Respiratory therapists are healthcare professionals who specialize in helping people breathe. They evaluate, treat, and manage patients with breathing disorders and cardiopulmonary conditions, working everywhere from emergency rooms and intensive care units to patients’ homes. Their role spans diagnostic testing, life-support equipment, emergency response, and long-term patient education.
Core Responsibilities
A respiratory therapist’s daily work revolves around a cycle of assessment, treatment, and monitoring. They interview and examine patients with breathing problems, consult with physicians to develop treatment plans, run diagnostic tests, deliver therapies, and track how patients respond over time. They also spend a significant portion of their day teaching patients how to use medications and equipment correctly.
What makes the role distinct from nursing or other bedside care is the deep specialization in the lungs and airways. Respiratory therapists are the go-to experts when a patient’s breathing is compromised, whether that’s a newborn in the NICU struggling to take first breaths, a trauma patient arriving in the ER, or someone with chronic lung disease learning to manage symptoms at home.
Diagnostic Testing
One of the most common tasks is pulmonary function testing. The therapist has the patient breathe into an instrument that measures the volume and flow of oxygen during inhalation and exhalation, giving a detailed picture of lung capacity. This helps diagnose conditions like asthma, COPD, and pulmonary fibrosis, and it helps track whether treatments are working.
Respiratory therapists also draw arterial blood samples, typically from a small artery in the inner wrist. They may use ultrasound to locate the artery before inserting a needle. The blood sample goes through a gas analyzer that measures oxygen and carbon dioxide levels, providing a real-time snapshot of how well the lungs are exchanging gases. This test is essential in critical care, where even small shifts in blood oxygen can signal a patient is deteriorating.
Ventilator and Life-Support Management
Managing mechanical ventilators is one of the most critical parts of the job. When patients can’t breathe on their own, respiratory therapists connect them to ventilators that deliver oxygen to the lungs. They set the machine’s breathing rate, the volume of air delivered with each breath, the oxygen concentration, and the amount of pressure used to keep the lungs open between breaths. Each of these settings is tailored to the patient’s size, condition, and how their lungs are responding.
Once a patient is on a ventilator, the respiratory therapist continuously monitors airway pressures and adjusts settings as the patient’s condition changes. If pressure readings spike, the therapist troubleshoots the cause. It could be something straightforward, like a tube kinked or clogged with secretions, or something more serious, like fluid buildup in the lungs or a collapsed lung segment. This constant fine-tuning is what keeps ventilated patients stable and prevents complications.
Beyond traditional ventilators, respiratory therapists also manage noninvasive breathing support like CPAP and BiPAP machines, which deliver pressurized air through a mask rather than a tube in the airway. These are commonly used for sleep apnea and for patients who need breathing support but aren’t sick enough to require full mechanical ventilation.
Emergency and Critical Care
Respiratory therapists are part of the rapid response when a patient goes into cardiac arrest, has a stroke, or arrives with major trauma. Their specific role on these teams includes assessing the airway, stabilizing it, and performing intubation (placing a breathing tube). They manage the ventilator if one is needed, administer medical gases like oxygen, draw and analyze blood samples on the spot, and help monitor the patient’s cardiovascular status. They also handle the transport of critically ill patients between departments or facilities, keeping life-support equipment running smoothly during the move.
In emergency departments, the pace is fast and the stakes are high. A respiratory therapist might be managing a ventilator for a patient with severe pneumonia in one room and then get called to help intubate a trauma patient minutes later. The ability to assess an airway quickly and act decisively is what defines the role in these settings.
Airway Clearance and Breathing Treatments
For patients with mucus buildup in their lungs, respiratory therapists perform chest physiotherapy. This involves rhythmically tapping on the patient’s chest and back to loosen mucus, then coaching the patient through coughing techniques to bring it up. It’s a hands-on treatment commonly used for patients with cystic fibrosis, pneumonia, or post-surgical complications where secretions pool in the lungs.
They also deliver aerosolized medications through nebulizers and manage inhaler therapies. Choosing the right delivery method matters more than most people realize. The therapist considers the patient’s ability to coordinate their breathing, their physical strength, their cognitive state, and personal preference when deciding between a metered-dose inhaler, a dry powder inhaler, or a nebulizer.
Patient Education and Chronic Disease Management
A large part of respiratory therapy happens outside of emergencies. Respiratory therapists educate patients with chronic conditions like COPD, asthma, pulmonary fibrosis, and cystic fibrosis on how to manage their disease day to day. This includes teaching proper inhaler technique (which a surprising number of patients get wrong), explaining how their medications work, and helping them recognize early warning signs of a flare-up.
For patients on home oxygen, therapists explain the differences between various home oxygen delivery systems and help determine which setup fits the patient’s lifestyle and medical needs. They also work on broader self-management skills: how to pace activities, when to adjust medications, and what symptoms should prompt a call or a trip to the hospital. Effective disease education reduces hospitalizations and helps patients maintain independence longer.
Respiratory therapists working in home care make regular visits to inspect and clean equipment, check the home for environmental hazards that could worsen breathing problems, and reinforce medication and equipment use with both patients and their families.
Specialized Settings
In neonatal intensive care units, respiratory therapists are part of the team that stabilizes newborns who have trouble breathing. Premature infants often have underdeveloped lungs and need carefully calibrated oxygen delivery. The respiratory therapist works alongside neonatologists and NICU nurses, using specialized tools to provide breathing support scaled to an infant who may weigh just a few pounds.
Sleep labs are another common workplace. Respiratory therapists help diagnose sleep apnea by monitoring patients overnight and interpreting the results. They then fit patients for CPAP machines and teach them how to use the equipment effectively. Some respiratory therapists also run smoking cessation programs, counseling patients through the process of quitting.
Education and Credentials
Becoming a respiratory therapist requires completing an accredited respiratory therapy program, which results in either an associate’s or bachelor’s degree. After graduating, therapists must pass a national credentialing exam. There are two main credentials: the Certified Respiratory Therapist (CRT), earned by achieving the baseline score on the exam, and the Registered Respiratory Therapist (RRT), which requires a higher score on that same exam plus passing an additional clinical simulation exam. The RRT is widely considered the standard credential for practice, and many employers prefer or require it.
All states require respiratory therapists to be licensed, though specific requirements vary. Beyond the entry-level credentials, therapists can pursue specialty certifications in areas like neonatal and pediatric care, adult critical care, pulmonary function testing, and sleep disorders.
Where Respiratory Therapists Work
Most respiratory therapists work in hospitals, split across emergency departments, intensive care units, general medical floors, and surgical recovery areas. Outside the hospital, you’ll find them in outpatient pulmonary rehab clinics, sleep disorder centers, home health agencies, and long-term care facilities. Some work in physician offices or diagnostic laboratories. The variety of settings means the day-to-day experience can look very different depending on where a therapist chooses to practice. Hospital-based RTs tend to handle more acute, high-intensity situations, while those in outpatient or home care settings focus more on education, equipment management, and long-term disease monitoring.