The ABCs of Respiratory Therapy and How RTs Impact Sleep Medicine 

By Nick Orr

Learnings from the 2022 RWJ Barnabas Health RT Conference

Before attending the RWJBarnabas Health Respiratory Therapy Conference at the end of June 2022, I didn’t know as much about the outstanding individuals who specialize in respiratory therapy (RT) beyond their penchant for becoming RPSGTs (registered polysomnographic technologists). However, the Health RT Conference opened my eyes to all the other areas in which this group of medical professionals excel. 

Airway, Breathing, and Circulation Medicine 

I particularly enjoyed the ABCs of RTs presentation from Dr. Tal Dagan, MD of ENT/Plastic Surgery, with a specialty in Head and Neck disorders. Dr. Dagan presented on the concept of the ABCs of Respiratory therapy: airway, breathing, and circulation. 

In most cases, the ABCs are used by everyone, from lifeguards to EMTs, to assess a potentially critically ill person. While this usually represents a prioritization (focus on airway, then patient breathing, then their circulation), there are exceptions to this rule. 

Dr. Dagan cited the following example: an RT supporting an acute hypoxemic patient who may begin their assessment by increasing O2 levels first before focusing on the airway, as that would be a likelier cause in this unique situation.

Expertise and experience are your best friend when it comes to determining these nuances. Dr. Dagan emphasized one point several times: airway management is hard and intense. It’s the above example that makes that so crystal clear. 

How the ABCs Apply to Sleep Medicine

When providing care in sleep medicine, knowing the physiology of your patients (specifically their airways) and ensuring you don’t cause physical harm to a patient during airway placement is so important. Sometimes, you only get one chance. 

As I see it, CPAP machines are a part of the ABC process. CPAPs impact the patient airway significantly, even if classified as non-invasive positive pressure ventilation (NIPPV). 

RTs and sleep professionals often have challenges getting patients to be willing and able (to tolerate) the CPAP unit. CPAP is not something every patient can get on board with, so knowing how a patient’s airway physiology impacts their breathing is critical to generating adherent CPAP users. 

Ethics in Medicine: What’s Your Code?

Another interesting presentation came from Kenneth Capek, RRT, on Professional Ethics, specifically for respiratory therapists. Having a strong moral and ethical code is imperative for healthcare. It can be challenging to maintain your moral compass in the face of stressful work, personal relationships, and other situations that may arise in the workplace.

Capek provided an example of an RT that noticed an inebriated colleague at work. When people were asked how they would approach the situation, 90% said they would do or say something. However, in practice, only 10% actually did. The moral of the story: even if it’s hard, it’s still up to you to make the right (ethical) decision. 

This presentation really made me think. How might this impact your workplace? What challenges might you see that require some backbone? 

To close his time, Capek quoted Amanda Gorman, the first-ever National Youth Poet Laureate in the United States and the youngest inaugural poet in U.S. history. Emotionally, Kenneth shared an excerpt with the audience, including a brief quote below: 

“I am the daughter of Black writers who are descended from freedom fighters who broke their chains and changed the world. They call me.”

His reading of the passage was followed by an important, self-reflective, almost philosophical diatribe. Capek’s time was a nice and important digression from the other, more clinically-focused presentations.

Looking forward to Next Year

It was an excellent learning experience for me, and it was great to see how closely related the work of RTs is to our work in and around sleep. Yes, they’re separate, but the parallels are clearly visible – and more than just the unique, fun, and tight-knit communities that sleep and RTs seem to share. 

I left New Jersey with a better understanding of the field and practice of respiratory therapists. I look forward to reconnecting with local folks next year and continuing my education. 

Nicholas Orr believes clinicians can achieve a higher standard of patient care if equipped with the right tools. Since graduating from the University of Michigan, Orr’s work exclusively focuses on these types of solutions, (first with Epic, and now EnsoData in Madison, WI). He currently operates as a Regional Sales Manager, bringing AI Sleep Scoring solutions to sleep centers.