lung is an example of what type of therapy?
Mechanical ventilation

8. What is the professional organization that accredits respiratory care programs?
CoARC

9. What system involves the heart and lungs working together?
The cardiopulmonary system

10. What methods can test the way that height, age, obesity, and disease alter lung function?
Pulmonary function testing (PFT)

11. What is another name for a respiratory therapist that is a more formal term?
Respiratory care practitioner

12. Who is an individual trained to deliver care to patients with heart and lung diseases?
Respiratory therapist

13. Which famous painter was among the first to dissect humans in order to better understand human physiology?
Leonardo da Vinci

14. The large-scale production of commercialized oxygen was developed in 1907 by whom?
Karl Von Linde

15. What law describes the law of diffusion for gases and started in 1831?
Graham’s Law

16. The CoARC is a committee that is sponsored by what four organizations to ensure that respiratory care follows accrediting standards endorsed by the American Medical Association (AMA)?
(1) American Association for Respiratory Care(AARC), (2) American College of Chest Physicians (ACCP), (3) American Society of Anesthesiologists (ASA), and (4) American Thoracic Society (ATS)

17. What does AARC stand for?
American Association for Respiratory Care

18. After World War I (1930), Ivan Magill introduced the use of what tube that made blind nasal intubation possible?
Soft rubber endotracheal tube

19. In 1911, what pulmotor ventilator was used in resuscitation?
Heinrich (Drager)

20. What mask allows oxygen administration in percentages and came about in 1960?
Campbell (Ventimask)

21. What famous artist studied human anatomy and determined that sub-atmospheric intrapleural pressures inflated the lungs?
Leonardo Da Vinci

22. The National Board for Respiratory Care (NBRC) is responsible for what?
For the credentialing examinations for respiratory therapists

23. What was developed to improve oxygen titration, especially for those with COPD?
The Venturi mask

24. In 1947, what organization was responsible for the first professional association for the field of Respiratory Care?
Inhalation Therapy Association (ITA)

25. What is the abbreviation for the Committee on Accreditation for Respiratory Care?
CoARC

26. In 1808, who described the relationship between gas pressure and temperature?
Joseph Louis Gay-Lussac

27. What organization in the 1980s made a major push to introduce state licensure for respiratory care practitioners based on what other organization that provides credentialing?
AARC and NBRC

28. During the polio epidemics of the 1930s and 1950s, a commercial version of the Iron Lung was developed by what two men?
Drinker and Emerson

29. The NBRC allows respiratory therapists to specialize in what areas?
NPS (Neonatal Pediatrics Specialist), PFT (Pulmonary Function Technologist), Polysomnography, and Critical Care.

30. What law describes the relationship between gas temperature and volume?
Charles’ Law

31. Inhalation therapists provided what support therapy to help improve a patient’s breathing?
Oxygen therapy

32. What committee is responsible for reviewing educational programs for respiratory care?
CoARC

33. What did David Pierson predict?
He predicted greater use of patient assessment protocols in disease management in all clinical settings, a more active role in palliative care, increasing emphasis on smoking cessation and prevention, early detection and intervention in COPD, and increased use of respiratory therapists as home health caregivers.

34. What did Drinker and Emerson invent?
The Iron Lung

35. What did Joseph Black rediscover?
He rediscovered CO2 and called it “dephlogisticated air.”

36. What did William Roentgen discover?
X-Rays

37. What does Karl von Linde contribute to the field of respiratory care?
He created large-scale commercial oxygen.

38. What is the AARC’s mission?
“The American Association for Respiratory Care (AARC) will continue to be the leading national and international professional association for respiratory care. The AARC will encourage and promote professional excellence, advance the science and practice of respiratory care, and serve as an advocate for patients, their families, the public, the profession, and the respiratory therapist.”

