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Respiratory Therapy Protocols in the ED

By Michael Davis posted 05-19-2015 08:46

  

The Respiratory Therapy Dept. at this hospital is a VERY progressive, goal oriented department; knee-deep in protocols throughout all inpatient areas.  Due to this level of involvement throughout the inpatient areas, the RCP’s are a well-respected member of the healthcare team. However, in the ER setting, our organization is operating in a very antiquated task-managed physician-says-caregiver-does model.  As you all could imagine, this results in a very low-level of respect for the RCPs in this environment.

Therefore, we are looking to drastically change the role of the RCP in the ER.  We envision a model in which the RCP [who primarily resides in the ED all shift] is called for every shortness-of-breath or airway issue that comes in.  The RCP would assess the pt, and implement interventions (O2, HHN, BiPAP, intubation, etc.) according to indications. 

Does anyone know of such a protocol or model out there? If you have such a protocol, would you mind sharing forms or key contacts? Any other thoughts or ideas would also be greatly appreciated.

Thank you in advance for any information that you can share with us!

 

Mike Davis

Manager, Pulmonary Services

Wheaton Franciscan Healthcare - All Saints

3801 Spring St.,  Racine, WI  53405

Michael.Davis@wfhc.org

Office 262.687.4327

Fax 262.687.5379

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Fred Gustafson
08-12-2017 11:41

I would love a copy of these protocols. We are meeting this week to start our process. 
Fred Gustafson RRT-ACCS clearyourlungs@gmail.com

Michael Davis
07-02-2015 16:36

Tim & Nathan,
Your protocols sound fantastic and exactly like what I am looking for! Any chance that you have a copy of them that you would be willing to share?
Thank you for responding to my post. Have a great holiday weekend!
Mike Davis, BS, RRT- ACCS/ NPS, CPFT
Manager, Pulmonary Services
Wheaton Franciscan Healthcare - All Saints
3801 Spring St., Racine, WI 53405
Michael.Davis@wfhc.org
Office 262.687.4327
Zone Phone 262.687.6541
Pager 262.499.4019
Fax 262.687.5379

Nathan Cosa
07-02-2015 14:30

Mike,
In my previous job, I created a protocol for the ER that allowed the RCP's to assess and treat every patient that came in with "Difficulty Breathing" or "Shortness of Breath". We called it the ED RAT protocol (ED Respiratory Assess and Treat). The triage nurses were trained to identify these patients and order the protocol. The protocol required RT's to assess patients, obtain a history, and provide the appropriate therapy and/or order a different protocol (asthma, bronchiolitis, pneumonia). This protocol worked extremely well and increased treatment times and throughput in our ED.

Timothy Howald
06-18-2015 08:43

We have standing protocols for RT to evaluate and treat in the ER. Also have vent and NIPPV protocols. The thereapist completely manage the vents and NIPPV per protocol. Usually by the time the physician sees the patient they are already on bipap and have had there first blood gas. The therapist have complete autonomy to treat the patient based on there assessment even if the physician has not seen the patient yet. The physcians love it, rarely tell us what to do because we are so proactive in stablelizing the patient. I will be glad to give you our protocols.