Respiratory Therapy and Pulmonary Function Testing - Thomas Taake, RT
Q: What is a respiratory therapist?
A: A respiratory therapist is trained and licensed to care for patients with breathing problems.
Q: What kind of patients do respiratory therapists help and how do they help them?
A: Respiratory therapists help all kinds of patients. Conditions such as asthma and cystic fibrosis affect patients of all ages while some conditions like chronic obstructive pulmonary disease (COPD) affect primarily older patients who smoke or have been exposed to chemical fumes or other pollutants. Respiratory therapists can also help athletes measure their aerobic capacity or oxygen uptake to optimize training and performance.
Patients with chronic lung conditions often work with respiratory therapists who perform tests to assess lung function and administer breathing treatments. Respiratory therapists provide patients with education about their lung condition and show them how to properly use medications and assistive breathing equipment at home. They also teach lifestyle modifications that can help the patient improve their daily activities in the presence of chronic lung disease. Smoking cessation classes are often taught by respiratory therapists.
Respiratory therapists also help patients in the emergency room and intensive care units who need breathing assistance with a ventilator. Respiratory therapists are also present in the birth center during C-section deliveries to stimulate the baby to start breathing after birth and to assist in airway clearance.
Q: What is a pulmonary function test?
A: A pulmonary function test is used to assess a patient’s ability to inhale, exhale, and transfer oxygen to the blood stream. Obstructive lung disorders, such as asthma, chronic bronchitis and emphysema, can cause the patient to have difficulty exhaling due to the narrowing of the airways. Other conditions, such as fibrosis, lung cancer and obesity, can cause the lungs to hold too little air and impair the lungs’ ability to transfer oxygen to the blood stream.
To determine lung volume, a pulmonary function test requires the patient to sit in a booth, similar to a phone booth, while breathing into a mouthpiece. The respiratory therapist will measure changes in pressure in the booth to calculate lung volume. To determine the lungs’ ability to transfer oxygen into the blood stream, the lung diffusion testing is used. For this test, the patient inhales a small amount of a trace gas, holds their breath, and then exhales. The respiratory therapist will measure how much of the trace gas was absorbed by the blood.
These tests are used to diagnose lung disorders and also performed in regular intervals for patients with chronic lung problems to help the physician determine whether treatments are working by tracking whether lung function is improving or weakening.
Q: What is the difference between a CPAP and BiPAP machine?
A: Positive airway pressure (PAP) is often used in hospital settings to assist patients’ breathing. The patient wears a mask attached to a machine that helps keep the lungs and airway open and expanded, improving the lungs’ ability to transfer carbon dioxide and oxygen. PAP is well-suited for patients who do not require intubation and ventilation but are experiencing a certain degree of respiratory distress.
CPAP (continuous positive airway pressure) and BiPAP (bi-level positive airway pressure) are typically used to treat sleep apnea; however CPAP is also used to help premature babies with under-developed lungs. CPAP helps people with sleep apnea by using pressure to keep the airways open, preventing the collapse or obstruction that causes snoring and potentially dangerous pauses in breathing during sleep.
Unlike CPAP which creates constant pressure, BiPAP offers two levels of pressure for patients who cannot tolerate exhaling against the level of pressure indicated for their condition. BiPAP temporarily reduces the level of pressure at the start of exhalation then increases it back to the indicated level prior to the next inhalation.
Both CPAP and BiPAP machines are adjusted to exact specifications in order to correct each individual patient’s level of breathing disorder, which, in the case of sleep apnea, is determined during a sleep study.
Thomas Taake, RT, has been a respiratory therapist at Sonora Regional Medical Center for 18 years. When he started at Sonora Community Hospital in 1994, he covered all areas of the hospital, serving in the emergency department, intensive care unit, birth center, and anywhere patients required respiratory therapy treatment or testing. In his current role, Taake is focused on performing pulmonary function tests and enjoys developing relationships with his patients and reducing their anxiety both about the actual test and about the condition that has warranted the test. He also spends part of his time mentoring respiratory therapy students on clinical rotation at the Medical Center. In his spare time, Taake enjoys cycling, sailing and swimming.