39. Which organization is responsible for accreditation in the respiratory care field?
Committee on Accreditation of Respiratory Care (CoARC)

40. Which organization is responsible for credentialing in the respiratory care field?
National Board of Respiratory Care (NBRC)

41. Who created the germ theory?
Louis Pasteur

42. Who described the law of partial pressures in a gas mixture?
John Dalton

43. Who described the relationship between gas pressure and temperatures?
Joseph Louis Gay-Lussac

44. Who described the relationship between gas volume and temperatures?
Jacques Charles

45. Who is credited with the discovery of oxygen?
Joseph Priestley

46. During WW1, advances in which field resulted in a reduction of non-battlefield mortality, compared to the Civil War?
Microbiology

47. What is the AAIT?
It stands for American Association for Inhalation Therapy and came about in 1954. The group helped to advance the science and practice of respiratory care.

48. What is the AART?
It stands for the American Association for Respiratory Therapy and came about in 1973. The group helped advocate for patients and their families.

49. Which physician was responsible for identifying the non-linear relationship between the binding of hemoglobin and oxygen and constructing the oxyhemoglobin-hemoglobin dissociation curve?
Christian Bohr

50. The first healthcare specialists appeared in what year?
They appeared in the 1940s.

51. What did Hutchinson observe?
He observed the relationship between height and lung volume and that vital capacity decreases with age, obesity, and lung disease.

52. What is the Inhalational Therapy Association (ITA)?
It was founded in 1947 in Chicago and was the first professional association for the field of respiratory care.

53. Who is credited with the development of the oxygen electrode, which allowed for the analysis of PaO2?
Clark

54. What is the NBRC, and when was it founded?
It stands for National Board of Respiratory Care and was founded in 1974. The NBRC provides the credentialing process for both the entry-level (CRT) and the advanced-practitioner (RRT).

55. When was the American Registry on Inhalation Therapists founded?
1960

56. What will respiratory therapists do in the future of medicine?
They will focus on patient assessment, care plan development, protocol administration, disease management and rehabilitation, and patient and family education, including tobacco education and smoking cessation.

57. What are the many names of the ITA?
The ITA became the American Association for Inhalation Therapists (AAIT) in 1945, the American Association for Respiratory Therapy (AART) in 1954, the American Association for Respiratory Therapy (ARRT) in 1973, and finally the American Association for Respiratory Care (AARC) in 1982.

58. What is in store for the future of respiratory therapy?
There will be an increase in demand for respiratory care because of advances in treatment and technology; increases in and aging of the population; and increases in the number of patients with asthma, COPD, and other cardiopulmonary diseases.

59. What is the ICRC?
An AARC-sponsored organization dedicated to the globalization of quality respiratory care.

60. What is the purpose of the ITA?
To encourage and promote professional excellence, provide professional advancement, foster cooperation with physicians, and advance the knowledge of inhalation therapy through educational activities.

61. When did aerosolized medication for the treatment of asthma begin?
1910

62. When did the first therapeutic administration of oxygen occur?
It first occurred in 1798.

63. How did respiratory therapy school get started?
The first course in inhalation therapy was offered in 1950. Programs in the 1960s focused on teaching students the proper application of oxygen therapy, oxygen delivery systems, humidifiers, nebulizers, and the use of various IPPB devices.

64. When was the iron lung used extensively?
The iron lung was used extensively during the polio epidemics of the 1940s and 1950s.

65. What historical figure is likely to have recorded the first respiratory physiology experiment?
Aristotle

66. What empire established measures to prevent and control epidemics?
The Roman empire

67. What is another name for the Bubonic plague?
“Black Death”

68. Who reported that sub-atmospheric pressures were required to inflate mammalian lungs?
Da Vinci

69. Who is credited with making the first barometer?
Torricelli

70. Who described the inverse relationship between gas volumes and pressures?
Boyle

Final Thoughts

The history of respiratory care is a testament to medical innovation and the ability to adapt to changing healthcare needs.

From its humble beginnings to its present-day sophistication, the field has been shaped by advances in technology, medical knowledge, and a greater understanding of respiratory physiology.

Respiratory care has continually evolved to meet the demands of diverse patient populations, including those suffering from conditions such as asthma and acute respiratory distress syndrome (ARDS).

As we look to the future, the profession will likely continue to adapt and expand, incorporating new technologies and treatments to further improve patient outcomes and the quality of respiratory care.